Posted by jrbecker on August 6, 2003, at 15:08:13
In reply to Re: Effexor.... » zinya, posted by jrbecker on August 6, 2003, at 13:38:11
whoops, "upswing" could be ambiguous. I just meant by that, "feeling better."
> sounds like you're on the upswing a little bit.
>
> The sensitivity to the SSRIs was always a problem for me as well. Effexor was always more tolerable, at least in terms of the sedation. I'm sure everyone else has given you this pep talk, but I just want to resonate that effexor was the one that I really did see gradual improvement on every week throughout the first 2-3 months. Not only will the mood effect improve, but more importantly, the side effects will diminish little by little. This being said, I'm surprised you started at 150 instead of a lower dose. Is this so you get more of a noradrenergic effect for the management of the pain? I only mention all this b/c you said you quit meds in the past due to sensitivity. So if anything, consider lowering the dose if you just can't tolerate it. As for the noradrenergic effect, the belief that there is no NE effect at lower levels is unfounded, there is less activity, but there is still some going on. If the high dose is more about treating the pain, or your doc recommends the high dose for any other reason, then please disregard my above comments -- they were only meant to address my fear of you disconintuing due to the side effects.
>
> As for the doc, if you feel he has a unique advantage by knowing your history and is generally good to work with, then stick with him. But if you feel that by being just an internist might be a barrier to knowing further treatment options, than by all means, explore pdoc options. Once again, this is said more for precaution rather than needed advice.
>
> sounds like progress on your part lately. And given your pain symptomology, you seem to be a great candidate for duloxetine when it arrives. take care
>
> JB
poster:jrbecker
thread:247363
URL: http://www.dr-bob.org/babble/20030802/msgs/248668.html