Posted by jrbecker on September 29, 2003, at 15:45:28
In reply to Re: Effexor XR need advice from other users, posted by Robert Fairburn on September 28, 2003, at 5:17:11
Hi Robert,
you might be right in that the effexor is worsening your anxiousness, and perhaps even exacerbate your depression. but it's hard to tell. even though you have high levels of noradrenaline (norepinpehrine), this doesn't mean that taking effexor (a serotonin and norephiprine reuptake inhibitor) is going to make your depression worse.
this is because, currently, the research is sort of unclear on whether depressive sufferers have increased or decreased norepinephrine (NE) levels. Most studies that have drawn blood sample have shown increased norepinephrine BLOOD levels (like yourself). However, this is only a measure of peripheral NE, not NE in the BRAIN. See, increased NE in the periphery can definitely cause ~physical~
symptoms of anxiety (sweating, heart palpiations, startle effect). However, it is unclear whether increased NE in the brain is helping or hindering anxiety/depression -- currently there is good evidence that NE drugs increase neurogenesis - which is thought to be the route of depression.Since this is sort of a more complicated topic, I'd suggest you read this article (it provides a good summary on the role of NE as well as how it's tied to the stress system, the HPA)...
http://www.sciam.com/search/search_result.cfm
Back to addressing your concerns about effexor,
many people have problems beginning on effexor. you should read the Tips section on Effexor (you can find the link at the top of the psycho-babble page). Perhaps you should cut back to 37.5mg tablets and go slow. I would also advise you to take it in the morning if it is disrupting your sleep. Once again, I can assure you that the side effects will decrease, by how much, well I can't tell you since that's individually determined.couple other notes...
Effexor is a great drug, and it usually works better in cases of atypical depression, not regular unipolar (melancholic) depression. Most melancholics find that an SSRI usually works best. This is a general theory, not a rule. But there was probably a reason why your doc put you on effexor besides effexor being known to be good for GAD and depression, can you infer what those reasons were? were there any other options discussed?
Have you been taking benzo's and have they been helping?
I'd suggest you stick it out for 2-3 weeks and then see if you're fairing better. If not, maybe a simple SSRI, like Lexapro, Celexa, or Paxil is better for you.
good luck, keep in touch with us.
JRB
> In reply to your questions
>
> 1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
>
> 2 I am taking the 75 mg at dinnertime
>
> 3 I am feeling very anxious depressed
>
> Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
>
>
> Thanks for your reply JRB Im interested in what you have to say from my answers
>
>
> Regards Robert
> > hang in there robert.
> >
> > yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
> >
> > couple questions...
> >
> > 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
> >
> > 2) what is your current dose of effexor?
> > 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
> >
> > Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
> >
> >
> > as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
> >
> > good luck
> >
> > JRB
> >
> >
> >
> >
> > > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> > >
> > > Anyones thoughts would be well appreciated
> >
> >
>
>
poster:jrbecker
thread:263682
URL: http://www.dr-bob.org/babble/20030928/msgs/264264.html