Posted by SLS on May 2, 2004, at 8:22:20
In reply to Re: please be civil}}Dr Bob » SLS, posted by TanyaJean on May 1, 2004, at 21:14:37
> My doctor had told me I was crashing so hard when missing a dose of PAXIL because it was just enhancing the serotonin. He put me on EFFEXOR because he said it enhanced both the serotonin and norepinephrine pathways. He said if I missed a dose, I wouldn't have such ill effects. So I wonder why I did then?
Your doctor is wrong for two reasons:1. He is wrong.
2. He is wrong.
:-)
1. The tendency for a withdrawal syndrome to occur upon missing doses has been observed for both Paxil and Effexor and is well known.
2. There is no medical foundation for concluding that Effexor will not produce this phenomenon simply because it inhibits the reuptake of norepinephrine (NE) in addition to serotonin (5-HT).
I am really appalled that this kind of ignorance and misinformation still exists. Even if a doctor doesn't want to read the most current medical literature, he must certainly come in contact with doctors who do.
The following is a citation on Medline from 1997. The authors are from Harvard / Massachusetts General Hospital. They are by no means obscure. Nor is the journal that published them, J Clin Psychiatry.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9219493
Here is something that can easily be found on the Web:
http://remedyfind.com/rem.asp?ID=3948&lPageNum=3
"
However, as Venlafaxine has a short half-life (approx. 5 hours), compared to say, Fluoxetine (2-3 days), sudden discontinuation or missed doses can result in serious side-effects. Withdrawal side-effects may include fatigue, nausea, dizziness, headache, insomnia, and nervousness. Venlafaxine withdrawal symptoms can be so significant that in March 2000, the U.S. FDA required manufacturer Wyeth-Ayerst to add additional labeling which states, “Abrupt discontinuation or dose reduction of venlafaxine at various doses has been found to be associated with the appearance of new symptoms, the frequency of which increased with increased dose level and with longer duration of treatment..... It is therefore recommended that the dosage of Effexor be tapered gradually and the patient monitored. The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
"The labelling of the drug manufacturer is unambiguous.
- Scott
poster:SLS
thread:1016
URL: http://www.dr-bob.org/babble/20040429/msgs/342415.html