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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 671 to 695 of 10407. Go back in thread:
Posted by Amy 5452 on March 28, 2001, at 18:37:53
In reply to Re: starting effexor... keep posting.. success/dosage?, posted by Racer on October 25, 1999, at 19:54:13
Today is my first day on Effexor XR. I only took the 37.5mg pill, but i am so dizzy and nauseaus it is unbelievable. How long will this last for?
Posted by Michele on March 28, 2001, at 20:28:04
In reply to Starting Effexor, posted by Amy 5452 on March 28, 2001, at 18:37:53
Amy,
Hi.... I was just posting recently, regarding the side effects. Yesterday I almost went off after 3 weeks(150mg) and I've never taken ADs before. And these posts terrified me. I had horrible, horrible side effects myself.... all the sudden this morning.... poof, they were gone.... and I feel terrific! Better than I have in years. Hopefully this isn't a fluke....and it'll last... but it does end.(And I questioned that it ever would.) Good luck.... and keep in touch with your progress, Michele
Posted by Voski on March 29, 2001, at 8:14:23
In reply to Re: Another satisfied customer! » Canuck, posted by Seraphim on March 28, 2001, at 10:36:48
Efferox XR, YES!!! It has helped me!!! After taking Zoloft with side effects and then Prozac, yet more side effects with muscle spasms, it was Efferox XR that helped with no side effects. Struggling with depression is no fun for yourself or your family. After a year of feeling out of touch with myself and out of control, I went to my doctor. The results are wonderful with the help of counseling. The hell I put my children and husband thru. I am currently up to twice a day taking Efforox XR with fantastic results. That's 150 mg. 75mg. each time. I was having a mid day crash, as I call it. Crying and feeling useless is not fun. Now I am smiling and laughing again with slight bouts of crying, etc. What great news!!!! I am still in couseling and probably will be for a while, which is fine with me along with med help. At least now, I can get through the day. I still have trouble sleeping nights, but with Ambien, I now have a night with sleep and not waking to my mind wondering.... Feel free to comment. Good luck with all!!
voski
Posted by Leo on March 29, 2001, at 8:43:32
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
IF YOU'RE ANGRY NOW..........WAIT UNTIL YOU READ THE INFORMATION......SUPPLIED BY THE FDA..... IN THE FOLLOWING. ANYTIME THE FDA HAS TO "FORCE" THE MANUFACTURER TO COME CLEAN, THERE IS A HUGE DEGREE OF UNDERLYING PROBLEMS. THIS IS JUST THE BEGINNING.................MORE TO COME
The text below is taken from the drug data sheet for Effexor XR (Venlafaxine HCI) which was approved in it's new form by the FDA on 12 July 2000. A full copy of the 20 page document in Adobe Acrobat format can be downloaded by clicking the link at the end of this page.
The first section, relating to the short term premarketing trials, confirms the link between the drug and many of the side effects which I have mentioned on this web site (and many of which are the symptoms of serotonin syndrome) including; amnesia, confusion, depersonalization, hallucinations, paranoia, gastrointestinal problems, increased depression and vision impairment.
The second section confirms that postmarketing reports have suggested links with serotonin syndrome, neuroleptic malignant syndrome-like events, involuntary body movements and shock-like electrical sensations subsequent to discontinuation or tapering of the dose.
Having regard to the Safety Related Drug Labelling changes forced by the FDA in March 2000, which confirmed the existence of a severe dose and time related withdrawal syndrome, I believe that everything that I have said about this drug has been proven; that patient's prescribed Venlafaxine are at risk of developing severe and potentially fatal side effects to the drug and that in many cases such patients are unable to discontinue the drug or taper withdrawal. Nevertheless I'm convinced that there is lots more to come.
The question which begs to be asked is, why weren't we warned!EFFEXOR & EFFEXOR XR (venlafaxine HCl) Tablets
[March 3, 2000: Wyeth-Ayerst]
DRUG ABUSE AND DEPENDENCE:
Physical and Psychological Dependence: New third paragraph -
"Discontinuation effects have been reported in patients receiving venlafaxine (see DOSAGE AND ADMINISTRATION)."
DOSAGE AND ADMINISTRATION:
Discontinuing Effexor (venlafaxine HCl): First sentence revised (new text in italics) -
"When discontinuing Effexor after more than 1 week of therapy, it is generally recommended that the dose be tapered to minimize the risk of discontinuation symptoms. Patients who have received Effexor for more than 6 weeks or more should have their dose tapered gradually over at least a 2-week period."
New second paragraph -
"Discontinuation symptoms have been systematically evaluated in patients taking venlafaxine, to include prospective analyses of clinical trials in Generalized Anxiety Disorder and retrospective surveys of trials in depression. 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. Reported symptoms include agitation, anorexia, anxiety, confusion, coordination impaired, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting. 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. Discontinuation effects are well known to occur with antidepressants."
Discontinuing Effexor XR:
"When discontinuing Effexor XR after more than 1 week of therapy, it is generally recommended that the dose be tapered to minimize the risk of discontinuation symptoms. In clinical trials with Effexor XR, tapering was achieved by reducing the daily dose by 75 mg at one week intervals. Individualization of tapering may be necessary. [The remainder of the paragraph beginning with "While the discontinuation effects of Effexor XR have not been systematically evaluated in controlled clinical trials, retrospective..." has been deleted] and replaced with -
"Discontinuation symptoms have been systematically evaluated in patients taking venlafaxine, to include prospective analyses of clinical trials in Generalized Anxiety Disorder and retrospective surveys of trials in depression. 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. Reported symptoms include agitation, anorexia, anxiety, confusion, coordination impaired, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting. It is therefore recommended that the dosage of Effexor XR be tapered gradually and the patient monitored.
Posted by Leo on March 29, 2001, at 9:03:17
In reply to Re: Sammy.........., posted by Michele on March 27, 2001, at 23:08:07
RE VENLAFAXINE WITHDRAWAL REACTIONS
DATE CITATIONDRUG REPORT
1996 Benazzi VenlafaxineSingle case report of withdrawal symptoms after abrupt cessation of four week treatment with VFX 150mg/day. Patient experienced "brief 'bursts' of dizziness, which lasted for a few seconds and occurred numerous times throughout the day", also with headache, nausea, fatigue, sweating and worsening of depression. Symptoms cleared when VFX 75mg/day was restarted and did not reappear during the gradual drug tapering that followed.
1996 Farah & Lauer Venlafaxine Single case report of a 32-year old woman, originally on VFX 300mg/day, treated for eight months for depression. On each of three occasions she failed to withdraw from the drug, after abrupt discontinuation: she "experienced headache, gastro-intestinal distress, fatigue and other symptoms ... She remains on a regimen of venlafaxine, 100mg t.i.d."
1966 Louie et al VenlafaxineThree cases are reported of VFX withdrawal, following both abrupt (2 cases) and very gradual cessation. Main symptoms were dizziness and G-I distress, but one patient also experienced auditory hallucinations and bizarre dreams. It took her ten weeks from the initial attempt at withdrawal to discontinue VFX. Neither of the two other patients was reported to have achieved withdrawal.
1996 Rauch et al VenlafaxineFour out of nine patients involved in an open 12-week trial of VFX for OCD "developed a troublesome withdrawal syndrome", in spite of gradual withdrawal of medication over four days to two weeks. Symptoms included "a flu-like syndrome with muscle aches, fatigue, headache, nausea and dizziness. In three cases, symptoms were relieved by resuming venlafaxine, followed by a more gradual discontinuation. Interestingly, the fourth patient developed withdrawal symptoms despite having initiated fluoxetine."
1997 Agelink et al. VenlafaxineTwo cases reported, both involving elderly women. In one case, patient was taken off VFX venlafaxine after 26 days because of persistent insomnia. Withdrawal symptoms included confusion, nausea, agitation, sweating, anxiety, visual hallucinations and fluctuation of blood pressure and heart rate. The severity of symptoms required close monitoring for eight hours in the psychiatric intensive care unit; symptoms resolved 24 hours after last dose. In the second case, VFX was stopped after 42 days because of lack of efficacy and unwanted effects. Withdrawal symptoms included nausea, feelings of abdominal distension, headache, restlessness, agitation, sweating and also visual hallucinations. Symptoms resolved within two to three hours after VFX was reinitiated. Thereafter, the drug was gradually withdrawn over four days, with no recurrence of symptoms.
1997 Cunningham Venlafaxine & Venlafaxine XRThis Wyeth-Ayerst sponsored study included measurements of withdrawal reactions in 127 patients treated with VFX but did not report them. Remarkable. Patients had been treated for 12 weeks with VFX (either the usual or Extended-Release version) in a double-blind, placebo-controlled trial, following which "study medications were tapered over a period of up to two weeks". The report states that patients were evaluated 4 to 10 days after medication was discontinued, but results are not reported.
1997 Fava et al Venlafaxine XRTwenty adult outpatients were randomly assigned to receive either an extended-release formulation of VFX or placebo. After eight weeks of double-blinded treatment, doses were tapered or stopped (tapered by 75mg/week for patients taking 150mg/day or 225mg/day - but not for patients on 75mg/day, or on PBO). Seven of the nine patients previously on VFX (78%) reported adverse effects on withdrawal (and became significantly more depressed), compared with two out of nine patients (22%) on placebo. The relationship between frequency and severity of effects and dosage of VFX was not recorded, but severity of withdrawal effects was significantly greater in the VFX group than for the group on placebo. See also: Cunningham, 1997.
1997 Giakas & Davis Venlafaxine FluoxetineThree consecutive cases reported of 26-35 year old women who experienced severe withdrawal after discontinuing venlafaxine, following treatment ranging from a week or two to seven months: "Repeated attempts at gradually tapering the dosage were unsuccessful and led to intolerable withdrawal sensations." In these and other cases, authors noted appearance of withdrawal symptoms within a few hours of patient missing a dose. Although, symptoms they saw "are not identical to a fully-fledged psychedelic experience or a true migraine headache, similarity is evident..." In all cases, venlafaxine was eventually discontinued under cover of fluoxetine, which itself was later withdrawn uneventfully in one of the three cases.
1997 Moore Venlafaxine"The investigators who were testing Effexor observed that 'clusters of symptoms sometimes occurred at or shortly after the discontinuation of Effexor treatment'. As a result, Wyeth-Ayerst did a survey of all the patients in the clinical trial's testing program. Overall, 35 per cent of the Effexor patients experienced withdrawal symptoms ranging from a flu-like syndrome to insomnia, nausea, nervousness and loss of energy. In five patients, Wyeth-Ayerst reported, withdrawal symptoms were so severe and prolonged that medical treatment was required. Two patients could not be withdrawn from the drug, and treatment was resumed. One patient was hospitalised. Two others had to be treated with another antidepressant. These five cases suggest a risk of severe addiction in some patients." Click for Moore
1997 Thase Venlafaxine XRReport of a manufacturer-sponsored, randomised, double-blind, placebo-controlled, multicentre evaluation of venlafaxine (extended release version) versus placebo. In this 8-week study, 91 patients were treated with VFX-XR and 100 with placebo. The medications were then tapered for up to two weeks, with a post- study evaluation made 4-10 days after discontinuation. In the 'Results' section of the paper, author noted: "Importantly, no clinically significant withdrawal syndromes were observed during double-blind discontinuation of study medications". However, the term "clinically significant" is not defined, and this finding was not considered sufficiently important to be mentioned in the Abstract of the paper.
1997 Wolfe Sertraline Venlafaxine Review including brief reports of two patients who had experienced withdrawal symptoms on discontinuing SRN and VFX respectively. The patient on VFX experienced severe restlessness (akathisia) which abated within hours of restarting the drug. The drug was later gradually tapered and withdrawn.1998 Boyd Venlafaxine
Brief review of the 13 reports of withdrawal reactions to VFX received by the Australian Adverse Drug Reaction Advisory Committee (ADRAC) between early 1996 and early 1998. "Four of the 13 patients recovered from their symptoms within two weeks and two required return to venlafaxine and a tapered withdrawal. Three patients had not recovered at the time the report was submitted to ADRAC and information on time to recovery was not available for three patients, while outcome was unknown for one patient."
1998 Dallal & Chouinard VenlafaxineLetter reports that, on completion of an 8-week open label study of venlafaxine, six of eight patients required gradual dose reduction (over 7-15 days, mean 11 days) because of severe withdrawal symptoms. In addition, two patients in the study had complained of a withdrawal symptom (nausea) shortly after missing a single dose. Authors advise: "clinicians should be aware of the potential for serious psychiatric and physical sumptoms that should not be confounded with the original illness when venlafaxine is abruptly discontinued".
1998 Johnson et al VenlafaxineCase report. Patient was a 42-year old man, successfully treated for depression with VFX 75mg/day for six months. Dosage was then halved (for an unspecified period) and stopped. Within 36 hours of stopping, patient "developed positional vertigo, which caused him significant incapacity, in addition to nausea and light- headedness". Symptoms soon resolved on reintroduction of drug. Dosage was reduced to 18.75mg/day for three weeks and then discontinued: "He had ongoing symptoms of vertigo which resolved slowly over three weeks. The patient's determination enabled him to discontinue ... but he did so with difficulty."
1998 Macbeth and Rajagopalan VenlafaxineCase report: After two year's unsuccessful treatment for depression, Mr Y (51) was tried on venlafaxine, to 300mg/day. "After four weeks on this dose, depressive symptoms continued unabated and Mr Y began to make active suicidal plans". A course of ECT was therefore planned, so the VFX was rapidly reduced, over two days. After 72 hrs, Mr Y developed severe nausea, anorexia, dizziness, unsteady gait, tinnitus and headache - all new symptoms which resolved when VFX was restarted at 75mg.day. Shortly after, Mr Y was withdrawn uneventfully from this dosage, over one week.
1998 Parker & Blennerhasset VenlafaxinePaper describes withdrawal problems associated with abrupt and tapered withdrawal of VFX and documents withdrawal symptoms occurring after missing a single dose. Two cases are discussed, including one where severe symptoms (including hallucinations) were experienced during slow tapering. Authors conclude that withdrawal "make make cessation of the drug extremely difficult", and they consider two strategies for addressing the problem.
1998 Raby VenlafaxineCase report in which odansetron was successfully used to relieve somatic symptoms (but not anxiety) of venlafaxine withdrawal. Patient (29 year old woman with 12-year history of bipolar I disorder) had been treated with VFX for 10 weeks without response. Dosage was decreased with difficulty: "when receiving less than 75mg/day of venlafaxine, Ms. A would experience nausea, headaches, diarrhea, and anxiety so severe that she was forced to remain at home" and "this proved to be a dose below which the tapering schemedule could not be continued".
1999 Goldstein et al , venlafaxineManic symptoms following antidepressant withdrawal have mainly been reported in unipolar depression. These cases involved bipolar patients, treated for an average 6.5 months, before taper (average 20 days, range 1-43). The first manic symptoms emerged, on average, 2 weeks into the taper period (range 1-23 days), and mean length of manic episode was 28 days (range 12-49 days).
1999 Sierra Santos et al VenlafaxineIn Spanish. Single case-history of severe reactions experienced in spite of gradual withdrawal and brief review.
2000 Pinzani et al VenlafaxineIn French. Short report of six cases of withdrawal reactions and a brief literature review. Authors conclude that "physicians must be aware of the frequency, rapidity and potent severity of these withdrawal syndromes".
2000 Patients' reports VenlafaxineSee this well-established, much visited US website operated by Belynda Warner at http://members.tripod.com/bwarner/effexor.html
Posted by Leo on March 29, 2001, at 9:13:01
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Withdrawal reaction associated with venlafaxine
H Johnson, W P Bouman, J Lawton.
Nottingham Healthcare NHS Trust, Wells Road Centre, Nottingham NG3 3AA
We report an apparent withdrawal reaction to venlafaxine, a recently introduced serotonin noradrenaline reuptake inhibitor antidepressant whose use is increasing.
A 42 year old man with a first episode of major depression was treated with venlafaxine after unsuccessful trials with fluoxetine and imipramine. He fully recovered over four weeks while taking a dose of 37.5 mg twice daily. This dose was maintained for 6 months and his mental state was stable. The dose was reduced to 37.5 mg once daily, which he tolerated well. However, within 36 hours after stopping venlafaxine treatment he developed positional vertigo, which caused him significant incapacity, in addition to nausea and light headedness. The symptoms resolved rapidly on reintroduction of the drug. The dose was reduced to 18.75 mg daily for three weeks and then discontinued. He had ongoing symptoms of vertigo, which resolved slowly over three weeks. The patient's determination enabled him to discontinue taking the drug, but he did so with difficulty. He had no previous history of adverse drug reactions or withdrawal symptoms.
At the time of writing, three reports had been published about five similar cases, but the patients in all five cases were taking higher doses of venlafaxine before treatment was discontinued. The possibility of a withdrawal reaction is mentioned in the manufacturer's data sheet, but it implies that such reactions are observed with doses of 150 mg daily and above. Given the possibility of a withdrawal reaction with low doses of venlafaxine, we suggest that this drug is used with caution and that care is taken to gradually taper any dose before discontinuing treatment.
Posted by Leo on March 29, 2001, at 9:30:41
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Other Adverse Events Observed During the Premarketing Evaluation of Effexor and Effexor XR
During its premarketing assessment, multiple doses of Effexor XR were administered to 705 patients in phase 3 depression studies and Effexor was administered to 96 patients. During its premarketing assessment, multiple doses of Effexor XR were administered to 476 patients in phase 3 GAD studies. In addition, in the premarketing assessment of Effexor, multiple doses were administered to 2897 patients in phase 2-3 depression studies. The conditions and duration of exposure to venlafaxine in both development programs varied greatly, and included (in overlapping categories) open and double-blind studies, uncontrolled and controlled studies, inpatient (Effexor only) and outpatient studies, fixed-dose, and titration studies. Untoward events associated with this exposure were recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of untoward events into a smaller number of standardized event categories.
In the tabulations that follow, reported adverse events were classified using a standard COSTART-based Dictionary terminology. The frequencies presented, therefore, represent the proportion of the 4174 patients exposed to multiple doses of either formulation of venlafaxine who experienced an event of the type cited on at least one occasion while receiving venlafaxine. All reported events are included except those already listed in Tables 3 and 4 and those events for which a drug cause was remote. If the COSTART term for an event was so general as to be uninformative, it was replaced with a more informative term. It is important to emphasize that, although the events reported occurred during treatment with venlafaxine, they were not necessarily caused by it. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions:frequent adverse events are defined as those occurring on one or more occasions in at least 1/100.patients;
infrequent adverse events are defined as those occurring in 1/100 to 1/1000 patients;
rare events are those occurring in fewer than 1/1000 patients.
Body as a whole - Frequent: chest pain substernal, chills, fever; Infrequent: face edema, intentional injury, malaise, moniliasis, neck rigidity, pelvic pain, photosensitivity reaction, suicide attempt; Rare: appendicitis, carcinoma, cellulitis, withdrawal syndrome.
Cardiovascular system - Frequent: migraine, postural hypotension; Infrequent: angina pectoris, arrhythmia, extrasystoles, hypotension, peripheral vascular disorder (mainly cold feet and/or cold hands), syncope, thrombophlebitis; Rare: arteritis, first-degree atrioventricular block, bigeminy, bradycardia, bundle branch block, cerebral ischemia, coronary artery disease, congestive heart failure, heart arrest, mitral valve disorder, mucocutaneous hemorrhage, myocardial infarct, pallor.Digestive system - Frequent: eructation, increased appetite; Infrequent: bruxism, colitis, dysphagia, tongue edema, esophagitis, gastritis, gastroenteritis, gastrointestinal ulcer, gingivitis, glossitis, rectal hemorrhage, hemorrhoids, melena, stomatitis, mouth ulceration; Rare: cheilitis, cholecystitis, cholelithiasis, hematemesis, gastrointestinal hemorrhage, gum hemorrhage, hepatitis, ileitis, jaundice, intestinal obstruction, oral moniliasis, proctitis, increased salivation, soft stools, tongue discoloration.
Endocrine system - Rare: goiter, hyperthyroidism, hypothyroidism, thyroid nodule, thyroiditis.
Hemic and lymphatic system - Frequent: ecchymosis; Infrequent: anemia, leukocytosis, leukopenia, lymphadenopathy, lymphocytosis, thrombocythemia, thrombocytopenia; Rare: basophilia, cyanosis, eosinophilia, lymphocytosis.Metabolic and nutritional - Frequent: edema, weight gain; Infrequent: alkaline phosphatase increased, glycosuria, hypercholesteremia, hyperglycemia, hyperuricemia, hypoglycemia, hypokalemia, SGOT increased, thirst; Rare: alcohol intolerance, bilirubinemia, BUN increased, creatinine increased, diabetes mellitus, dehydration, gout, hemochromatosis, hypercalcinuria, hyperkalemia, hyperlipemia, hyperphosphatemia, hyponatremia, hypophosphatemia, hypoproteinemia, SGPT increased, uremia.
Musculoskeletal system - Frequent: arthralgia; Infrequent: arthritis, arthrosis, bone pain, bone spurs, bursitis, leg cramps, myasthenia, tenosynovitis; Rare: pathological fracture, myopathy, osteoporosis, osteosclerosis, rheumatoid arthritis, tendon rupture.Nervous system - Frequent: amnesia, confusion, depersonalization, emotional lability, hypesthesia, vertigo; Infrequent: apathy, ataxia, circumoral paresthesia, CNS stimulation, euphoria, hallucinations, hostility, hyperesthesia, hyperkinesia, hypotonia, incoordination, libido increased, manic reaction, myoclonus, neuralgia, neuropathy, paranoid reaction, psychosis, seizure, abnormal speech, stupor; Rare: akathisia, akinesia, alcohol abuse, aphasia, bradykinesia, buccoglossal syndrome, cerebrovascular accident, loss of consciousness, delusions, dementia, dystonia, facial paralysis, abnormal gait, Guillain-Barré syndrome, hypokinesia, neuritis, nystagmus, psychotic depression, reflexes decreased, reflexes increased, suicidal ideation, torticollis.
Respiratory system - Frequent: dyspnea; Infrequent: asthma, chest congestion, epistaxis, hyperventilation, laryngismus, laryngitis, pneumonia, voice alteration; Rare: atelectasis, hemoptysis, hypoventilation, hypoxia, pleurisy, pulmonary embolus, sleep apnea.
Skin and appendages - Frequent: rash, pruritus; Infrequent: acne, alopecia, brittle nails, contact dermatitis, dry skin, eczema, skin hypertrophy, maculopapular rash, psoriasis, urticaria; Rare: erythema nodosum, exfoliative dermatitis, lichenoid dermatitis, hair discoloration, skin discoloration, furunculosis, hirsutism, leukoderma, pustular rash, vesiculobullous rash, seborrhea, skin atrophy, skin striae.
Special senses - Frequent: abnormality of accommodation, mydriasis, taste perversion; Infrequent: cataract, conjunctivitis, corneal lesion, diplopia, dry eyes, exophthalmos, eye pain, hyperacusis, otitis media, parosmia, photophobia, taste loss, visual field defect; Rare: blepharitis, chromatopsia, conjunctival edema, deafness, glaucoma, retinal hemorrhage, subconjunctival hemorrhage, keratitis, labyrinthitis, miosis, papilledema, decreased pupillary reflex, otitis externa, scleritis, uveitis.
Urogenital system - Frequent: metrorrhagia,* prostatitis,* urination impaired, vaginitis*; Infrequent: albuminuria, amenorrhea,* cystitis, dysuria, hematuria, female lactation,* leukorrhea,* menorrhagia,* nocturia, bladder pain, breast pain, polyuria, pyuria, urinary incontinence, urinary retention, urinary urgency, vaginal hemorrhage*; Rare: abortion,* anuria, breast engorgement, breast enlargement, fibrocystic breast, calcium crystalluria, cervicitis,* ovarian cyst,* prolonged erection,* gynecomastia (male),* hypomenorrhea,* kidney calculus, kidney pain, kidney function abnormal, mastitis, menopause,* pyelonephritis, oliguria, salpingitis,* urolithiasis, uterine hemorrhage,* uterine spasm.*
*Based on the number of men and women as appropriate..Postmarketing Reports
Voluntary reports of other adverse events temporally associated with the use of Effexor (the immediate release form of venlafaxine) that have been received since market introduction and that may have no causal relationship with the use of Effexor include the following;agranulocytosis, anaphylaxis, aplastic anemia, catatonia, congenital anomalies, CPK increased, deep vein thrombophlebitis, delirium, EKG abnormalities (such as atrial fibrillation, supraventricular tachycardia, ventricular extrasystoles, ventricular tachycardia), epidermal necrosis/Stevens-Johnson Syndrome, erythema multiforme, extrapyramidal symptoms (including tardive dyskinesia), hemorrhage (including eye and gastrointestinal bleeding), hepatic events (including GGT elevation; abnormalities of unspecified liver function tests; liver damage, necrosis, or failure; and fatty liver), involuntary movements, LDH increased, neuroleptic malignant syndrome-like events (including a case of a 10-year-old who may have been taking methylphenidate, was treated and recovered), pancreatitis, panic, prolactin increased, renal failure, serotonin syndrome, shock-like electrical sensations (in some cases, subsequent to the discontinuation of Effexor or tapering of dose), and syndrome of inappropriate antidiuretic hormone secretion (usually in the elderly).
There have been reports of elevated clozapine levels that were temporally associated with adverse events, including seizures, following the addition of venlafaxine. There have been reports of increases in prothrombin time, partial thromboplastin time, or INR when venlafaxine was given to patients receiving warfarin therapy.
Posted by Leo on March 29, 2001, at 9:40:37
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
What I have just posted is the tip of an enormous iceberg. I could spend days posting the facts associated with the devistating effects of effexor. This drug makes Prozac look like an M&M.
In the future I will post the sources of information about the drug so that you can go to the sites and spend whatever time you feel i necessary navigating through all the information.
An excellent source to start with is:www.effexorfx.freeuk.com
This site will lead you to an abundance of sources and information about this "wonderful" drug.
Posted by JaneB on March 29, 2001, at 9:50:04
In reply to The Icing on the Cake............, posted by Leo on March 29, 2001, at 9:30:41
I took Effexor XR for over a year and experienced many of these symptoms. Tried to go without antidepressants at all and 10 months later had to start Celexa. Will I experience similar reactions upon discontinuation of Celexa? Scarey!
JaneB
Posted by Julie L on March 29, 2001, at 9:58:00
In reply to Is the same true of Celexa?, posted by JaneB on March 29, 2001, at 9:50:04
All of the studies that I'm reading only involve tests on people that have been on Effexor or Effexor XR for a year or less...
One of the studies that Leo posted mentioned breifly that the severity/intensity of the symptoms increased with the longer amount of time that the person was on Effexor.
Should I sue my doctor? Why did he leave me on this for so long if its not a common practice?
I'd really like to know when the withdrawal symptoms will stop...
Julie
Posted by McGuyver on March 29, 2001, at 10:38:25
In reply to Case Studies......More FACTS to come......, posted by Leo on March 29, 2001, at 9:03:17
Leo,
Ahh the light. I will continue to take my chances, as I've emntioned before I'm sure it's not as bad as other withdrawls I've had. But please note, I'm sure that I'm not alone in saying thanks. Backing up all the former bickering with something substansiated gained my respect immediatly. However, i will be taking it with a grain of salt, if you were to go into as much detial with something like asprin, I'm sure you could find similar results. Case studies and statistics are as good as the people who do them. Again, thanks.
Mc
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Posted by goofy on March 29, 2001, at 11:42:51
In reply to EFFEROX XR YES!!!, posted by Voski on March 29, 2001, at 8:14:23
> Efferox XR, YES!!! It has helped me!!! After taking Zoloft with side effects and then Prozac, yet more side effects with muscle spasms, it was Efferox XR that helped with no side effects. Struggling with depression is no fun for yourself or your family. After a year of feeling out of touch with myself and out of control, I went to my doctor. The results are wonderful with the help of counseling. The hell I put my children and husband thru. I am currently up to twice a day taking Efforox XR with fantastic results. That's 150 mg. 75mg. each time. I was having a mid day crash, as I call it. Crying and feeling useless is not fun. Now I am smiling and laughing again with slight bouts of crying, etc. What great news!!!! I am still in couseling and probably will be for a while, which is fine with me along with med help. At least now, I can get through the day. I still have trouble sleeping nights, but with Ambien, I now have a night with sleep and not waking to my mind wondering.... Feel free to comment. Good luck with all!!
> voski
voskiIam a 35 year old woman who had the same situation you discribed in your post. The only exceptions were, i was only on 75mg. and i was not seeing a counsler. I was excited with the results of this drug just like you. I did not have any side effects and was looking at this drug as a life saver. When I had been on the effexor for about a year, I started noticing some stange things gradually happening to me. The most noticable was I was having a hard time waking up. I started requiring 10-12 hrs. of sleep. Then i noticed my sex life was changing. I was becoming numb to any stimulation. Of course these are some of the signs of depression so my first thought was i had to increase my effexor dose. The fact that i was fine and great with my life one day and all of a sudden over a few weeks noticing these symptoms baffled me. I started investigating this drug and monitoring this board. all I can say is THANK GOD, I did not increase my dose at my dr. advise and that I startrd to take myself of this drug. I was able to get off this drug with very minimal side effects( check my previous post for details) I have now been effexor free for 19 days and all aspects of my life are great. I am glad you are doing great. I just felt compelled to share my situation with you because you reminded me of myself.
goofy
Posted by goofy on March 29, 2001, at 11:52:01
In reply to The Tip of the Iceberg.............., posted by Leo on March 29, 2001, at 9:40:37
> What I have just posted is the tip of an enormous iceberg. I could spend days posting the facts associated with the devistating effects of effexor. This drug makes Prozac look like an M&M.
> In the future I will post the sources of information about the drug so that you can go to the sites and spend whatever time you feel i necessary navigating through all the information.
> An excellent source to start with is:
>
> www.effexorfx.freeuk.com
>
> This site will lead you to an abundance of sources and information about this "wonderful" drug.Leo,
I just wanted to take a second to thank you. Your posts and some of the others have changed my life. Iam very grateful to you for all the time and effort you put in trying to inform all of us on this site.
goofy
Posted by kid47 on March 29, 2001, at 11:52:55
In reply to The Tip of the Iceberg.............., posted by Leo on March 29, 2001, at 9:40:37
> What I have just posted is the tip of an enormous iceberg. I could spend days posting the facts associated with the devistating effects of effexor. This drug makes Prozac look like an M&M.
> In the future I will post the sources of information about the drug so that you can go to the sites and spend whatever time you feel i necessary navigating through all the information.
> An excellent source to start with is:
>
> www.effexorfx.freeuk.com
>
> This site will lead you to an abundance of sources and information about this "wonderful" drug.Hi Leo. I promise this will be my last post re: FXR withdrawal. I understand this is an important issue for you. To put this in some perspective I might suggest you check out some other AD sites like Paxil etc. You will see the same type horror stories about these meds as you see about FXR. The FDA sites also post similar side effects as FXR about several AD's. Meds effect all of us differently. I think any widely prescribed med will have its share of bad press. Penicillin has been known to kill people. Some chemotherapy patients experience side effects that very nearly destroy them. But many of us feel the good out weighs the bad. I do appreciate all your hard work in bringing this info to our attention. Add this to what already exists in the archives & I would venture to say this is probably the most comprehensive site on the net for FXR info. Perhaps the next generation of FXR will have fewer problems as a result of sites like PB. I do agree with you that drug co. monitor these sites. Maybe they've learned something!
Those of us with chronic long term illness are an impatient & sometimes desperate bunch. As long as there has been reasonable testing as to a drugs effectiveness & safety bring it on!!! We would however hope the drug cos. & the FDA would be forthcoming with any & all info as it becomes available. Lawsuits are so prevalent against drug companies that the federal govt. actually will pay for there defense & settlement if any. Otherwise it would not be feasible for these cos. to R&D new drugs & bring them to the market place. Yes we are "dollar driven" here in the US. But I hope these companies continue trying to find better drugs w/fewer side effects not just for mental disorders but for all illness (Boy I do sound like I work for a drug Co.)
The FXR continues to work well for me & others. There are folks who have successfully withdrawn from FXR with little or no problem. People are now more aware that there is a potential as with many powerful drugs for some severe & possibly as yet unknown side effects. I think the potential consumer has an opportunity to make an educated decision about FXR especially if we try & present a "balanced" view free from hype & drama.
Well I'm rattling like an old truck. Hope you are feeling better. Take care.
Posted by Seraphim on March 29, 2001, at 11:56:08
In reply to Re: Has anyone been on Effexor for longer ....., posted by Julie L on March 29, 2001, at 9:58:00
Julie,
I've been on 300mg of Effexor for two and a half years. My doctor also combined that with 100mg of Elavil. I had no problem eliminating the Elavil about 5 weeks ago. Looking back, I can see how wrong I was to think drug therapy was the answer. I'm down to 125mg of effexor in three weeks. The withdrawal is awful! I'm so sick. I've heard it can last anywhere from several weeks to several months. I'm determined to go quickly and get this out of my system (my choice), so I'll update everyone on my progress. Also, I faxed my psychiatrist many of the postings here, good and bad, including the postings from Leo today. I'll let you know what response I get and what his suggestions are to get some relief; Other than staying on Effexor any longer than absolutely necessary. But I would NEVER have taken even one pill if I knew what I would be going through today. Stay positive, it can't last forever :-)
Seraphim
> All of the studies that I'm reading only involve tests on people that have been on Effexor or Effexor XR for a year or less...
>
> One of the studies that Leo posted mentioned breifly that the severity/intensity of the symptoms increased with the longer amount of time that the person was on Effexor.
>
> Should I sue my doctor? Why did he leave me on this for so long if its not a common practice?
>
> I'd really like to know when the withdrawal symptoms will stop...
>
> Julie
Posted by Seraphim on March 29, 2001, at 12:11:36
In reply to The Tip of the Iceberg.............., posted by Leo on March 29, 2001, at 9:40:37
Thank you, thank you , thank you!!!!!
I have faxed over all of this information you posted today to my psychiatrist, my family physician and plan to share it with my husband. It means so much to me to have found people who understand what I am going through and don't dismiss the symptoms I am suffering through on a daily basis as trivial or exagerated.Seraphim
> What I have just posted is the tip of an enormous iceberg. I could spend days posting the facts associated with the devistating effects of effexor. This drug makes Prozac look like an M&M.
> In the future I will post the sources of information about the drug so that you can go to the sites and spend whatever time you feel i necessary navigating through all the information.
> An excellent source to start with is:
>
> www.effexorfx.freeuk.com
>
> This site will lead you to an abundance of sources and information about this "wonderful" drug.
Posted by Leo on March 29, 2001, at 12:21:43
In reply to Re: Case Studies......More FACTS to come...... » Leo, posted by McGuyver on March 29, 2001, at 10:38:25
Mc
The studies speak for themselves. No emotions....just the facts. They do confirm the experiences of the people posting world wide about the drug. It is a bigger problem than originally estimated. Effexor seems to be extremely effective in initially "snapping" people out of depression, however, continued use begins to work against the disease because of the side effects associated with its use. These side affects adversely affect the physical body as well as the patient’s mental state. These symptomatic side effects progressively worsen the longer the patient stays on the drug. There are some people that have been off the drug for 2-3 years that are still experiencing a number symptomatic side affects directly associated with effexor. This is just starting to be recognized. This should be a great area of concern for all of us that have been exposed to the drug. Good or bad experiences. I believe, based on the research that I have done, that as the studies filter in that we will find that the drug will end up being directly responsible for some permanent mental and physical damage to its users. What bothers me the most is that the manufacturer still has not voluntarily stepped forward and lad the cards on the table. I think that it is now only a matter of time before the FDA steps in once again and forces them to do so or pulls the drug off the market until these issues are researched in depth and specifically addressed.
Regards,
Leo
Posted by Fish on March 29, 2001, at 13:02:14
In reply to Re: beginning to wean hopefully losing weight » vanroni, posted by goofy on March 22, 2001, at 12:33:28
Goofy, you had mentioned you divided the granuals in the capsules while you lowered your dosage. How do you know the mg amount when you divide them? I want to stop taking this drug and your way has seemed to have the most favorable results. Thanks! Fish
Posted by Leo on March 29, 2001, at 13:22:00
In reply to Re: The Tip of the Iceberg.............. » Leo, posted by kid47 on March 29, 2001, at 11:52:55
I respect the stand you take in strongly attempting to nuetralize the facts surrounding effexor. And yes, I do strongly suspect that you are employed by Wyeth-Ayerst. But thats OK to. Yes we can all look at the other drugs out there. And yes, we can read all the horror stories about all the other drugs. The people coming to this site are interested in only the one drug that is adversly affecting them........effexor. Attempting to nuetralize what people are saying about the drug is an of obvious form of "damage control." So we will respect your attempts to do so. However, the one thing that you can't neutralize are the experiences posted here and on the hundreds of other sites out there. They are real and exacting.
Let me give you some more facts:
1) All the side effects of Chemotherapy and Radiation Therapy are disclosed prior to treatment beginning. This is done so that the patient knows what to expect....both short and long term. I know because I'm a cancer survivor.
And of course the good (living) undergoing treatment outways the bad (certain death)left untreated. I think you'll agree that this is a no brainer.2) Those of us that will not be exposed to the next gerneration of effexor aren't concerned about what fewer problems may be associated with the drug. We are victims of the existing drug. That is our concern.
3) Those people out there that suffer from depression, chronic or otherwise, seek medical treatment to help cure or abate their illness. They trust that what their doctor is prescribing is going to make them better. Not worsen their condition by presenting a whole new set of side effects that exaserbate the problem.
4) All legal drugs undergo reasonable testing for effectiveness and safety.....as did Phen Phen. I think everyone is aware of the aftermath associated with its "reasonable testing for effectiveness and safety."
5) I know of no federal aid ever being available to any drug company for defense or settlement money. I do know that the government gets invloved as an arbitrator involving any settlement amounts and dispersion. They don't finance legal defense fees, nor do they delve out settlement money. This comes out of the drug companies pocket.
6) If people were more aware of the potential side effects of the drug prior to taking it then there wouldn't be so many bewildered or frightened people coming to sites like this.
DISCLOSURE......DISCLOSURE.......DISCLOSURERegards,
Leo
Posted by Fish on March 29, 2001, at 13:45:50
In reply to The Tip of the Iceberg.............., posted by Leo on March 29, 2001, at 9:40:37
Leo, first I want to thank you for sharing the information you have found. I have been on effexor xr for a year and a half and have experienced hot flashes, sweats, confusion, "brain freeze", nightmares and even periods where I would wake out of a sound sleep because I stopped breathing. I have told my doctor of these symptoms and he tells me it can't be the drug and if it is, since the drug is working, which is worse? The Effexor did work in the beginning and since my depression was so bad, I could tolerate the side effects. Now that I am feeling better, and thinking of going off, I found this site to get information. I have missed doses and have gone through the aweful dizziness, etc and am terrified of the withdrawl symptoms. The person who keeps saying we aren't weighing the facts. Don't even answer his/her emails. It is obviously a ploy. If he thought this was a load of s*%t, he wouldn't even have bothered to write anything, he would have just moved on. He is obviously not on the drug because no one is so organized that they wouldn't miss a day and I don't believe anyone could get through one day without this drug after taking it and not have side effects. This drug did help me tremendously in the beginning, but it is not worth it. I am glad you are taking a stand. I feel cheated and I am angry that I have to suffer through withdrawl symptoms. Will start soon, have to muster up the courage. Thank you again! Fish
What I have just posted is the tip of an enormous iceberg. I could spend days posting the facts associated with the devistating effects of effexor. This drug makes Prozac look like an M&M.
> In the future I will post the sources of information about the drug so that you can go to the sites and spend whatever time you feel i necessary navigating through all the information.
> An excellent source to start with is:
>
> www.effexorfx.freeuk.com
>
> This site will lead you to an abundance of sources and information about this "wonderful" drug.
Posted by Quasibarbidoll on March 29, 2001, at 14:15:13
In reply to Re: withdrawal - effexor ...how long??, posted by Kim Hazell on January 17, 2001, at 22:40:08
4 months
Posted by Quasibarbidoll on March 29, 2001, at 14:25:03
In reply to Re: The Tip of the Iceberg.............., posted by Fish on March 29, 2001, at 13:45:50
Agree 100% and a word of kind advice for employees(No one specific.. just a general statement.) of publicly traded companies that post info on the internet. It is not "proper" to not identify yourself if you do in fact work for the company in question. (Ask your corporate lawyer....she'll fill you in.:)
Was on the drug for fibro... took 4 months to get off and it was not a "Mind set" or imagined and I'm no victim. Vomiting daily, nausea, vertigo, being incoherent and spaced out is physical...good luck to you all!
> Leo, first I want to thank you for sharing the information you have found. I have been on effexor xr for a year and a half and have experienced hot flashes, sweats, confusion, "brain freeze", nightmares and even periods where I would wake out of a sound sleep because I stopped breathing. I have told my doctor of these symptoms and he tells me it can't be the drug and if it is, since the drug is working, which is worse? The Effexor did work in the beginning and since my depression was so bad, I could tolerate the side effects. Now that I am feeling better, and thinking of going off, I found this site to get information. I have missed doses and have gone through the aweful dizziness, etc and am terrified of the withdrawl symptoms. The person who keeps saying we aren't weighing the facts. Don't even answer his/her emails. It is obviously a ploy. If he thought this was a load of s*%t, he wouldn't even have bothered to write anything, he would have just moved on. He is obviously not on the drug because no one is so organized that they wouldn't miss a day and I don't believe anyone could get through one day without this drug after taking it and not have side effects. This drug did help me tremendously in the beginning, but it is not worth it. I am glad you are taking a stand. I feel cheated and I am angry that I have to suffer through withdrawl symptoms. Will start soon, have to muster up the courage. Thank you again! Fish
Posted by kid47 on March 29, 2001, at 17:14:00
In reply to Re: The Tip of the Iceberg..............Kid47 » kid47, posted by Leo on March 29, 2001, at 13:22:00
> I respect the stand you take in strongly attempting to nuetralize the facts surrounding effexor. And yes, I do strongly suspect that you are employed by Wyeth-Ayerst. But thats OK to. Yes we can all look at the other drugs out there. And yes, we can read all the horror stories about all the other drugs. The people coming to this site are interested in only the one drug that is adversly affecting them........effexor. Attempting to nuetralize what people are saying about the drug is an of obvious form of "damage control." So we will respect your attempts to do so. However, the one thing that you can't neutralize are the experiences posted here and on the hundreds of other sites out there. They are real and exacting.
>
> Let me give you some more facts:
>
> 1) All the side effects of Chemotherapy and Radiation Therapy are disclosed prior to treatment beginning. This is done so that the patient knows what to expect....both short and long term. I know because I'm a cancer survivor.
> And of course the good (living) undergoing treatment outways the bad (certain death)left untreated. I think you'll agree that this is a no brainer.
>
> 2) Those of us that will not be exposed to the next gerneration of effexor aren't concerned about what fewer problems may be associated with the drug. We are victims of the existing drug. That is our concern.
>
> 3) Those people out there that suffer from depression, chronic or otherwise, seek medical treatment to help cure or abate their illness. They trust that what their doctor is prescribing is going to make them better. Not worsen their condition by presenting a whole new set of side effects that exaserbate the problem.
>
> 4) All legal drugs undergo reasonable testing for effectiveness and safety.....as did Phen Phen. I think everyone is aware of the aftermath associated with its "reasonable testing for effectiveness and safety."
>
> 5) I know of no federal aid ever being available to any drug company for defense or settlement money. I do know that the government gets invloved as an arbitrator involving any settlement amounts and dispersion. They don't finance legal defense fees, nor do they delve out settlement money. This comes out of the drug companies pocket.
>
> 6) If people were more aware of the potential side effects of the drug prior to taking it then there wouldn't be so many bewildered or frightened people coming to sites like this.
>
>
> DISCLOSURE......DISCLOSURE.......DISCLOSURE
>
> Regards,
> Leo
The government money available for defense & settlement of lawsuits for drug companies is only when it involves vaccines. My only excuse is I take a fairly heavy drug cocktail. Sorry for the error.
Posted by goofy on March 29, 2001, at 17:19:38
In reply to Goofy or Anyone how do you know the mg in EFXR, posted by Fish on March 29, 2001, at 13:02:14
> Goofy, you had mentioned you divided the granuals in the capsules while you lowered your dosage. How do you know the mg amount when you divide them? I want to stop taking this drug and your way has seemed to have the most favorable results. Thanks! Fish
Hi Fish,
Each capsule that I had was 37.5 mg. I was taking 2 per day a total of 75 mg. when I decided to ween of the drug. I only took 1 capsule (37.5mg.) for 10 days. then i opened the capsule and divided the granuals in half which gave me 2 piles of granuales that I assumed equaled 18.75 mg. I emptied out some other meds that I had and used those capsules to put the divided amount into. I divided enough effexor 37.5 capsules to go at 18.75 mg. for 5 days. I then took another 37.5 capsule and divided the granuales into 4 piles which I assume gave me a dose of 9.375 mg. I refilled more empty capsules with this amount and took that dose for 5 days. then I divided another capsule into 8 piles which gave me a dose of 4.6875 I took this amount for 5 days then I divided a 37.5 capsule into 16 piles which gave me a dose of 2.3437. I took this amount for 5 days then I went off the drug. I had some very mild side effects starting the third day but they stopped after a couple of days. I am now 19 days free and feel great. I hope this info will help you. GOOD LUCK!!!!
goofy
Posted by Noa on March 29, 2001, at 17:38:44
In reply to Re: Goofy or Anyone how do you know the mg in EFXR, posted by goofy on March 29, 2001, at 17:19:38
I don't reccomend opening the capsules because the granules are of varying sizes and so you won't know how much you are really taking at one time.
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