![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 707 to 731 of 10407. Go back in thread:
Posted by Pamela on March 30, 2001, at 9:55:40
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,
I am not Goofy (or maybe I am, these days), but I didn't care what the mgs. were I just started eying it every day and dumping out the granuales little by little. I had weaned down to what I believe was about 12 -15 mg over a period of 2 mos and "STILL" when I stopped totally I ended up having to go back on due to no one helping me (ER and doctor) and now I believe I am at around 7 - 8 mg. As I have posted before I will take it down to 1 or 2 granuales if I have to, don't know how well it will work, but I like everyone am desparate to minimize the effects.
Good luck.
Pamela
Posted by Pamela on March 30, 2001, at 10:13:44
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,
> LeoDear Leo,
This made my heart warm, angry and determined. Thank You....Thank You....Thank you!!!!!
Pleae stay with us!
Pamela
Posted by Pamela on March 30, 2001, at 10:23:55
In reply to Re: Correction Leo, posted by kid47 on March 29, 2001, at 17:14:00
> > 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.Kid47,
Not much to say about Leo's FACTS! Hit a nerve? Or beter yet "THE TRUTH"!!!!
It doens't seem as though you are surving too well on this site, maybe you should start a site for masicists, who LOVE feeling like #$!& everyday, Yeah that's the ticket.
Posted by Pamela on March 30, 2001, at 10:35:24
In reply to Started Effexor XR Today, posted by Cam W. on March 29, 2001, at 21:04:08
> Today I start Effexor XR (37.5mg daily and increasing to at least 300mg or more - depending on response - over the next 3 months).
>
> Thank goodness I know the difference between case studies, case series, post marketing surveillance, restospective studies, naturalistic studies, randomized placebo controlled trials, and other types of articles written about medications and disease states. I also know the merits and limitations of each.
>
> Thank goodness I have extensively studied all aspects of all antidepressants available in Canada (and most of those available in other parts of the world).
>
> Thank goodness I understand physiology (physical and chemical processes in the body), pharmacology (preparation, properties, uses, and actions of drugs), pharmacodynamics (how an antidepressant acts in the body , including duration of response relative to plasma concentration), pharmacokinetics (including absorption, onset of action, distribution, biotransformation, metabolite action, and excretion route), and pharmacogenetics (including the effects and differences of antidepressant action in different people). Otherwise partial explanations of these factors involving a small subset of people who did not withdraw from the drug in a proper manner, might scare me into not taking this drug.
>
> Even if I do happen to get withdrawl symptoms while being weaned from this drug, I know of several strategies to minimize these withdrawl effects. Most of which have been posted several times on this site. In the past, this drug has not been understood as well as it is today, although I and my colleagues knew of the withdrawl syndrome and it's extent in a minority of people, for at least the past 3 years and we have dealt with it appropriately. Withdrawl syndrome still occurs in some of our patients, but this is almost always due to nonadherence to the treatment regimen.
>
> Since I know how to wean myself from this drug if and when need be, I am very confident the this drug has the ability resolve my depressive symptoms and PTSD so that I may be able to lead a more productive and "normal" life, again. I see this drug as a useful tool, not an evil demon.
>
> Sincerely - CamYes thank God you do know "ALL" this unfortuanely....Our issue is if you have been reading is.........WE DIDN'T!!!!!!
Please inform us of your feelings when you do decide to go off.
Being one who is down to about 7-8 mgs after 2 1/2 mos, and going totally off at about 10-12 mgs.still feeling like #$%^, I don't know how much more responsibly I can do it and since I have no HELP from my docotr and two ER trips, any KNOWLEDGE is appreciated. Then I want to hear experinces to back it.
Pamela
Posted by Pamela on March 30, 2001, at 10:39:45
In reply to Re: Withdrawal after 6 YEARS-Pamela, posted by Julie L on March 30, 2001, at 0:05:44
> hi-
> I just wanted to clarify that I've been on the regular Effexor not the "XR" version for 6 yrs. i wasn't sure if you were insinuating something because I sure wasn't ingesting candy...
>
> Julie
Hi Julie,
Not sure what you mean. I am sure you weren't taking candy and I knew you weren't on XR since it is new. Only trying to give a little support.
Blessings, Pamela
Posted by Pamela on March 30, 2001, at 10:44:18
In reply to Re: Started Effexor XR Today, posted by Fish on March 30, 2001, at 8:22:24
> > CAM, just out of curiousity. Who are your colleagues? Are you in the medical profession? There is one thing that really upsets me. I have noticed that doctors and the medical profession listen more to pharmaceutical companies than they do their patients. I can't tell you how many times I have told my doctor of strange symptoms and he says "oh, that can't be the drug". What really gets me is I told my doctor of these symptoms and told him they began when I started the drug and he just didn't believe it so he did
> FSH/LH testing and also tested my thyroid. Now here are lots of people writing in and telling of the same exact symptoms I have. It's a relief to know that I can verify that it is indeed the drug that is causing these problems and that I know going off of it will relieve them. Why are the people who take this drug and speak of the many SIMILAR side affects ignored and pooh-poohed off like we're idiots who couldn't possibly know what we are talking about because we don't have the "medical" knowledge that you have. Take the medicine, enjoy the ride, but don't tell us that we don't know what is happening to our bodies. I hope these emails keep someone else from taking it and ending up like some of us have. What scares me is how many people are out there who don't know enough to look on the web and read this information. Experience is knowledge and your medical research is wrong. The medicine will work for you in the beginning, it did for me, but I hope it is all worth it to you in the end. I am still on it and trying to figure out when I can ween myself off of it with minimal disruption to my life. I have to work full-time, take care of a 14 year old and finish out the semester. I am not looking forward to the struggle of getting myself off this stuff. By the way, another FACT. I attend college at night. Since I began taking this drug I went from an "A" student to a "C" student with even more effort on my studying. This is very real, so is the delay in being able to come up with the words sometimes when I am trying to get a thought out of my head. So is the memory lapses I experience at least 3 times a day. So are the hot flashes that make me feel like I am on fire and then the sweating. So is the fear when I wake up suddenly because I stop breathing. You see, it is NOT just the withdrawl that has patients upset, it is the side effects. I hope to God they go away after I stop taking the medicine. I'm not buying it, your medical knowledge, and I hope people read these emails before they start taking Effexor. I believe that drug is dangerous and should be taken off the market. People with depression don't need these added burdens, life with depression is hard enough without more struggle from a medication that is suppose to help.
>
> Fish
>
> Today I start Effexor XR (37.5mg daily and increasing to at least 300mg or more - depending on response - over the next 3 months).
> >
> > Thank goodness I know the difference between case studies, case series, post marketing surveillance, restospective studies, naturalistic studies, randomized placebo controlled trials, and other types of articles written about medications and disease states. I also know the merits and limitations of each.
> >
> > Thank goodness I have extensively studied all aspects of all antidepressants available in Canada (and most of those available in other parts of the world).
> >
> > Thank goodness I understand physiology (physical and chemical processes in the body), pharmacology (preparation, properties, uses, and actions of drugs), pharmacodynamics (how an antidepressant acts in the body , including duration of response relative to plasma concentration), pharmacokinetics (including absorption, onset of action, distribution, biotransformation, metabolite action, and excretion route), and pharmacogenetics (including the effects and differences of antidepressant action in different people). Otherwise partial explanations of these factors involving a small subset of people who did not withdraw from the drug in a proper manner, might scare me into not taking this drug.
> >
> > Even if I do happen to get withdrawl symptoms while being weaned from this drug, I know of several strategies to minimize these withdrawl effects. Most of which have been posted several times on this site. In the past, this drug has not been understood as well as it is today, although I and my colleagues knew of the withdrawl syndrome and it's extent in a minority of people, for at least the past 3 years and we have dealt with it appropriately. Withdrawl syndrome still occurs in some of our patients, but this is almost always due to nonadherence to the treatment regimen.
> >
> > Since I know how to wean myself from this drug if and when need be, I am very confident the this drug has the ability resolve my depressive symptoms and PTSD so that I may be able to lead a more productive and "normal" life, again. I see this drug as a useful tool, not an evil demon.
> >
> > Sincerely - Cam
FISH,Well said, I support you 100%!
Pamela
Posted by Fish on March 30, 2001, at 10:44:32
In reply to Re: Started Effexor XR Today, posted by Pamela on March 30, 2001, at 10:35:24
Pamela, Thank you for your input and concern. I want to say that I am sorry for what you are going through. I too am afraid and wish there was more I could do to help you. Please post if you need to talk and I will email back with as much encouragement as possible. Your not alone, many of us here understand what you are going through. One day missed on a dosage and I am a mess, so I can't imagine the horror of withdrawl. Hang in there ... you can do it and just remember we are here for you and we know what you are going through is real! Fish
Posted by goofy on March 30, 2001, at 12:02:36
In reply to Re: Goofy or Anyone how do you know the mg in EFXR, posted by Fish on March 30, 2001, at 8:48:49
> Goofy, thank you for getting back to me. It sounds like this is the best solution from what I have read in these emails. Were you able to function on the job, etc.? How bad were your side effects? Can you share some of your experience of withdrawl with me and include severity of them? I think it will help me stay focused if I know what to expect. I appreciate your input.
> If I am prepared and know there is an end to the withdrawl symptoms I know I can do it! Fish
>
> 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.
> >
> > some of the granuales are fused together and some are a little smaller it is very easy to eye ball this and divide the granuales equally by size. As far as the dose it may differ a slight bit but I don't think it matters that much. It was time consuming but it was worth it!
> >
> > goofy
Hi Fish,
I expected not to be able to function coming off effexor. The side effects I encountered while going off effexor were very mild and I was able to still function. I was a little fuzzy, tired, emotional and I had some achiness and electrical jolts to my body. None of these symptoms were consistant. I would notice them at different times while I was coming off the effexor. I also noticed a positive difference in the way I felt even with these symptoms. Everybody reacts different, but I was able to still function and be productive. Iam now 20 days free and I feel 100% better. There is a light at the end of the tunnel. Good luck.
goofy
Posted by Cam W. on March 30, 2001, at 12:53:16
In reply to Re: Started Effexor XR Today, posted by Fish on March 30, 2001, at 8:22:24
Fish
>Experience is knowledge and your medical research is wrong.
Where is your validated proof? How can you make a statement like that without proof. Just because you want something to be the way you think it should be does not make it true.
"Experience is knowledge"? Did you really think about this statement before typing it and how wrong it really is? Blind faith in one's experiential beliefs is dangerous. We only have 5 senses and it HAS been scientically proven that all 5 can be fooled.
>I'm not buying it, your medical knowledge, and I hope people read these emails before they start taking Effexor. I believe that drug is dangerous and should be taken off the market.No one is asking you to "buy into my medical knowledge". I believe that cigarettes are dangerous and should be taken off the market. Effexor is a safe drug IF used properly. Fearmongers and hype have blown this issue totally out of proportion. I also hope people read these e-mails before starting Effexor, if not just to see what can happen when a drug regimen is not managed properly.
Sincerely - Cam
Posted by Cam W. on March 30, 2001, at 13:22:26
In reply to Re: Started Effexor XR Today » Cam W., posted by SLS on March 30, 2001, at 8:56:14
Scott - I stopped the Wellbutrin back in November. Third time was not lucky, as it didn't seem to touch this latest round of depression (perhaps this last depression was more serotonergic in nature and may have been a reaction to the death of Suzanne, which I am not handling very well, as of late). I am having PTSD-like traits with this depression, so a serotonergic/norepinephrinergic antidepressant may do the trick.
The thing that I like about Effexor is that, as you increase the dose, you increase the efficacy. Whereas SSRI effect, after a certain blood level plateaus.
Naturalistic studies are done in people who do not have pure disorders. Whereas clinical trials exclude people for various reasons (usually to try to minimize cofounding variables of other disease states), naturalistic trials include people with comorbid medical and psychiatric problems. They mimic the "real world" use of the drug to a greater degree. Naturalistic studies can still be double blind, but are done to see if the confounding variables of other disorders and disease state affect the efficacy of the drug being tested. These studies (if done properly) are basically set up the same as the randomized, placebo controlled trial, but the exclusion criteria is greatly reduced. I would think (hope?) that investigators in a naturalistic study watch the groups being investigated much more closely for any potential problems that could arise.
I hope this helps and hope that you are keeping well. Yours in affliction - Cam
Posted by Fish on March 30, 2001, at 13:24:35
In reply to Re:Intractable Effexor Withdrawl , posted by cjl on August 23, 2000, at 21:07:19
CAM, I don't feel the need to justify my opinions. You have every right to feel the way you want to feel and I respect that. I wish you luck with the Effexor and hope you have a positive experience. Best of Luck. Fish
Posted by McGuyver on March 30, 2001, at 13:24:50
In reply to Re: Started Effexor XR Today » Fish, posted by Cam W. on March 30, 2001, at 12:53:16
Cam,
Again I agree with you! 'Expierience is knowledge' is what my GM said to me before I took his job. Also, 'I've been doing this for 40 years', well, I said "yah, 40 years the wrong way".
Point being, use it right, and maybe it will work. I've been on it a month now, I'm not jumping for joy, but I feel 10 times better.
Cam, anyone else with positive results, I'm starting a new thread right now.
Mc
Fish
>
> >Experience is knowledge and your medical research is wrong.
>
> Where is your validated proof? How can you make a statement like that without proof. Just because you want something to be the way you think it should be does not make it true.
>
> "Experience is knowledge"? Did you really think about this statement before typing it and how wrong it really is? Blind faith in one's experiential beliefs is dangerous. We only have 5 senses and it HAS been scientically proven that all 5 can be fooled.
>
> >I'm not buying it, your medical knowledge, and I hope people read these emails before they start taking Effexor. I believe that drug is dangerous and should be taken off the market.
>
> No one is asking you to "buy into my medical knowledge". I believe that cigarettes are dangerous and should be taken off the market. Effexor is a safe drug IF used properly. Fearmongers and hype have blown this issue totally out of proportion. I also hope people read these e-mails before starting Effexor, if not just to see what can happen when a drug regimen is not managed properly.
>
> Sincerely - Cam
Posted by Fish on March 30, 2001, at 13:54:55
In reply to Re:Intractable Effexor Withdrawl , posted by cjl on August 23, 2000, at 21:07:19
Your comments are belittling and you send message that give the impression that you are right and anyone who isn't happy with this drug is wrong. You don't have to make smart remarks about other peoples experiences. If you like the drug, so be it, but you don't need to attack other peoples opinions. It's not nice and completely unnecessary. Fish
Posted by Cam W. on March 30, 2001, at 14:06:55
In reply to CAM and MCGUYVER, posted by Fish on March 30, 2001, at 13:54:55
Fish - Sorry if I upset you you, but I base my remarks in scientific fact, not subjective experience. There is a huge difference between the two and the public has a right to know which is which. - Cam
Posted by kid47 on March 30, 2001, at 17:14:38
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. 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.
>
>Leo I'm not trying to neutralize anything. Damage control for what purpose? Are you on any meds now?
> 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.>
> For many of us our illness is a life & death struggle. It is estimated that over 15% of folks with untreated or ineffectly treated mental illness will die by their own hand!> 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.
>
>It is believed by some that mental illness shows a familial & genetic predisposition. If God forbid either of my children were to have my illness I would certainly be interested in the next generation of meds. In fact I would think anyone with a mental disorder would be hopeful for the next batch of meds-if not for themselves for anyone else who is suffering3) 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.
>
> Ya Right.> 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."
>
>Pick a battle Leo. You mad at the drug companies, the FDA, the docs, me?
> 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.>
>My mistake. This money is available only when the lawsuits involve vaccines.
> 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.>
>Agreed. But I think anyone visiting this site would be well aware of the potential for side effects. Perhaps you should take your case to the National Enquirer. It is read by millions.>
>Leo & Pam. As you might have gathered I am getting a little fed up with the somewhat disparraging tone of your most recent posts. I am partly to blame as I have failed to communicate clearly to you my concerns. First I am afraid that this type of hysteria might put someone off from trying FXR who might desperately need it. Secondly, in the past, I have seen some very wise & helpful people become fed up & exit this site because of..... shall I say people pursuing a questionable agenda with more than adequate zeal. Sue whomever you wish to sue & bring whatever legal action you feel necessary but pleeeeaaaase no more swinging the cat by the tail or I may be forced to call the SPCA. ( Sorry Dr. B I was civil for as long as I could be)
>
>PS What have you got against electrical engineers Pamela?
Posted by Dr. Bob on March 31, 2001, at 1:18:03
In reply to Re: Correction Leo-to Kid47, posted by Pamela on March 30, 2001, at 10:23:55
> Not much to say about Leo's FACTS! Hit a nerve? Or beter yet "THE TRUTH"!!!!
> It doens't seem as though you are surving too well on this site, maybe you should start a site for masicists, who LOVE feeling like #$!& everyday, Yeah that's the ticket.I've warned you before, so now I'm going to have to block you from posting. Follow-ups, if any, regarding this should be redirected to Psycho-Babble Administration. Thanks,
Bob
Posted by Dr. Bob on March 31, 2001, at 1:26:34
In reply to Re: Started Effexor XR Today » Fish, posted by Cam W. on March 30, 2001, at 12:53:16
> "Experience is knowledge"? Did you really think about this statement before typing it and how wrong it really is? Blind faith in one's experiential beliefs is dangerous.
I appreciate what you're trying to do, but please keep your cool, especially when things get heated. Experience is in fact one form of knowledge, and "blind" has negative connotations.
> Fearmongers and hype have blown this issue totally out of proportion.
Strong opinions certainly have blown up this thread, size-wise!
Bob
Posted by SLS on March 31, 2001, at 9:49:21
In reply to Re: Started Effexor XR Today » SLS, posted by Cam W. on March 30, 2001, at 13:22:26
Hi.
Are most of the people in this thread using Effexor XR? I wonder if using the original preparation of the Effexor tablet (without the extended release) could be used as a tool to more precisely fine-tune the last stages of the weaning process. When I was coming off Effexor, I also experienced many of the withdrawal symptoms, including the bolts of lightening episodically shooting through my head. What I began doing was to wait until these symptoms *began* to reappear, and then use smaller and smaller pieces of the Effexor tablet to relieve them. My goal was to use less and less Effexor and try to maintain or extend the time between the emergence of withdrawal symptoms. One can get Effexor into their blood stream immediately by letting it disolve under the tongue (sublingual). At some point, one must take the last step of discontinuation. For me, this last step wasn't too bad. The withdrawal symptoms were mild to moderate and lasted less than a day.
Maybe this is a bad idea, I don't know. As has been discussed, there are other strategies such as using Prozac as a temporary bridge. A few people have used Benadryl (diphenhydramine), an over-the-counter drug used as an antihistamine, to greatly ease the withdrawal symptoms. I don't know how universally effective this is.
EFFEXOR:Effexor is a good drug that is considered by many physicians to be generally more effective than the SSRIs. I have not yet asked around enough to qualify if this trend is based upon an impression that Effexor gets more people well, gets the same number of people more well, or both. I think doctors tend to report in terms of how many people are successfully treated.
Hearsay:I was told by a source I deem reputable that a large-scale investigation comparing Effexor to the SSRIs has just been completed and the data analyzed. He said that it clearly demonstrates the superiority of Effexor. I am not sure if and when the study will be published, although I can't imagine that it would not be. Since I forgot to ask him specifically about a publication date, I don't feel that I can confidently comment on the authors' intent. I'll let you folks know if I find out anything more.
- Scott
Posted by JahL on March 31, 2001, at 10:37:05
In reply to Re: Started Effexor XR Today, posted by SLS on March 31, 2001, at 9:49:21
Posted by SLS on March 31, 2001, at 15:43:32
In reply to Re: Study » SLS, posted by JahL on March 31, 2001, at 10:37:05
Thanks Jah.
Like all other currently used antidepressants, Effexor isn't for everyone. I'm sorry it wasn't for you, Jah.
Since this has been such a long thread about such a critical topic, I decided to invest a little more bandwidth and post the entire article as it appears on the PR Newswire website.
It is important to note that the study concludes that:
1. Effexor gets more people well than SSRIs.
2. Effexor produces a greater improvement than SSRIs. More people experienced a complete remission of depression with Effexor.
Dr. Thase, the principal investigator, has authored or co-authored 180 articles appearing in the Medline database.
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New University of Pittsburgh Depression Study Shows Venlafaxine Significantly Superior to SSRIs
- Virtual Elimination of the Symptoms of Depression with Novel Antidepressant - Could Have Substantial Public Health Implications -PITTSBURGH, March 1 /PRNewswire/ -- Results of a new study published today in the "British Journal of Psychiatry" shows that significantly more patients with depression who were treated with venlafaxine (Effexor(R)) or venlafaxine extended-release capsules (Effexor XR(R)) become virtually symptom free than patients treated with selective serotonin reuptake inhibitors (SSRIs) or a placebo(1). The study demonstrated consistent evidence that remission rates with venlafaxine were approximately 10 percentage points higher than those observed with SSRIs. To put this in perspective, this represents a 30 percent increase in the probability of remission with venlafaxine vs. SSRIs. This difference is thought to be because venlafaxine is a selective serotonin and norepinephrine reuptake inhibitor, which may result in two modes of action.
Antidepressant efficacy traditionally has been measured by an ability to reduce depressive symptoms by 50 percent. This is the typical mandatory benchmark that has been established in order to gain approval by regulatory authorities like the U.S. Food and Drug Administration (FDA)(2). A higher standard of efficacy measurement is known as "remission," or the virtual elimination of all symptoms of depression. When patients achieve full remission they are less likely to relapse(3) and are fully restored to normal psychosocial functioning(4) -- in other words, they are able to return to activities previously enjoyed before the onset of depressive symptoms.
"For the millions of people who suffer from depression, the study results are very exciting," said Michael E. Thase, M.D., professor of psychiatry, University of Pittsburgh School of Medicine, and lead author of the study. "Given the high global prevalence of depression, coupled with its staggering associated costs, this difference represents a potentially tremendous clinical and economic advantage. This certainly is the strongest evidence yet that all antidepressants are not equally effective."
The new data comes from eight double-blind trials that were pooled to compare remission rates of 2,045 patients with major depressive disorder who were treated with venlafaxine or venlafaxine extended-release capsules, an SSRI, or placebo. In the study, overall venlafaxine remission rates were 45 percent, compared to 35 percent for SSRIs, and 25 percent for placebo (p< 0.001 for all comparisons).
"I struggled with depression for many years and tried many different antidepressants that simply were not working," said Shelia Singleton, a depression sufferer. "But Effexor XR was the one that saved my life and got me to fully recover from depression. I'm excited to hear about the findings of this study and maybe now patients who are not getting well with other medications will be motivated to seek better treatment, and at least give them hope that it is possible to lead a happier, more productive life."
As a selective serotonin and norepinephrine reuptake inhibitor, venlafaxine simultaneously effects both serotonin and norepinephrine neurotransmitters implicated in depression and in anxiety(5,6). The extended-release formulation of venlafaxine (Effexor XR(R)) is the first and only antidepressant approved by the FDA and 33 countries worldwide to treat depression and generalized anxiety disorder (GAD). GAD, the most common anxiety disorder, is a long-term condition marked by overwhelming, chronic, and excessive worry, anxiety, and tension that persists for at least six months. Effexor XR has the proven ability to work long-term to achieve and sustain remission in GAD and in depression, helping patients not only get relief from their symptoms, but also helping them to maintain a complete recovery from their disease.
Study Findings
Remission frees sufferers from the symptoms of depression and allows them to participate in and enjoy their normal activities. In studies of depression, it is determined clinically by a score of < ,= 7 on the 17-item Hamilton Rating Scale for Depression (HAM-D).*
Data from eight comparable randomized, double-blind studies were pooled to compare remission rates of 851 people with major depressive disorder who were treated with venlafaxine or venlafaxine extended-release, 748 patients who were treated with SSRIs (Prozac(R) (fluoxetine), Paxil(R) (paroxetine), and Luvox(R) (fluvoxamine)) and 446 patients treated with placebo (from four studies), for up to eight weeks.
Significant differences in final remission rates were observed between patients given venlafaxine and patients given an SSRI or placebo. The significant difference between venlafaxine and the SSRIs started at week two, whereas the difference between the SSRIs and placebo reached significance at week four. Additional analyses confirmed that the findings were not dependent on any one study, nor were they limited to any particular definitions of remission.
"I believe the dual-action mechanism of action conveyed by venlafaxine increases the chances of patients obtaining the best treatment outcome -- the ability to achieve remission. This, in turn, may enhance their chances of long-term recovery," said Dr. Thase.
About Depression
Major depressive disorders, which include depression, affect an estimated 340 million people worldwide(7). The World Heath Organization recently concluded that depression is the world's fourth greatest public health problem. If left untreated, the effects of depression can be devastating, robbing people of the energy or motivation to perform everyday activities and, in some cases, leading to suicide. Symptoms of the disorder include feelings of sadness or emptiness, lack of interest or pleasure in nearly all activities, and feelings of worthlessness or inappropriate guilt. In addition to the personal costs of depression, the disease also results in more than $40 billion annual costs in the United States alone due to premature death, lost productivity and absenteeism.
About The University of Pittsburgh School of Medicine
The University of Pittsburgh School of Medicine is consistently ranked among the nation's leading medical schools. It is one of the university's six Schools of the Health Sciences, which include the schools of Nursing, Dental Medicine, Pharmacy, Health and Rehabilitation Sciences and the Graduate School of Public Health. Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance the understanding of the causes and treatments of disease and to participate in the delivery of care as a partner with the UPMC Health System. Among the many areas for which its faculty and programs are internationally recognized are oncology, psychiatry, genetics, transplantation and public health.
REFERENCES
(1) "Remission Rates During Treatment with Venlafaxine or SSRIs" abstract,
Thase et al.
(2) Thase ME, Entsuah AH, Rudolph RI. "Br J Psych." Remission Rates During
Treatment with Venlafaxine or SSRIs". In Press.
(3) Judd LL, Akiskal HS, Paulus MP. "J Affect Disorder." The role and
clinical significance of subsyndromal depressive symptoms (SSD) in
unipolar major depressive disorder. 1997;45:5-18.
(4) Sulser F. J "Clin Psychiatry." Serotonin-norepinephrine receptor
interactions in the brain: implications for the pharmacology and
pathophysiology of affective disorders. 1999;60:213-214.
(5) Dubovsky SL. "J Clin Psych." Beyond the Serotonin Reuptake Inhibitors:
Rationales for the Development of New Serotonergic Agents. 1994.
(6) Brunello N, Racagni G. "Human Psychopharmacology." Rationale for the
Development of Noradrenaline Reuptake Inhibitors. 1998.
(7) World Health Organization. The Newly Defined Burden of Mental
Problems. WHO website: http://www.who.int/inf-fs/en/fact217.html.
Accessed September, 2000.* HAM-D is a common psychiatric scale on which the severity of depressive symptoms is measured to determine treatment efficacy.
SOURCE University of Pittsburgh School of Medicine
Posted by JaneB on March 31, 2001, at 16:40:20
In reply to Re: Study, posted by SLS on March 31, 2001, at 15:43:32
> >"Effexor XR has the proven ability to work long-term to achieve and sustain remission in GAD and in depression, helping patients not only get relief from their symptoms, but also helping them to maintain a complete recovery from their disease."
Is this "complete recovery from their disease" a recovery while using the medication or recovery to the extent that antidepressants are no longer necessary--is the illness cured??? I want to be cured!! Celexa is not taking the depression or anxiety completely away. Should I switch to Effexor? I know, ask my pdoc. But what is this study saying about being recovered (cured)? JaneB
Posted by JahL on March 31, 2001, at 18:10:50
In reply to Re: Study--Is the illness cured?, posted by JaneB on March 31, 2001, at 16:40:20
> > >"Effexor XR has the proven ability to work long-term to achieve and sustain remission in GAD and in depression, helping patients not only get relief from their symptoms, but also helping them to maintain a complete recovery from their disease."
> Is this "complete recovery from their disease" a recovery while using the medication or recovery to the extent that antidepressants are no longer necessary--is the illness cured???
There is no cure as such 4 depression-the best you can hope for is complete control of symptoms.
I think the 'complete recovery' refers to remission whilst *on* Effexor itself.
After a suitable period of time, some (lucky!) individuals can wean off ADs w/o reoccurrence of their depression. However you need only ask Scott to appreciate the potential pitfalls of discontinuing a med that works...
J.
Posted by Canuck on April 1, 2001, at 3:13:08
In reply to Can't decide. PLEASE help!, posted by Michele on March 27, 2001, at 13:20:29
> Hi everybody,
> I am trying to make a desion. I have been on effexor xr for 3 weeks. 37.5,75,150. I have not felt any POSITIVE from this yet.... but many side effects that are scaring the *#*# out of me. Is it possible to tell if a drug is going to work for you in this amount of time? I've never taken an AD before... and I think if I want to stop them, now is the time, before I'm on it too long? I'm pulling hair out of my head trying to decide what to do. I can stop now, with hopefully minimal effects... or hang on and see what happens? If it's not the drug for me, I'd rather stop now and get it over with, since I'm out of work for 2 weeks. Any advice would be GREATLY appreciated. I'm sooo tired of these side effects.. they are messin' with my mind!!!! Thanx guys....... MicheleHello Michele,
I started to see results at about the three week mark. My physician says it can take up to six weeks to see an improvement though. I am like you, I had never taken an AD before this med (or any med, for that matter). It is frightening to finally decide that you are at the point where you need outside help. I think if you are comfortable continuing the med, then do so, at least until you have reached the six week mark to see if it is really working for you. You should also consult your doctor and share you concerns with him/her. If you are truly not comfortable with taking the med, don't quit cold turkey. As you know from this sight, there can be severe consequences. Speak to you doctor, and he/she can help you taper off the med. Good like in your struggle. Thank you for your time.
Canuck
Posted by Canuck on April 1, 2001, at 3:22:09
In reply to Re: Another satisfied customer! » Canuck, posted by Seraphim on March 28, 2001, at 10:36:48
> Seraphim,
Your points are well taken. You are correct, I have not gone off the med and cannot contest to how my body will react. I will have to cross that bridge when I come to it. I will keep you posted when I do make that decision. Wish me luck! Thank you for your time and kind words. Take care.
Canuck
> > > >Canuck,
> I too wish you the best. I must say that I know none of us here would have wanted to do you or anyone else a disservice of any kind by speaking of the fear and suffering we have been, or are currently going through due to side effects and withdrawal. I am very glad you stumbled upon this discussion group. You are able to make an informed decision and hopefully will take the warnings about missed or late doses very seriously. I wish I had known to be more careful, it would have saved me a lot of pain. I truly think that most of us just feel that all of the information on Effexor, especially withdrawal (you have no idea how horrid it is), should have been disclosed to us prior to our decision to start taking it. That is what I would like to see happen. If you are feeling happy again, then I cheer you on! Happy and Healthy are what we are all striving towards. Good luck :-)
> Seraphim
> > > >
> > > > Just a quick note to say that I have had great results with Effexor XR. I did have a few side effects in the first three days. I had nausea for the first few hours after taking the drug. I also had a hard time sleeping for the first few nights, but I was having a hard time sleeping before the med anyway. And then there was the constant yawning that I could not control. (That could be guite comical depending on where I was.) But I am happy to say that all of that has ended now and I am feeling great. I am feeling more and more like my old self every day. I don't pretend to think that this drug will have the same effect on everyone, but it has done wonders for me. I do wonder, however; if the reason that there are far more unhappy people than happy ones posting on this web sight is because the happy ones aren't looking for a forum to sing Effexor XR's praises. If you are taking the medication and are having good results, why would you bother looking for a sight on the internet? I only found this sight purely by chance one night when I first started taking the med. Let me say, had I read many of the postings before I started taking the drug, I would not have taken it. This would have done me a great disservice. I have always just checked in on this sight and read the postings, but today I feel compelled to share my "good" Effexor XR story. Thank you for your time.
> > > >
> > > > Canuck
> > >
> > > Canuck,
> > > Once again, you are talking about FXR while you are "on" it, please don't be fooled it is the scariest thing I have experienced "GOING OFF" it. I loved it while on it, it did wonders for me. Information is good and you are right about this site with no one reporting good stuff. I would love to read just "ONE" positive about the withdrawals's.... JUST ONE! It might give me hope, but in the meantime, keep reading so you become aware. Our society likes the quick fix (as did I) so we tend to hide our head in the sand if it does the job, quickly. My life will never be the same (knowledge and appreciation for my previous good health)) as for my health, I pray everyday for a full recovery from this drug. I have other detailed info if yo haven't already read. Please don't dismiss what you read, these are real people, with real suffering going on. This site helped me tremedouly knowing that I wasn't the only one and wasn't going crazy.
> > > God Bless and I will pray for your success,
> > > Pamela
> >
> > I do not believe that I am being "fooled". My head is not hidden "in the sand". I spoke at length with my physician before starting this medication and she was very clear that I would experience side effects when coming off of the drug. I also spoke to a friend and also a co-worker who have both been on the med and are now both off of it. Both complained of extreme headaches when tapering off, but have had no other adverse reactions. I don't pretend to say that there are not patients who go through extreme withdrawl, but to be back to my old self again, I was willing to take the chance. I did not make this decision blind folded. I am extremely comfortable with my decision and when I feel strong enough to go off Effexor XR, I will do so with an open mind and a positive attitude knowing that I made my decision with my eyes wide open. Thank you for your time.
> >
> > Canuck
Posted by Canuck on April 1, 2001, at 3:40:36
In reply to Started Effexor XR Today, posted by Cam W. on March 29, 2001, at 21:04:08
> Today I start Effexor XR (37.5mg daily and increasing to at least 300mg or more - depending on response - over the next 3 months).
>
> Thank goodness I know the difference between case studies, case series, post marketing surveillance, restospective studies, naturalistic studies, randomized placebo controlled trials, and other types of articles written about medications and disease states. I also know the merits and limitations of each.
>
> Thank goodness I have extensively studied all aspects of all antidepressants available in Canada (and most of those available in other parts of the world).
>
> Thank goodness I understand physiology (physical and chemical processes in the body), pharmacology (preparation, properties, uses, and actions of drugs), pharmacodynamics (how an antidepressant acts in the body , including duration of response relative to plasma concentration), pharmacokinetics (including absorption, onset of action, distribution, biotransformation, metabolite action, and excretion route), and pharmacogenetics (including the effects and differences of antidepressant action in different people). Otherwise partial explanations of these factors involving a small subset of people who did not withdraw from the drug in a proper manner, might scare me into not taking this drug.
>
> Even if I do happen to get withdrawl symptoms while being weaned from this drug, I know of several strategies to minimize these withdrawl effects. Most of which have been posted several times on this site. In the past, this drug has not been understood as well as it is today, although I and my colleagues knew of the withdrawl syndrome and it's extent in a minority of people, for at least the past 3 years and we have dealt with it appropriately. Withdrawl syndrome still occurs in some of our patients, but this is almost always due to nonadherence to the treatment regimen.
>
> Since I know how to wean myself from this drug if and when need be, I am very confident the this drug has the ability resolve my depressive symptoms and PTSD so that I may be able to lead a more productive and "normal" life, again. I see this drug as a useful tool, not an evil demon.
>
> Sincerely - CamCam,
A positive attitude! I love it!
Canuck
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