![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 37 to 61 of 71. Go back in thread:
Posted by ed_uk2010 on May 27, 2013, at 13:17:06
In reply to correction- Lou's reply-drugs.com, posted by Lou Pilder on May 27, 2013, at 8:56:25
>Here is a link from drugs.com showing the interactions between Trileptal and Effexor.
Unfortunately, this interaction checker is not accurate. There are no reports in the medical literature of venlafaxine + oxcarbazepine causing respiratory depression. These particular meds are not respiratory depressants, either alone or together.
Beware of using the drugs.com interaction checker. Instead, use a reliable source such as the textbook 'Stockley's Drug Interactions', which is written by experts and uses a huge range of case reports and studies from the published medical literature.
Posted by Lou Pilder on May 27, 2013, at 15:28:47
In reply to Online automatic drug interaction checkers » Lou Pilder, posted by ed_uk2010 on May 27, 2013, at 13:17:06
> >Here is a link from drugs.com showing the interactions between Trileptal and Effexor.
>
> Unfortunately, this interaction checker is not accurate. There are no reports in the medical literature of venlafaxine + oxcarbazepine causing respiratory depression. These particular meds are not respiratory depressants, either alone or together.
>
> Beware of using the drugs.com interaction checker. Instead, use a reliable source such as the textbook 'Stockley's Drug Interactions', which is written by experts and uses a huge range of case reports and studies from the published medical literature.
>
> ed,
When no interaction is listed, that does not mean that there can not be an interaction.
In the case here, Trileptal is an anticonvulsant and has sedation listed as a consequence of taking the drug. Effexor has sedation also listed.
Drugs that sedate depress the central nervous system. These two drugs are CNS depressants. Reactions that are exponential rather than arithmetic can happen when more than one CNS depressant is taken. The danger is sudden death via cardiac or respiratory depression.
The drugs.com site even states that they do not have reports of events from combining the drugs, but they state that CNS depression can happen when the two drugs are combined. It may be that prescribers know that combining CNS depressants could cause death and do not prescribe them together. Another thought here is that Trileptal is a chemical modification of another anticonvulsant.
DRugs.com said what it said and I accept that the two drugs are CNS depressants. I have never seen the drugs profiled stating that they do not cause sedation, which is a characteristic of a depressant. I have also studied the chemical composition of the drugs and sedation can come from those chemicals.
Lou
Posted by vbs on May 27, 2013, at 16:44:30
In reply to Lou's response- » ed_uk2010, posted by Lou Pilder on May 27, 2013, at 15:28:47
Lou, antidepressant drugs are not CNS depressants. You've lost all credibility with me. Stop your distorted campaign of misinformation.
Posted by diana1981 on May 27, 2013, at 18:31:49
In reply to Re: Just trying to find the right meds for me » Dinah, posted by Emme_V2 on May 27, 2013, at 10:39:50
Thank you Dinah and Emme
The Lamictal had made me too drowsy to even stay on. Space cadet.
I am just so distraught over this situation. I don't want the anger fits but on the other hand I don't want the falling asleep mid day and jaw clenching and overeating.
Its very stressful.
Diana
Posted by Lou Pilder on May 28, 2013, at 7:24:31
In reply to Re: Lou's response-uh oh my crap detector went off » Lou Pilder, posted by vbs on May 27, 2013, at 16:44:30
> Lou, antidepressant drugs are not CNS depressants. You've lost all credibility with me. Stop your distorted campaign of misinformation.
Friends,
Be not deceived. The two drugs in question here taken together could cause death. They are both CNS depressants, for they cause sedation and drowsiness. And taken together causes exponential effects which could lead to death by heart or respiratory depression.
Many of you already know from reading on the admin board here where the post that I am responding to here (redacted by respondent). But it is much more than that, for deaths could occur if what is cast at me here is allowed to be thought to be true. People could die as a result of thinking that one could take an anti seizure drug together with Effexor. You see, I am trying to save lives here by posting educational material that could mark the difference between you or your child or other loved one being a live person or a corpse.
Here is a link that shows that Trileptal is a CNS depressant. And then I will show you Effexor as also a CNS depressant
Lou
http://www.speedyhealth.com/drug/trileptal.html
Posted by SLS on May 28, 2013, at 9:48:53
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
I felt that it was important to reset the subject line in this instance.
- Scott
Posted by SLS on May 28, 2013, at 9:58:33
In reply to Re: Just trying to find the right meds for me, posted by diana1981 on May 27, 2013, at 18:31:49
> Thank you Dinah and Emme
>
> The Lamictal had made me too drowsy to even stay on. Space cadet.How did you go about beginning Lamictal treatment? At what dosage did you begin to experience sedation and sleepiness?
I hope that you can maintain your positive and constructive attitude, despite your current disappointments. It can take quite awhile to discover a treatment that works. I hope that you find it helpful to post here, despite the occasional presence of extremism.
- Scott
Posted by Willful on May 28, 2013, at 10:16:08
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
I just wanted to note that on this logic, it's quite possible to argue that someone should never leave the house. Leaving the house can lead to death-- for example, by being run over by a bus, being hit by lightening, or tripping and hitting one's head on the sidewalk..
Everything you can do- including leaving one's house in the morning-- involves weighing risks and benefits-- and the likelihood of them. Clearly, all actions have risks-- and therefore if you're to avoid any risks, no matter how great the benefit-- and no matter how unlikely-- you would need not to get out of bed in the morning. Dire events can happen even in your apartment-- much less on the street.
Most of us, however, make the choice to take certain risks in the belief that it's worth that risk, even if it's a small risk of a dire event-- because the belief in the probability of a real benefit is much more probable. Of course, these become complex questions at times.
This is certainly the case with Anti-depressants-- we all know they have risks-- and benefits. Each of us tries to make a rational decision about these. You, Lou, have decided to avoid any even minimal risk -- but most people see benefits that, in various medications, outweigh the risks.. We can share our experiences-- and I assume yours have been very bad-- but I wonder if you realize that most people have a different view of risks-- and therefore that the small chance of death that you're mentioning, while it might-- I emphasize~~~might~~~ be possible-- would be seen in the light of many factors that seem to be missing in your discussions.
Diana seems to have already decided that the risks of some medications are greater than the risks-- and be asking for much more nuanced advice on how to weight specific regimens-- and I think therefore that your interventions- are basically, are not on point.
'X ( action) "can" cause Y (result)' is not an answer. There are so many more elements to be accounted for-- as in the question of whether to leave the house.
Posted by vbs on May 28, 2013, at 11:07:36
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
Lou, I apologize for my previous post. It was a bit abrasive. You're certainly entitled to formulate your own opinions regarding the pharmacology of psychotropic drugs.
Posted by ed_uk2010 on May 28, 2013, at 15:42:44
In reply to Lou's response- » ed_uk2010, posted by Lou Pilder on May 27, 2013, at 15:28:47
>When no interaction is listed, that does not mean that there can not be an interaction.
True.
>In the case here, Trileptal is an anticonvulsant and has sedation listed as a consequence of taking the drug. Effexor has sedation also listed.
Both drugs can cause drowsiness in some patients, no one disputes that. My point is that they do *not* cause respiratory depression.
Posted by Lou Pilder on May 28, 2013, at 16:31:45
In reply to Re: Lou's response- » Lou Pilder, posted by ed_uk2010 on May 28, 2013, at 15:42:44
> >When no interaction is listed, that does not mean that there can not be an interaction.
>
> True.
>
> >In the case here, Trileptal is an anticonvulsant and has sedation listed as a consequence of taking the drug. Effexor has sedation also listed.
>
> Both drugs can cause drowsiness in some patients, no one disputes that. My point is that they do *not* cause respiratory depression.
>ed,
There is a lot that I am not permitted to post here concerning Effexor due to prohibitions posted to me here by Mr Hsiung.
You see, we are talking about taking the two drugs together. It is when they are combined that the sudden death could happen. This is because of properties in the drug Effexor that may not be easily understood.
The drug can induce somnolence and insomnia. I have studied this but can not post what I know about this here. There are a lot of reports available concerning this and one from here over 10 years ago concerning the person falling asleep in the day while on Effexor.
But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
The chemical in the drug comes from diesel fuel and is highly toxic and is used in insecticides and nerve agents. It is also used as a solvent in industrial applications of which I am prevented from posting about here. You see, Effexor is not a new drug, but a new name for a knock-off of an old drug that I am prevented from posting about here. And the addiction/withdrawal can be horrific to the point where some can not get off of it and have to take it and get the awful effects of log-term use of the drug.
Yet today, I could post how one could overcome addiction to this drug, but I am prevented from posting that here. But thanks for posting to at least bring this aspect of Effexor up so that readers could have more information to make a more informed decision as to take this drug or drug their child in collaboration with a psychiatrist/doctor.
Lou
Posted by polarbear206 on May 28, 2013, at 16:35:42
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
Hey Lou...I've been taking effexor and an antiseizure drug for over 10 years and I'm ALIVE and happy!! You talk about them causing death??? Death is how I felt before being on meds. So analyze that!!
Posted by ed_uk2010 on May 28, 2013, at 17:05:17
In reply to Lou's reply-psykloehex » ed_uk2010, posted by Lou Pilder on May 28, 2013, at 16:31:45
>But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.
Posted by Lou Pilder on May 28, 2013, at 17:27:48
In reply to Re: Lou's reply-psykloehex » Lou Pilder, posted by ed_uk2010 on May 28, 2013, at 17:05:17
> >But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
>
> True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.ed,
On the contrary. People die from taking two drugs that can depress the cns. A few months ago, a girl died here . She took a pain pill and later before bed she had a mixed drink. She died in her sleep and the report stated it was the combination of the drug and the alcohol taken that killed her.
The drug Effexor is listed as having the effects exponentially magnified when another drug such as Trileptal is taken together.
Now Effexor by itself has the aspect of addiction/withdrawal. And the drug can increase suicidal and homicidal thinking and when in withdrawal the person could kill themselves and/or others and even commit mass-murder. If someone wants to promote a drug that could cause the taker of the drug to kill themselves, I think that it is even more appropriate to warn those people concerning combining the drug wiht another psychotropic drug that could exponentially increase the aspect of death.
Lou
Posted by Lou Pilder on May 28, 2013, at 17:35:49
In reply to Lou's reply-extudhaen » ed_uk2010, posted by Lou Pilder on May 28, 2013, at 17:27:48
> > >But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
> >
> > True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.
>
> ed,
> On the contrary. People die from taking two drugs that can depress the cns. A few months ago, a girl died here . She took a pain pill and later before bed she had a mixed drink. She died in her sleep and the report stated it was the combination of the drug and the alcohol taken that killed her.
> The drug Effexor is listed as having the effects exponentially magnified when another drug such as Trileptal is taken together.
> Now Effexor by itself has the aspect of addiction/withdrawal. And the drug can increase suicidal and homicidal thinking and when in withdrawal the person could kill themselves and/or others and even commit mass-murder. If someone wants to promote a drug that could cause the taker of the drug to kill themselves, I think that it is even more appropriate to warn those people concerning combining the drug wiht another psychotropic drug that could exponentially increase the aspect of death.
> Lou
>
Friends,
Now here I a link showing what has been reported when Effexor and alcohol are combined.
Notice the suicide attempts and the completed suicides. I think that readers here should have as amny facts as they can to make an informed decision as to tske these drugs or not.
Lou
http://www.ehealthme.com/drug-interactions/effexor-and-alcohol
Posted by SLS on May 28, 2013, at 18:37:50
In reply to Lou's reply-alcohol-effexor, posted by Lou Pilder on May 28, 2013, at 17:35:49
This was the last subject line posted that referenced content related to this thread.
- Scott
Posted by SLS on May 28, 2013, at 18:49:14
In reply to Risks and benefits, posted by SLS on May 28, 2013, at 18:37:50
> This was the last subject line posted that referenced content related to this thread.
What are the risks and benefits of maintaining a dialogue with recalcitrant individuals?
Successful baiting?
What is there to be gained?
As a rebuttal, perhaps statements can be made without their being directed at or soliciting a reply from a specific poster.
* Maintain the integrity of the forum by exercising your control over the subject line.
- Scott
Posted by Emme_V2 on May 28, 2013, at 21:55:07
In reply to Re: Just trying to find the right meds for me, posted by diana1981 on May 27, 2013, at 18:31:49
> Thank you Dinah and Emme
>
> The Lamictal had made me too drowsy to even stay on. Space cadet.
>
> I am just so distraught over this situation. I don't want the anger fits but on the other hand I don't want the falling asleep mid day and jaw clenching and overeating.
>
> Its very stressful.
>
> DianaHi Diana,
How high was your dose of Lamictal when you had to give it up? I wonder if you were on a higher dose than you needed to be. I'm pretty sensitive to side effects, and the strategy that my doctors have sometimes taken is to use a couple of drugs that work in concert, avoiding side effects by keeping the doses on the low side.
Obviously being to drowsy to function is a problem. If you get some mood benefit from drugs that make you very sleepy, is your doctor willing to discuss adding a speck of something like provigil to counteract that?
Then of course there's double shots at Starbucks. ;)
I've been posting enthusiastically now and then about my experiences with minocycline. It's been very helpful for me over the past 9 months or so. It feels like a clean antidepressant and took effect pretty quickly. Studies are either in progress or have been completed on its use in bipolar depression.
Anyway, those are a few thoughts. Hang in there.
emme
Posted by Phil on May 29, 2013, at 7:39:26
In reply to At a dead end- stop meds or switch., posted by Diana1981 on May 25, 2013, at 8:40:22
I found this thread on Crazy Meds. Jerod, the owner, posted the first response. Sorry if this has already been posted.
Stick with it Diana.http://www.crazymeds.us/CrazyTalk/index.php?/topic/3368-trileptal-and-mouth-problem/
Posted by Lou Pilder on May 29, 2013, at 10:55:58
In reply to Lou's reply-alcohol-effexor, posted by Lou Pilder on May 28, 2013, at 17:35:49
> > > >But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
> > >
> > > True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.
> >
> > ed,
> > On the contrary. People die from taking two drugs that can depress the cns. A few months ago, a girl died here . She took a pain pill and later before bed she had a mixed drink. She died in her sleep and the report stated it was the combination of the drug and the alcohol taken that killed her.
> > The drug Effexor is listed as having the effects exponentially magnified when another drug such as Trileptal is taken together.
> > Now Effexor by itself has the aspect of addiction/withdrawal. And the drug can increase suicidal and homicidal thinking and when in withdrawal the person could kill themselves and/or others and even commit mass-murder. If someone wants to promote a drug that could cause the taker of the drug to kill themselves, I think that it is even more appropriate to warn those people concerning combining the drug wiht another psychotropic drug that could exponentially increase the aspect of death.
> > Lou
> >
> Friends,
> Now here I a link showing what has been reported when Effexor and alcohol are combined.
> Notice the suicide attempts and the completed suicides. I think that readers here should have as amny facts as they can to make an informed decision as to tske these drugs or not.
> Lou
> http://www.ehealthme.com/drug-interactions/effexor-and-alcohol
>
> Friends,
The drug, Effexor, has the warning from the FDA that taking the drug could increase suicidal thinking. But it is much more than that for when the drug is combined with other mind-altering drugs, there can be an exponential increase in adverse events.
Here is a link showing the suicidal ideation aspect of those that take Effexor. Notice that this is a huge number, statistically that is.
Lou
http://www.ehealthme.com/ds/effexor/suicidal+ideation
Posted by Lou Pilder on May 29, 2013, at 11:37:53
In reply to Lou's reply-suicide-effexor, posted by Lou Pilder on May 29, 2013, at 10:55:58
> > > > >But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
> > > >
> > > > True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.
> > >
> > > ed,
> > > On the contrary. People die from taking two drugs that can depress the cns. A few months ago, a girl died here . She took a pain pill and later before bed she had a mixed drink. She died in her sleep and the report stated it was the combination of the drug and the alcohol taken that killed her.
> > > The drug Effexor is listed as having the effects exponentially magnified when another drug such as Trileptal is taken together.
> > > Now Effexor by itself has the aspect of addiction/withdrawal. And the drug can increase suicidal and homicidal thinking and when in withdrawal the person could kill themselves and/or others and even commit mass-murder. If someone wants to promote a drug that could cause the taker of the drug to kill themselves, I think that it is even more appropriate to warn those people concerning combining the drug wiht another psychotropic drug that could exponentially increase the aspect of death.
> > > Lou
> > >
> > Friends,
> > Now here I a link showing what has been reported when Effexor and alcohol are combined.
> > Notice the suicide attempts and the completed suicides. I think that readers here should have as amny facts as they can to make an informed decision as to tske these drugs or not.
> > Lou
> > http://www.ehealthme.com/drug-interactions/effexor-and-alcohol
> >
> > Friends,
> The drug, Effexor, has the warning from the FDA that taking the drug could increase suicidal thinking. But it is much more than that for when the drug is combined with other mind-altering drugs, there can be an exponential increase in adverse events.
> Here is a link showing the suicidal ideation aspect of those that take Effexor. Notice that this is a huge number, statistically that is.
> Lou
> http://www.ehealthme.com/ds/effexor/suicidal+ideation> Friends,
There are sites that do not permit anecdotal posts. I agree with doing that unless all anecdotal reports could be included, which could be impossible. Now just because one person says that they fell out of an airplane at 10000 feet and survived, that does not mean that you would if you took that fall. This is the potential deception of anecdotal in particular here. That is why I do not accept anecdotal posts. The ones that say that they like a drug could be the EXCEPTION, not the RULE. (emphasis mine).
And in a lot of anecdotal reports that I have read that promote a psychotropic drug, the person had taken previously other psychotropic drugs that created permanent damage already to them so that taking the drug promoted could not do any more damage to that already done. And then those people can leave out any horrors that they experienced on the drug leading people falsely to believe in only what is posted.
Here is another anecdotal report on Effexor so that readers could make a more informed decision as to drug themselves or their child in collaboration with a psychiatrist/doctor with this drug.
I want readers to have all of the facts. And for every anecdotal report here that I see that promotes a mind-altering drug that could induce the person to kill themselves and/or others, I will give you three.
Lou
http://www.dr-bob.org/babble/20010212/msgs/53878.html
>
Posted by SLS on May 29, 2013, at 11:56:10
In reply to Lou's reply-warning of anecdotal, posted by Lou Pilder on May 29, 2013, at 11:37:53
I believe the eHealthMe website relies entirely on volunteered anecdotal reports rather than prospective blinded drug trials or retrospective meta-analyses of such trials.
Oh, and I changed the subject line back to its original verbiage. I thought it better reflected the theme of the thread.
- Scott
Posted by Dr. Bob on May 29, 2013, at 17:32:16
In reply to Re: Lou's response-an apology » Lou Pilder, posted by vbs on May 28, 2013, at 11:07:36
Posted by ed_uk2010 on May 30, 2013, at 17:38:13
In reply to Lou's reply-extudhaen » ed_uk2010, posted by Lou Pilder on May 28, 2013, at 17:27:48
>On the contrary. People die from taking two drugs that can depress the CNS.
We are not talking generally, we are talking specifically about the venlafaxine + oxcarbazepine combination.
>A few months ago, a girl died here . She took a pain pill and later before bed she had a mixed drink.
We are not discussing pain pills or alcohol. These drugs have a different mechanism of action and can both cause respiratory depression in overdose.
>The drug Effexor is listed as having the effects exponentially magnified when another drug such as Trileptal is taken together.
The only drugs which exponentially magnify the effects of venlafaxine are the MAOIs, and as such this combination results in toxicity. The effects of venlafaxine are not exponentially magnified by oxcarbazepine.
Posted by Willful on May 30, 2013, at 19:21:04
In reply to Re: At a dead end- stop meds or switch. » Diana1981, posted by Phil on May 29, 2013, at 7:39:26
Hi. I"m following up about the burning sensation in your tongue, which the crazy meds physician suggested was burning tongue syndrome.
This syndrome actually exists-- and despite the silly name (can't they call it "lingua ardentis disturbens" or something?) .
I had this problem myself when I was taking cymbalta-- and it's quite uncomfortable, depending on the severity-- although I didn't notice salivating particularly. In fact salivating more usually mitigates the discomfort. However, while there are no medical treatments, what worked for me was chewing a small piece of gum or sucking on sugarless candies a lot. It actually is quite soothing, although until the syndrome dies down-- which it usually does, although it can last for quite a while-- there is often a certain amount of discomfort. I continued with the cymbalta, as it was the only thing available at the time for me.
I'm very sensitive to serotonin although I don't know if that's involved-- they really don't understand and as well as not being able to treat burning tongue syndrome--. However--if this is what you have-- it's not at all serious-- it's just uncomfortable, at least so I was told.
If you can reduce the discomfort, there's no reason you can't go ahead with a drug regimen if you need it. There are special toothpastes and chewing gums that purport to cause more salivation-- which helps--- although they didn't particularly work for me. Regular gum worked just as well-- but you could try them. (I notice that some people say certain toothpastes cause it-- but mine was definitely linked to cymbalta.)
I hope you can find meds that work-- I"m sorry about the weight gain-- which must make it hard to continue-- but maybe you can adapt and will lose some weight sooner rather than later.
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Dr. Bob is Robert Hsiung, MD,
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