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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Canadian Michele on February 9, 2000, at 11:27:42
I posted in late December regarding Gender Biased Drug trials and the resultant 'standardized' dosing that can be inappropriate for many people particularily females. Drug trials are done on a young, all MALE caucasian group.
Now 37.5mg of Effexor is considered a low dose - for whom? and by whom? well for a healthy, sturdy young man by a drug company that wants to sell product of course.I see a very progressive Psychiatrist who supports a different, some may think radical approach. AD's are started in homeopathic amounts ie., I began with 1/16th of 37.5 and progressed to my present dosage of less than 1/2 a 37.5 tablet over 30 days. I have had very marked side effects when I tried to increase the dosage before the 7 day plateau was completed. Even at this "low" dose I am not happy with the extra sleeping and flat mood.
I cannot imagine taking the massive quantities some of you site as your dosages without major problems. We must be given the option of starting these meds in a very moderate and judicious fashion especially women and drug sensitive males. I must say that I also experienced after 5 days on my 'teenie tiny' dose, a marked relief from my very deep depression. Moving to 1/2 of the 37.5 tab has only resulted in major drowsiness and emotional detachment.I recommend some rethinking on this standardized dosing. My psydoc said she has patients on different AD having very good response on minute doses over a period too long to be placebo.
This method seems to me to be the safest way to go when the side effects are so damn debilitating and dangerous.
Love, Michele
Posted by Cam W. on February 9, 2000, at 20:34:53
In reply to Effexor/Venlaxifine - Inappropriate Dosing, posted by Canadian Michele on February 9, 2000, at 11:27:42
> I posted in late December regarding Gender Biased Drug trials and the resultant 'standardized' dosing that can be inappropriate for many people particularily females. Drug trials are done on a young, all MALE caucasian group.
> Now 37.5mg of Effexor is considered a low dose - for whom? and by whom? well for a healthy, sturdy young man by a drug company that wants to sell product of course.
>
> I see a very progressive Psychiatrist who supports a different, some may think radical approach. AD's are started in homeopathic amounts ie., I began with 1/16th of 37.5 and progressed to my present dosage of less than 1/2 a 37.5 tablet over 30 days. I have had very marked side effects when I tried to increase the dosage before the 7 day plateau was completed. Even at this "low" dose I am not happy with the extra sleeping and flat mood.
> I cannot imagine taking the massive quantities some of you site as your dosages without major problems. We must be given the option of starting these meds in a very moderate and judicious fashion especially women and drug sensitive males. I must say that I also experienced after 5 days on my 'teenie tiny' dose, a marked relief from my very deep depression. Moving to 1/2 of the 37.5 tab has only resulted in major drowsiness and emotional detachment.
>
> I recommend some rethinking on this standardized dosing. My psydoc said she has patients on different AD having very good response on minute doses over a period too long to be placebo.
>
> This method seems to me to be the safest way to go when the side effects are so damn debilitating and dangerous.
>
> Love, MicheleMichele - Goodness knows that I do not want to defend drug companies, but the reason the trials are done in healthy, young men is that the researchers to not want to risk inadvertently giving a pregnant woman an unproven drug. This could, in some cases, be disasterous. Most women I have seen who take Effexor can start with a 37.5mg dose of the XR in the morning and increase (slowly) from there. One lady I know is going remarkably well on 300mg XR in the morning. She was titrated up to that dose over three months and had minimal side effects. She still does complain of mild nausea for about an hour or two after taking it (but not every time). You seem to be extremely sensitive to Effexors effects, which relates to your body's chemical make-up. I believe that starting doses for antidepressants are too high for most people, men and women. Docs should follow the
"start low & go slow" method when initiating antidepressants. You have raised a good point. Good luck with you therapy. Sincerely - Cam W.
Posted by Noa on February 9, 2000, at 21:01:57
In reply to Re: Effexor/Venlaxifine - Inappropriate Dosing, posted by Cam W. on February 9, 2000, at 20:34:53
I take 375 in the am. No nausea. (I do get a bit of queasiness from the lithium)
But some people are sensitive to it, just as I am sensitive to other things that don't bother others. I cannot seem to tolerate TCAs much, and had a terrible reaction to a small dose of amytriptaline.
I do believe in starting small and titrating gradually, tho the amounts you mention are REALLY small. I guess whatever works.
Posted by Cn. Michele on February 11, 2000, at 13:52:49
In reply to Re: Effexor/Venlaxifine - Inappropriate Dosing, posted by Noa on February 9, 2000, at 21:01:57
> I take 375 in the am. No nausea. (I do get a bit of queasiness from the lithium)
>
> But some people are sensitive to it, just as I am sensitive to other things that don't bother others. I cannot seem to tolerate TCAs much, and had a terrible reaction to a small dose of amytriptaline.
>
> I do believe in starting small and titrating gradually, tho the amounts you mention are REALLY small. I guess whatever works.Precisely my point. I don't think I am an anomaly. The dosage I take is not tiny for me - you are just comparing it to the 'standard' of 37.5mg. It is a matter of perception. Now my psychdoc has many patients doing well on smaller dosages as well as those who require larger amounts. For me the important point is the healthcare giver being aware of the issues and being willing to move outside the 'standards'.
Regarding drug trials - the pregnancy 'problem' has long been used as an excuse for not using women in drug trials. There are many ways around it ie, using women who are sterilized, post menopausal or celibate. Lots of ways around it if the motivation was there. You see the perception is that males are the 'norm' and females an aberration.
This is the end of the thread.
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