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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by willow on March 7, 2001, at 23:17:44
I'm curious of what other AD's you had been prescribed before the effexor. My reason for asking is that Ralph posted above saying that his doctor is refusing to prescribe it anymore. I do agree that maybe it shouldn't be a first line AD used for everyone. For myself all other AD's had made my symptoms worse. And the funny thing is everything that is being described as withdrawal symptoms is what I've lived with for the past five years, and the effexor has helped. My fear is that it can be withdrawn from the market. Is this a reality???
Trembling Willow
Posted by sar on March 8, 2001, at 2:29:14
In reply to If you have ever used Effexor ..., posted by willow on March 7, 2001, at 23:17:44
I was prescribed Paxil last summer--tried it for a week and hated it. (I was also given free samples of BusPar but never tried it.)
How many mg Effexor are you on?
peace,
sar
Posted by Cam W. on March 8, 2001, at 7:04:30
In reply to If you have ever used Effexor ..., posted by willow on March 7, 2001, at 23:17:44
Willow - I sincerely doubt that Effexor will be withdrawn from the market. I am not sure that the company is aware of the extent of the backlash against it. You can still find psychiatrists (but mainly GPs; who BTW, treat a majority of depressions) who still do not know of that the Effexor's short half-life is causing problems (in a majority of people, it is not - really).
There is a problem with withdrawl symptoms only if the withdrawl is not handled properly. It is up to the drug company (Wyeth-Ayerst) to launch an education campaign for the physicians (and possibly the patients, as well), on how to watch for and treat serotonin withdrawl. Effexor withdrawl symptoms are far less severe, less dangerous and less common than withdrawl from long term use of a short acting benzodiazepine (eg Xanax™ - alprazolam), especially when Xanax is used at higher doses. MAOIs and TCAs are far more toxic and potentially lethal, with far more side effects, than Effexor.
While real, the Effexor withdrawl phenonmenon has blown out of proportion on the internet, with websites being created to feed the frenzy. I would like to see a study done that actually determines the true extent Effexor withdrawl; 1) separated from rebound bouts of depressive symptoms and depressive disorder; 2) psychosomatic symptoms; 3) primary depressive symptoms that never abated but some of the symptoms were masked by the secondary side effects of Effexor, 4) scapegoat-finding instead of working on the real issues behind the depression; 5) copycat withdrawers; 6) etc.
Don't get me wrong, serotonergic withdrawl is a real phenomenon, but is no where near as dangerous as withdrawl from the long term use of benzodiazepines, opiates, amphetamines, nor cocaine. In this sense, Effexor is not addictive, does not cause drug-seeking behavior, and does not produce dependence (outside of the case of any antidepressant causing a syndrome a person worrying that they will not be able to function without the antidepressant, which is a different syndrome altogether). There have not been, to my knowledge, any deaths directly related to the serotonergic withdrawl effects of Effexor (to severe serotonin syndrome, yes there have, but this is different).
Most people who do post on the serotonergic withdrawl symptoms do so within the first week of removal of the offending antidepressant (be it Effexor, Paxil, Zoloft, or Luvox). Why especially with Effexor? It has a shorter half-life than any of the other agents AND it is being used very extensively, at the moment. With the efficacy and widespread use of Effexor, it is not going to be taken off the market any time soon.
Willow - I'd have liked to have e-mailed you directly on this because I am sure a backlash will ensue (which is not my intention). If emotion could be left out of the discussion of Effexor withdrawl, perhaps we could arrive at a consensus of the best ways to monitor for and treat this phenonmenon. Perhaps we could find a way to get the word out to Wyeth-Ayerst and the media about the need for public awareness of serotonin syndrome, so that it will not take people by surprize. Perhaps Wyeth-Ayerst should begin a physician education campaign.
Effexor is too valuable a medication to be removed from the market. Until the next generation of mood-modifiers/HPA stabilizers hits the market, antidepressants (and ECT) are really the only treatments we can offer to augment the psychotherapies (esp CBT & IP) in treating major depressive disorder (and some other mood disorders).
Sincerely - Cam
Posted by Noa on March 8, 2001, at 15:21:15
In reply to Re: If you have ever used Effexor ... » willow, posted by Cam W. on March 8, 2001, at 7:04:30
I agree with Cam. This medication has helped me. And it can help others, but it is important that it be used properly and with knowledge about proper dosing, and how to wean off of it if to be discontinued. It would be extremely unfortunate, imho, if it got a bad rap altogether just because people werent' prepared with the right information about how to use it effectively.
BTW, I tried Prozac, Paxil and Wellbutrin before Effexor. Prozac worked but the first time I was on it was only for about a year. Then, when I tried again, it kept pooping out and I couldn't tolerate higher doses. Same with Paxil. Wellbutrin immediately caused headaches and tinnitus for me. Effexor got a good response for me in a short time.
It isn't perfect, there are side effects to deal with and manage, and I ended up augmenting it with other meds for that reason when it became clear that I had a maximum dose that I could tolerate, but it did give the AD effect I desparately needed.
I hope it doesn't get demonized. It would be a total shame.
Posted by willow on March 8, 2001, at 17:24:06
In reply to Re: If you have ever used Effexor ... » willow, posted by Cam W. on March 8, 2001, at 7:04:30
"You can still find psychiatrists (but mainly GPs; who BTW, treat a majority of depressions) who still do not know of that the Effexor's short half-life is causing problems (in a majority of people, it is not - really).
There is a problem with withdrawl symptoms only if the withdrawl is not handled properly. It is up to the drug company (Wyeth-Ayerst) to launch an education campaign for the physicians (and possibly the patients, as well), on how to watch for and treat serotonin withdrawl."I was prescirbed effexor by my family doctor. After starting to read some of the threads concerning this medication I thought I would ask the doctor about it. He seemed knowledgable about the drawbacks of the medication but didn't seem concerned. He had orginally given me a sample which I presume he had recieved from a rep of Wyeth-Ayerst. Inside the samples were pamphlets with information regarding the medication, and I'm presuming the doctor must get a more detailed one.
"I would like to see a study done that actually determines the true extent Effexor withdrawl;"
Effexor was the first AD to list heart palipations as a side. I've had this and other side effects with other ADs. The doctors just disregarded them and said that I had anxiety about taking medications. I think we still have a lot to learn about how drugs interact with differnt people.
Regarding not wanting to post something that may have truth to it but people don't want to hear it, they always have the option of closing the window until they're ready to listen. I think the truth though even it can bring pain with it is a lot more helpful in the long wrong.
"... it is being used very extensively, at the moment."
Why is it being prescribed so much? Should it only be used after other medications have failed? I wonder if I would have tolerated the first three months if I had to go to work every day or function at home without support, and this was with increasing the dosage by 37.5mg every three to four weeks. Plus, knowing that the side-effects for myself weren't as bad as the other ADs I had used.
"With the efficacy and widespread use of Effexor, it is not going to be taken off the market any time soon."
This I am glad to hear!
"If emotion could be left out of the discussion of Effexor withdrawl, perhaps we could arrive at a consensus of the best ways to monitor for and treat this phenonmenon."
Myself having a somatisation disorder, I don't believe that we can ever seperate the emotional component from the physical. : ) I think this logic is showing your scientific background.
"the need for public awareness of serotonin syndrome, so that it will not take people by surprize. Perhaps Wyeth-Ayerst should begin a physician education campaign."
I'm not familar with serotonin syndrome, but will look it up for something to do.
"Effexor is too valuable a medication to be removed from the market."
I concur! But is there any reason I couldn't take this medication indefinitively?
Cam thanks so much again for your reassurance and taking the time to share your knowledge.
Willow
Posted by willow on March 8, 2001, at 17:42:29
In reply to Re: If you have ever used Effexor ..., posted by Noa on March 8, 2001, at 15:21:15
"It isn't perfect, there are side effects to deal with and manage, and I ended up augmenting it with other meds ..."
Noa you are so right. Luckily for me the effexor is making me feel normal, but I've had to use baclofen almost continuously because of muscle pain and the jumping at night and added domperidone to help with my digestion. (Good grief I'm starting to be like my grandmother, taking pills so I can take my pills.) Have you ever heard of the effexor loosing its effect?
"I was prescribed Paxil last summer--tried it for a week and hated it."
Sar - How long have you been on the effexor? I'm taking 75mg twice a day. (PS I like your name!)
Willow
Posted by ralph s. on March 9, 2001, at 8:31:03
In reply to Effexor's future ..., posted by willow on March 8, 2001, at 17:24:06
I took effexor for only 6 months to help with some depression I went through in the Fall. My therapist could not believe my regular doctor prescribed this strong of a medication for a depression like I had. She said the side effects were awful. I would rather live with the depressed feelings I had rather than subject myself to the feelings I had going off effexor. It was a 4 week nightmare. I felt like a druggie trying to kick the habit. I feel it is very dangerous and needs to be looked into very seriously.
Posted by willow on March 9, 2001, at 20:43:43
In reply to Re: Effexor's future ..., posted by ralph s. on March 9, 2001, at 8:31:03
Ralph
Had you tried other ADs before the effexor? My thinking is maybe it shouldn't be the first AS prescribed for someone. How long did it take you to taper off the effexor?
Thanks
Willow
Posted by krista on June 11, 2001, at 21:24:30
In reply to Re: If you have ever used Effexor ... » willow, posted by Cam W. on March 8, 2001, at 7:04:30
I had to actually go to the emergecy room from withdrawl from Luvox and I went off real slowly. It lasted 4 months. I don't think a herion addict could feel much worse. They had to give me fluids and my body temperature was almost 96 degrees.
krista
Posted by mi5fit on March 24, 2003, at 13:08:30
In reply to Effexor's future ..., posted by willow on March 8, 2001, at 17:24:06
Interestingly enough I'm currently suffering symptoms of withdrawl from Effexor. I've been on other drugs, to include Paxil, and have experienced withdrawl, so this isn't exactly something new to me. However, I've been experiencing heart palpitations DAILY for the past week, the start of which would be the beginning of 4 weeks off of Effexor. Apart from the palpitations though, I've experienced nothing unusual. And I must add, MY DOCTOR WARNED ME OF WITHDRAWAL SYMPTOMS if I went cold turkery vs. stepping down.
Posted by Sean9 on March 24, 2003, at 15:26:06
In reply to Re: Effexor's future ..., posted by mi5fit on March 24, 2003, at 13:08:30
I agree Effexor is effective in treating depression and I’m sure it will stay on the market. I also understand how some people have taken Effexor and quit and never experience a withdrawal symptom they would deem abnormal or excessive.
But the fact is, there are many people out there that have experience what they call severe withdrawal symptoms from quitting this drug (even when they wean off). And when it comes down to it, these are the people that need help and information.
This issue is about informed consent and degrees of risk associated with taking drugs. Do the manufacturer of Effexor and the medical community effectively communicate the range and depth of withdrawal symptoms an average person will experience from quitting this drug?
Apparently not, given the fact that so many people are reporting what they consider to be inappropriate levels of physical pain in association with the withdrawal of Effexor. And the fact that many people report the same withdrawal symptoms, even without reading about them in advance, points to the fact that this is more than just mass hypnosis or coincidence. Over 1500 people have signed a petition in support of the above sentiment. How many more voices are there out there that have not even been heard yet?
So in the interest of the free speech we all love so much, here's my two cents worth:
I’ve done some research on the subject, and can offer opinion but not legal or medical advice on how to quit Effexor if you want to quit. Effexor is effective in treating depression, but it is very, very, very difficult to stop taking. I don’t think the makers of Effexor or the medical community have even begun to make this degree of risk of painful withdrawal apparent to the average consumer. So here’s how to quit:
First point: Don't quit cold turkey, make a tapering off plan with your doctor.
Second point: Take Benadryl to relieve your withdrawal / discontinuation symptoms. It apparently gets rid of most dizziness, nausea, brain flashes, and sensory overload feelings within an hour of taking it. I do not know if this is recommended by the medical community, rather I heard about this cure on a newsgroup. I've also read that other antihistamines (like Allegra), doctor prescribed anti-vertigo medication, and low dosages of doctor prescribed Prozac all help with withdrawal symptoms of Effexor.
Third: Effexor is really dangerous. In researching the Internet, a lot of people experience the exact same withdrawal or discontinuation symptoms and these are severe, but no one was fully informed in advance.
Fourth: There is something you can do. File a report with the FDA. They regulate Effexor (which is made by Wyeth Laboratories Inc. in Philadelphia.). Help the next generation of Effexor users to be better informed by doctors and the manufacturer. You can submit a complaint to the FDA online at https://www.accessdata.fda.gov/scripts/medwatch/
The more people that report this problem, the better response we will get. You can also call in your complaint to an FDA state office (here are each state’s telephone number)
http://www.fda.gov/opacom/backgrounders/complain.html
You can also sign the petition: http://www.petitiononline.com/effexor/petition.html
Finally: Note - This is not medical or legal advice, it is only my opinion based on experience and research. I do not take Effexor, but I know someone who does, and they were not fully informed how seriously difficult it would be to stop (even through slow tapering off).
This is the end of the thread.
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