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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Janelle on October 9, 2001, at 23:03:34
Okay, for the first few days after I completely tapered off EffexorXR, I experienced that *electric head* feeling (which didn't surprise nor alarm me; I almost *expected* it!) ... then it was gone for about 2 1/2 weeks so I figured I was home free. Well, now it has returned (not frequent, but definitely happening a few times during each day).
My question is this - aside from being a withdrawal effect immediately after stopping an SSRI a-d, can the return of *electric head* mean that I'm not getting enough serotonin in the synapses and therefore this is a sign that I should be back on an SSRI a-d.
I'm feeling reeeeeeeal cruddy in general so I'm about to go back on Paxil, but I can't help wondering if the return of *electric head* is some kind of signal that an SSRI a-d is needed?
Thanks for any info, comments, etc.
-Janelle
Posted by SLS on October 10, 2001, at 0:16:27
In reply to Question about *Electric Head* ..., posted by Janelle on October 9, 2001, at 23:03:34
> Okay, for the first few days after I completely tapered off EffexorXR, I experienced that *electric head* feeling (which didn't surprise nor alarm me; I almost *expected* it!) ... then it was gone for about 2 1/2 weeks so I figured I was home free. Well, now it has returned (not frequent, but definitely happening a few times during each day).
>
> My question is this - aside from being a withdrawal effect immediately after stopping an SSRI a-d, can the return of *electric head* mean that I'm not getting enough serotonin in the synapses and therefore this is a sign that I should be back on an SSRI a-d.
>
> I'm feeling reeeeeeeal cruddy in general so I'm about to go back on Paxil, but I can't help wondering if the return of *electric head* is some kind of signal that an SSRI a-d is needed?
>
> Thanks for any info, comments, etc.
> -Janelle
Dear Janelle,You have asked very intelligent questions. I have no intelligent answers to them. Perhaps someone else does. In the meantime, I don't think it makes sense to theorize as to what physiological processes are at work to produce the "shock" phenomenon and how their appearance might be indicative of desease state or predictive of effective treatment.
It might not be a terribly popular idea amongst us who suffer from affective, anxiety, obsessive, or schizoid disorders, that neuroscience has not yet reached the point of understanding them in the way we naive laymen would believe ourselves to. There has been no demonstration that depression is the result of abnormally low concentrations of serotonin in the neural synapse. Any theory or explanation that relies on this premise is bound to be unworkable. It can neither explain what causes mental illness nor forecast how it will be cured.
It is my advice to you not to take too seriously posts that purport as fact explanations of how things work.
You could be right, though. Perhaps a latent return of "electric head" is indicative of a need for continued treatment with a serotonin reuptake inhibitor. However, it is perhaps better to look to your case history for answers. If your depressions have been recurrent and progressively more severe or difficult to treat, a case can be made for continuing treatment indefinitely. I would at least consider continuing treatment for 12 - 18 months beyond the point that maximum response is first attained.
Why did you decide to discontinue Effexor anyway?
- Scott
Posted by Janelle on October 10, 2001, at 17:07:10
In reply to Re: Question about *Electric Head* ..., posted by SLS on October 10, 2001, at 0:16:27
Why did I discontinue EffexorXR - it was not working right for me and giving me persistent, undesirable side effects.
I titrated up to 150 mg/day, but was bouncing off the walls even before I reached that dosage level (feeling jittery, edgy, overcaffeinated, lightheaded, rubbery legs). It was so bad at 150mg that I called the pdoc that day and she had me cut back to 75mg/day.
The overstimulation went away, but I was foggyheaded and numbed out. The only reason the doc continued me on EffexorXR 75 mg was to hold that med constant while having me increase the Lamictal. If I had done BOTH tapering off Effexor and increasing Lamictal simultaneously, we'd have had no way of knowing which was having what kind of effect on me.
So, I rode it out for about 4 weeks on 75mg/day of Effexor, while titrating up to 100mg of Lamictal. The next step was to get off the Effexor, then start increasing the Lamictal a bit.
This is the end of the thread.
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