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Dr. Bob is Robert Hsiung, MD,
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Posted by JANNBEAU on December 3, 2001, at 15:35:34
In reply to Re: effexor scares me, posted by Timbuk2 on December 3, 2001, at 12:48:28
> Amen, Faith in God (or a higher power, as you understand him) does help a lot! However, I think that the thing that struck me most about this last message is the reference to a heritary predisposition to depression. As with diabetes and many other condtions, depression must be a genetic thing. Also, as with diabetes, sometimes our environment and/or our behaviors affect the expression of depression. Therefore, it is nothing to be ashamed of, just as you wouldn't be ashamed of diabetes. What you WOULD do is take your medicine and make lifestyle changes that limit the effects of your disease on your life, yes?
The other thing that struck me as being very true is that a good reason for the many negative postings is that those who take their medicine and get better often have no need to post messages. They're too busy living. I, myself, usually do not get involved. However, I found this site while looking for information on Effexor and noted the negative feedback that predominated, so I felt compelled to send some positive feedback. Ergo---
Jannbeau
Posted by sid on December 3, 2001, at 16:44:37
In reply to Re: effexor scares me » Timbuk2, posted by JANNBEAU on December 3, 2001, at 15:35:34
Thanks JANNBEAU,
I am looking for positive feedback on all this.
I've gotten rid of major depression 5 yrs ago with psychotherapy and acupuncture, but chronic depression remains. I just started taking Effexor XR and I am hoping for the best. I did not want to take drugs, but I have done all I can on my own, so I decided to try them. I am the best I've been in years, so it's weird to take meds now, but I would like not to have even chronic depression anymore. And to avoid other episodes of major depression at all cost because the mere thought of it makes me shiver.
Anyway, thanks, it gives me some hope!
Posted by JANNBEAU on December 3, 2001, at 18:15:23
In reply to Re: effexor scares me » JANNBEAU, posted by sid on December 3, 2001, at 16:44:37
> Thanks JANNBEAU,
>Sid,
Thanks for your kind response. I know what you mean by "shiver" -- How frightening!
Remember, you have a disease for which you take a medication! Remember, also, however, that the medicine is not a miracle drug. You have to work on your depression and help the medicine. The medication will make this easier, which seems a paradox, but is really true. You will still have "down" periods--that's NORMAL! and you will gradually learn what IS normal and what is pathological. However, you should be better able to pull out of the "downs" relatively more easily!
I'd like to add a couple of other thoughts and ideas for helping yourself to benefit maximally from your medication, too.
Chronic depression just seems to slowly suck the life and soul from its sufferers, who gradually slide into the pit and may not even recognize what's happening until they begin to recover-as we are both beginning to experience with Effexor--and wonder how they survived the inertia and chaos.
I think that much of what we do in any situation is just HABIT and habits CAN be changed, although with difficulty. It's just habit to withdraw, to go to sleep, to attempt escape in whatever way. With the help of the medication, you will be able to change behaviors that actually deepen your depression, isolation, avoidance, etc.
Some ways to help yourself in addition to swallowing your pills:
1) Use the technique of "thought-stopping"--just like Scarlett O'Hara did in "Gone with the Wind" --Tell yourself "I'll think about that tomorrow; Just say "STOP" to yourself when sel-defeating thoughts arise, or when anything you don't want to think about comes up, until you feel more ready to deal with it. This is a GOOD defense mechanism, and is NOT denial or avoidance behavior. Rather, it is one aspect of cognitive therapy--you've probably heard all of this from your therapist, I guess. Again the medicine HELPS you to do this.
2) Take a limited time each day (don't ruminate), or week or whatever, and DO use this time time to think about whatever is bothering you. At this time, try to pose some solutions for the problem. That's the differenc between "worrying" and problem solving! Write down your "solutions" in the form of goals and objectives. Don't make these complex!
3) Even though it may seem as if you don't have the energy to put one foot in front of the other, take heed of ANY impulse you have to do something you used to like to do, but dropped at some point--any little thing that returns your behavior to a more "normal" state. The "new" activities will gradually take the place of the old behaviors and you will find yourself doing more and more. Then you will find your attitude changing to reflect you new behaviors--you'll get your zest for life back! It's circular, just like the vicious circle of depression and anxiety. The medication will help immensely with this process!
4) REWARD YOURSELF FOR EACH STEP YOU TAKE (you don't have to spend much, or any money on this reward, as you've probably learned from your psychotherapy--we're just talking behavior modification here).5) Accomplish SOMETHING useful each day, be it ever so little--just one task each day. Make lists and check off each item, but DO NOT worry yourself if you don't finish--that's self-defeating. What you want to do is get the positive feedback from the check (star)!
6) Again, reward yourself for EACH small step forward! but don't berate yourself for backwards steps-everyone goes backwards at some points, even those who don't suffer from our ailment!
7) Try to do something nice for yourself or your loved ones each day. Start with once a week (or whatever you can manage) and MAKE yourself do it--whatever it is that you choose to do or that your family chooses. You will be amazed at how little it takes to reassure them and make them happy and you will also be amazed at how little it takes to make YOU happy.
8) (or FIRST, perhaps) Spend some time with God each day. Ask his help and blessings, not only for yourself, but for others. Enumerate your own blessings!
9) Though it may seem trite--Take time to smell the roses!
Sorry this was so long--I've learned a lot, some of which I actually use, during my protracted battle with chronic depression. I felt like sharing these thoughts with you.
God Bless and Good Luck.
Jannbeau
Posted by sid on December 3, 2001, at 18:59:29
In reply to Re: effexor scares me » sid, posted by JANNBEAU on December 3, 2001, at 18:15:23
Well, thanks again,
Yes, I've been doing many of those things and managed to stay out of major depression for 5 years. It is the chronic depression (low level, I can still function but don't feel quite right) which I'm trying to beat with meds. I am so close to being OK, but I seem to have reached a plateau. I hope the meds can help me get past that. So far, cognitive and behavioral changes have not worked to get out of the chronic depression. I am functioning, doing a lot, doing OK on a day to day basis, but scared of the next major episode if there is one, and not looking forward to the future. Making few plans, not dreaming much. That's what I'd like to fix. I want to live, not just survive on a day to day basis.
Anyway, I am hopeful about all this. I never took anti-depressant meds before, and from what I read, it means they have a higher potential of benefiting me. I hang on to that and hope for the best.
Best to you. Take care, as always !
Posted by AnneL on December 3, 2001, at 22:55:49
In reply to Re: effexor scares me » JANNBEAU, posted by sid on December 3, 2001, at 18:59:29
And to all who are there for all of us when the going gets tough, you all are an inspiration and a source of information and comfort. A special word of thanks to Sid, Jannbeau, Timbuk2, Pamela Lynn and Spencer and especially to Beezie for taking a chance and posting his/her fears and concerns about taking medication and this illness we call depression. :) AnneL
Posted by Allen F. on December 3, 2001, at 23:07:37
In reply to effexor scares me, posted by beezie on December 1, 2001, at 15:02:39
I don't like the side effects of the Medication ... or at least that's what I think is happening. I have been on anti-depresants so long that I am not sure what "normal" is anymore. What I wouldn't give to feel a "real" emotion, to cry, to laugh, to feel free.
I realize that they work well for some, and that some feel the feelings I long for, but for me I don't think they are. The ringing in my ears is driving me crazy, the loss of memory, the slowness of my cognative abilities, I miss being me. I am tired of being "tired" all the time, I want to be able to sleep without having to take something.
All medication scares me, but I think the effects on my mind have scared me the most.
Allen
Posted by sid on December 4, 2001, at 9:30:02
In reply to Re: effexor scares me, posted by Allen F. on December 3, 2001, at 23:07:37
Dear Allen F.,
that's what depression feels like too though...I've been out of major depresion for a few years now, but I do remember how it felt, and your description is darn close to it.
I don't like meds either and I minimize my taking them... my doctor is warned! But I felt I needed an extra boost as I had done all I could but chronic depression remained and I did not know what else to do but try meds.
If there is no progress in your condition you should talk with your doctor and therapist if you have one. There needs to be progress although sometimes it is slow. One thing I learned in the process: patience. It is frustrating at times, but it does take time. Do you exercise? Eat well? Depresion has a way of getting you back on track as far as healthy living goes. Do you have a therapist or a good friend you can talk to about your depression? All these things can help.
Anyway I hope you find a way to get out of the rut you seem to be in. And also patience, it does take time.
Take care.
Posted by Denise528 on December 5, 2001, at 10:13:50
In reply to Re: Anyone had success on Effexor XR? , posted by kid47 on November 8, 2001, at 15:50:33
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> Hi,To those who had success with Effexor, did you notice a slight improvement as soon as you started taking it or did you have to wait for weeks before feeling any effect at all. I am currently taking Zyprexa and Prothiaden and although I feel that the Zyprexa is helping, I don't think the prothiaden is doing anything. Am now considering Effexor.
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Posted by Pamela Lynn on December 5, 2001, at 10:40:12
In reply to Re: Anyone had success on Effexor XR? , posted by Denise528 on December 5, 2001, at 10:13:50
Denise...when I was on 150mg's of Effexor I didn't notice much. When I was raised to 225mg's the very next day I noticed, kinda, well...like a 'jolt of happy energy'. The raise in dosage helped me immensely!
P.L.
Hi,
>
> To those who had success with Effexor, did you notice a slight improvement as soon as you started taking it or did you have to wait for weeks before feeling any effect at all. I am currently taking Zyprexa and Prothiaden and although I feel that the Zyprexa is helping, I don't think the prothiaden is doing anything. Am now considering Effexor.
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Posted by Mary-Teresa on December 5, 2001, at 10:59:15
In reply to RE EFFEXOR-DID ANYONE HAVE TINNITUS SYMPTOMS, posted by Mary-Teresa on November 3, 2001, at 16:41:49
Allen, how are you doing? Have your side effects cleared up. How's the ringing in your ears?
Mary
Posted by sid on December 5, 2001, at 11:02:28
In reply to Re: Anyone had success on Effexor XR? , posted by Pamela Lynn on December 5, 2001, at 10:40:12
Hi all,
I'm using Effexor XR to try to curb my long-standing, chronic depression. My doctor put me on 1-month 37.5 mg of it, although I read everywhere that you're supposed to increase to 75 mg rapidly. Any thoughts on that? I'm seeing her in a couple of weeks and will discuss it with her of course.My sleep pattern is disturbed by it, that's the mains drawback so far (8 days on it). Although I tend to sleep too much, so sleeping less is not so bad. Some nights it's not enough though; I'll crash at some point if I don't find a way to sleep more (no other meds though - hot milk, warm bath before bed perhaps - I don't like to take meds in general).
One good thing however, already: I have more energy, feel more upbeat and my concentration is the best it's been in years. I'm writing my PhD dissertation, and these days I am making great progress. Easier than before to write a mathematical proof from beginning to end. Perhaps I just need this little of it? I don't know. I've had chronic depression all my adult life, so I'm not sure what it feels like to be OK.
Well, another good thing: loss of appetite. I eat well, I force myself to (I know what starving your body does in the long run: more weight gain !), but I've already lost 3 lbs. My depression makes me eat too much carbs and sleep too much in general, so that's a welcomed side-effect. Over the years I've turned into the little Pillsbury woman thanks to depression.
Has 37.5 mg made a difference to anyone else? I don't think it's placebo b/c after reading about the med, I did not expect anything to happen at all with such low dosage. I have not had major depression in 5 years, so I'm thinking that perhaps such low dosage is enough to give me some benefits? Probably up to 75 mg next month. I wonder why she's leaving me at 37.5 mg for so long though. Any thoughts?
Posted by Denise528 on December 5, 2001, at 11:11:40
In reply to Re: Anyone had success on Effexor XR? , posted by Pamela Lynn on December 5, 2001, at 10:40:12
>
> Thanks Pam, it's nice to read success stories. I've been really depressed since June. Thought it would be so easy, just thought I'd go back on the Seroxat and everything would be fine again. Only it hasn't worked out like that. It's been an absolute nightmare, the Seroxat made me worse instead of giving me the feeling that they used to. I've been completed devastated, anyway it's nice to know there are alot of other drugs out there, if a bit mind boggling.Denise
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Posted by spencer on December 5, 2001, at 13:24:24
In reply to Re: Anyone had success on Effexor XR? , posted by Denise528 on December 5, 2001, at 10:13:50
Denise
I definitely did not notice a difference straight away. I started on 75mg Effexor XR and then up to 150mg. Things got worse before they got better after about 5 weeks, but I did have very severe depression...actually a nervous breakdown in the old terminology. I was warned by my psychiatrist that it would take a while, so I just hung in.
The end result has been excellent although it does make me feel a bit speedy and insomnia is a problem. Nevertheless I feel great and am enjoying life to the full. Hope things work out for you.
Posted by Lorin O. on December 5, 2001, at 14:43:20
In reply to Re: withdrawal, posted by ronda on January 24, 2001, at 16:34:29
Out of desperation I actually tried a couple of Theraflu tablets last night before bed (was undergoing fairly horrible Effexor withdrawal - nausea/dizziness/and that weird "brain shiver" thing. Ugh.). Believe it or not, I woke up today feeling about 80% better! Could actually focus, sit at my desk, and get some work done. Like others, I have no idea why this works. I'm certainly not a shill for the Theraflu people. Still have some residual withdrawal feelings, but am MUCH better today.
Go figure.
Good luck to anyone else going through this. Just know there's light at the end of the tunnel.
Lorin O.
> I hope this helps everyone who is experiencing withdrawal
> because it helped me. I was one effexor for about
> 7 months and began to wean myself off of it because
> I was just too numb. No sex drive, tired, no
> emotions. Don't get me wrong, effexor made me feel
> a lot better, I just didn't like the side effects.
> Anyway, while trying to wean myself off of this
> drug, which by the way was MURDER, somehow I caught
> a cold. Anyway, you could imagine the pain I was
> going thru trying to wean myself off of this medicine
> I mean guys, I thought I was going crazy and would
> die, I took some Theraflu (nighttime formula). In
> less than 10 minutes, and I am not kidding, all of
> the dizziness, headaches, swimming of my head,
> sweatiness, went away. I didn't know what the hell
> was going on. Well, I took the theraflu and Niquil
> for about a week, and that was it. No withdrawal
> no nothing. Now, I don't know if this will work
> for you guys, but it worked for me. I don't know
> why cold medicine worked, but it did. I asked my
> doctor, and she said she didn't have an answer.
> Anyway, I thought I'd let you guys know. I know
> how withdrawal is, and I know I would have done
> anything to make it stop. If anyone tries this,
> let me know if it worked. Good luck.
>
> Ronda
Posted by Allen F. on December 5, 2001, at 15:45:02
In reply to To Allen F. re side effects, posted by Mary-Teresa on December 5, 2001, at 10:59:15
Still have the ringing in my ears and wish it would STOP! Its like a constant reminder of what I am feeling.
Some of the side effects are better, most are the same. Today is not a good day for me to answer that though. I am really frustrated with the lack of sleep and the depression that appears to be continuing. Today is not a good day.
Allen
Posted by Mary-Teresa on December 5, 2001, at 18:06:57
In reply to Re: To Allen F. re side effects, posted by Allen F. on December 5, 2001, at 15:45:02
Hi Allen, are you still taking effexor. Its highly seratonergic. I saw a neurologist about the ringing I developed from an ssri, and he suggested it could have been caused by spikes in the seratonin levels. This was also the explanation given by the manufacturer. I have been on benzodiazepams (excuse the spelling) for weeks, and today started on nortriptyline. I did find that listening to a cd of a sound that matched the tone of the ringing helped me. There are cds sold through the American Tinnitus Society that can give you some relief in that dept. I hope you feel better soon. Please keep me posted. Mary
Posted by Allen F. on December 5, 2001, at 21:28:51
In reply to Re: To Allen F. re side effects, posted by Mary-Teresa on December 5, 2001, at 18:06:57
Yes, still on Effexor but hopefully I can find something that I don't have the reactions too soon. I am confussed as to what is causing the side effects, when I talk to the Doctor (Phch) he doesn't believe that they are related to the meds.
Are you still on Effexor? Has the ringing in your ears stoped?
Posted by MB on December 6, 2001, at 12:24:13
In reply to Re: To Allen F. re side effects, posted by Allen F. on December 5, 2001, at 21:28:51
For what it's worth, my dad had horrible tinnitus on both Effexor and Paxil. Now it's better since he got off those medications. It really makes me mad when I hear stories of psychiatrists not believing patients about medication side effects. They've never had to take these drugs, and they don't know all the weird, horrible side effects that can emerge. I feel for you and am sending warm wishes your way. Best of luck to you. If you need medication, maybe an antidepressant that works a little differently would give you relief without the tinnitus?
> Yes, still on Effexor but hopefully I can find something that I don't have the reactions too soon. I am confussed as to what is causing the side effects, when I talk to the Doctor (Phch) he doesn't believe that they are related to the meds.
>
> Are you still on Effexor? Has the ringing in your ears stoped?
Posted by Mary-Teresa on December 6, 2001, at 12:31:37
In reply to Re: To Allen F. re side effects » Allen F., posted by MB on December 6, 2001, at 12:24:13
> Can you please tell me if your Dad's tinnitus went completely away after stopping the meds, and how long did that take. Mine is now a pulsating wispery noise after 12 weeks off zoloft.
Thanks
Mary
Posted by JANNBEAU on December 6, 2001, at 12:44:31
In reply to Re: To Allen F. re side effects » Allen F., posted by MB on December 6, 2001, at 12:24:13
> Irritates me, too--especially when the product insert states that a side-effect is KNOWN to the drug company. For instance, TINNITUS is listed as a side effect of Effexor!! FYI, you can get the physician's product insert from the pharmacist by asking for it. I always get these physician's inserts (NOT the "Information for patients" insert) and I READ them before I start a new medication. I also search books and internet, including Medline for DRUG INTERACTIONS.
For what it's worth, my dad had horrible tinnitus on both Effexor and Paxil. Now it's better since he got off those medications. It really makes me mad when I hear stories of psychiatrists not believing patients about medication side effects. They've never had to take these drugs, and they don't know all the weird, horrible side effects that can emerge. I feel for you and am sending warm wishes your way. Best of luck to you. If you need medication, maybe an antidepressant that works a little differently would give you relief without the tinnitus?
>
> > Yes, still on Effexor but hopefully I can find something that I don't have the reactions too soon. I am confussed as to what is causing the side effects, when I talk to the Doctor (Phch) he doesn't believe that they are related to the meds.
> >
> > Are you still on Effexor? Has the ringing in your ears stoped?
Posted by MB on December 7, 2001, at 1:52:03
In reply to Re: to MD, posted by Mary-Teresa on December 6, 2001, at 12:31:37
My dad had mild tinnitus before he started on the medication. On the medication, it became unbearable. I think his case was a case where the medicine made the tinnitus worse, but it wasn't the entire cause. Now that he is off the medicine, the ringing in his ears has gotten a lot better. I'm not sure if it has gone completely away, though.
> > Can you please tell me if your Dad's tinnitus went completely away after stopping the meds, and how long did that take. Mine is now a pulsating wispery noise after 12 weeks off zoloft.
> Thanks
> Mary
Posted by Spencer on December 7, 2001, at 3:58:38
In reply to Re: to MD » Mary-Teresa, posted by MB on December 7, 2001, at 1:52:03
I'm sorry to hear that people are suffering from bad side effects. I have had tinnitus generally in a mild form for years, but I had really bad tinnitus in the months leading up to my severe depression this August/September. The ringing noise has actually subsided a lot since I went on Effexor XR. Also, my sinus problem, in the form of a post-nasal drip, has got very much better. The tickly irritating cough I had has gone completely.
Posted by dhldn on December 8, 2001, at 11:40:37
In reply to Re: I've had success. Why won't you print that? » Noddie, posted by Leo on March 16, 2001, at 17:21:15
It is concerning that venlafaxine has a close structural similarity to tramadol (a new narcotic analgesic). There is evidence that it has analgesic effects that are blocked by naloxone; that suggests it may be acting partly as an opioid drug.
It seems that venlafaxine may be particularly prone to interact with MAOIs and thus be implicated in fatal serotonin syndrome reactions.
Venlafaxine, when used in larger doses of over ~150 mg, may cause hypertension in some people, another problem that requires monitoring and may debar its use in some patients.
What the place of venlafaxine should be at lower doses (ie up to ~150 mg) in primary care is hard to judge. It shares the low interaction propensity (via CYP450) of sertraline and citalopram; but at lower doses probably has no particular advantages and is much more toxic in over-dose than any of the SSRIs or even than some of the old tricyclic antidepressants.
It behoves us all to be especially cautious about drugs when there is uncertainty over the mechanism of their action. Venlafaxine's toxicity in over-dose and its similarities to the narcotic analgesic 'tramadol' warrant close monitoring and caution.
My evaluation of the current evidence is that venlafaxine should be used sparingly in primary care settings with care and due recognition of the uncertainties surrounding it; wether it will prove suitable as a treatment for generalised anxiety disorder may become a contentious issue.
History repeatedly demonstrates that new is not always better. History is repeatedly ignored.
The FDA have now officially amended the product information on venlafaxine (2000) as follows:--Discontinuation symptoms have been systematically evaluated in patients taking venlafaxine.... Abrupt discontinuation or dose reduction... is associated with the appearance of new symptoms, the frequency of which is increased at higher doses and with longer duration of treatment.
Reported symptoms:--
agitation, anorexia, anxiety, confusion, coordination impaired, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting.
It is therefore recommended that the dosage of Effexor be tapered gradually and the patient monitored. The period required for tapering may depend on the dose, duration of therapy and the individual patient.Subscribe to 'Psychopharmacology update notes' to see a fuller analysis and references.
Dr Ken Gillman MRC PsychPsychoTropical Research
Posted by Elizabeth on December 8, 2001, at 19:57:05
In reply to Effexor an opiate?, posted by dhldn on December 8, 2001, at 11:40:37
> It is concerning that venlafaxine has a close structural similarity to tramadol (a new narcotic analgesic). There is evidence that it has analgesic effects that are blocked by naloxone; that suggests it may be acting partly as an opioid drug.
That would be interesting, although I'm sure that Wyeth-Ayerst would do their best to keep it quiet.
> It seems that venlafaxine may be particularly prone to interact with MAOIs and thus be implicated in fatal serotonin syndrome reactions.
No more than any of the other serotonin reuptake inhibitors.
> ...is much more toxic in over-dose than any of the SSRIs or even than some of the old tricyclic antidepressants.
More than some of the TCAs? That's a bit of a surprise.
> History repeatedly demonstrates that new is not always better. History is repeatedly ignored.
In the (admittedly brief) history of pharmaceuticals, it seems to have been the case, mostly, that newer drugs have had *less* effect than their predecessors.
-elizabeth
Posted by Cloud 9 on December 10, 2001, at 5:51:55
In reply to Effexor an opiate?, posted by dhldn on December 8, 2001, at 11:40:37
>Venlafaxine, when used in larger doses of over ~150 mg, may cause hypertension in some people, another problem that requires monitoring and may debar its use in some patients.
>What the place of venlafaxine should be at lower doses (ie up to ~150 mg) in primary care is hard to judge. It shares the low interaction propensity (via CYP450) of sertraline and citalopram; but at lower doses probably has no particular advantages and is much more toxic in over-dose than any of the SSRIs or even than some of the old tricyclic antidepressants.
Just a few questions regarding your entry...
Does this mean at a low dosage it is inferior OR equal to other SSRI's in efficacy? If it's a potentially toxic drug is it possible to over-dose at such a low dosage? What are the advantages of taking effexor at high doses ( >150mg)? Would you recommend another SSRI in lieu of Effexor for GAD?
Thanks for your help.
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