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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 jackt on December 19, 2002, at 15:25:46
I posted this on the 17th with hopes that you would read and comment. In case you missed it, I reposted the message with a few modifications.
Larry and anyone else who wants to comment,I suffer from severe GAD and possibly mild ADD. I would like to know your theory on why Effexor would work for anxiety.
I think I read that the down regulation of serotonin (S)and norepinephrine (N) could be the action that makes it work. Of course we know that Effexor is a SSRI and SNRI ... but one theory is that once an individual has extra S and N floating around in your brain that you will tend to produce less of it. Therefore, taking Effexor over time would actually reduce S and N in your brain.
My mind is always in a "fight or flight" mode. Extra N would only increase the anxiety rather than reduce it, right? Maybe the brain goes through a stage of increased N before it is decreased. Effexor in the less than 4 week stage makes me more anxious. I think the extra N is causing the increased anxiety.
I've tried Effexor about 7 years ago, but I probably only stayed on it for 4 weeks. Maybe I didn't give it enough time.
Bottom line is maybe it will take a while for the brain to adapt and ultimately reduce the production of N and possibly S to alleviate the anxiety. Is this a valid assumption, or am I way off?
If I am wrong, what does "down regulation" really mean and why would Effexor work for anxiety?
Thanks in advance for your responses.
Jack T.
Posted by Larry Hoover on December 20, 2002, at 16:04:04
In reply to Larry Hoover: I'd like your opinion, posted by jackt on December 19, 2002, at 15:25:46
I'm uncomfortable with the idea of mechanisms, in general. What we don't know about how psychoactive medication works far, far exceeds what we do know. And, add in the unknown and unknowable genetic differences that make each of us unique, and I'm left just shrugging my shoulders.
If you take a medication that is supposed to treat your anxiety and it makes you more anxious, that is way more important than any rationale I could possibly offer you. Because, in the end, the only way to know what works is to try different things. It doesn't seem like Effexor is a good match with your body.
Posted by JackT on December 21, 2002, at 10:22:04
In reply to Re: Larry Hoover: I'd like your opinion » jackt, posted by Larry Hoover on December 20, 2002, at 16:04:04
Larry, thanks for the feedback. Effexor does make me more anxious, but I'm only in week 3 of the medication. My overall question is: would I expect the anxiety to decrease after 4 - 6 weeks?
I can feel the Effexor right after I take it. I feels like I have taken too much Ritalin or caffeine. It is a more of a physical anxiety. I suppose this is because of the increased norepinephrine.
Do you have an atypical anxiolytics that you could recommend? My list of unsuccessful drugs: remeron, serzone, depakote, benzos, buspar, prozac, and celexa.
If there were some sort of drug that blocks the production of norepinephrine or somehow interferes with the adrenalin chemisty, I'd give it a try. Thanks.
Posted by Larry Hoover on December 23, 2002, at 9:39:26
In reply to Re: Larry Hoover: I'd like your opinion » Larry Hoover, posted by JackT on December 21, 2002, at 10:22:04
> Larry, thanks for the feedback. Effexor does make me more anxious, but I'm only in week 3 of the medication. My overall question is: would I expect the anxiety to decrease after 4 - 6 weeks?
I couldn't predict anything.
> I can feel the Effexor right after I take it. I feels like I have taken too much Ritalin or caffeine. It is a more of a physical anxiety. I suppose this is because of the increased norepinephrine.
If I'm not mistaken, effexor has very broad activity, when compared to other reuptake inhibitors.
> Do you have an atypical anxiolytics that you could recommend? My list of unsuccessful drugs: remeron, serzone, depakote, benzos, buspar, prozac, and celexa.
>
> If there were some sort of drug that blocks the production of norepinephrine or somehow interferes with the adrenalin chemisty, I'd give it a try. Thanks.Ordinarily, I would have recommended Remeron, but you've already tried that. Have you considered a TCA? Some people find them to be calming/sedating.
With respect to adrenal chemistry, ginkgo reduces cortisol levels in the blood.
This is the end of the thread.
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