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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Dr. Bob on April 1, 2003, at 22:58:34
[Posted by Ssunflower on April 1, 2003, at 12:46:54]
> Hi...I just started effexor a week ago and am not too familiar with it as my Dr. did not go into much detail. He told me to take 37.5 mgs for a week and if I did not feel better to keep increasing it each week but yet others tell me that it can take up to six weeks to notice changes...not a week. My Dr. was not very informative at all and I am venturing to find a new one. Could you please enlighten me as to the pros and cons of this med. I've stuggled with depression off and on for years and this is the 6th med that I am trying. I went without meds for years because I did not feel taking pills was the answer. I was totally relying on my faith but then I got worse so I had to go on something! Anyone else feel the same? Thank's in advance for your advice. God Bless...Ssunflower
Posted by Janelle on April 1, 2003, at 23:49:15
In reply to New to Effexor XR « Ssunflower, posted by Dr. Bob on April 1, 2003, at 22:58:34
I think I can explain why you need to give EffexorXR a long time in gradually increased doses to see if it will work. I'll get to that in a minute, but I also want to say I have experience with it, but it's bad and I don't want to sway you with that.
Okay, here's how EffexorXR works, you have to be at least at 75mg/day for it to hit Serotonin receptors, then 150mg/day it hits Serotonin AND Norepinephrine, then 225mg/day it hits Serotonin, Norepinephrine and Dopamine. I think these are the dose levels. I know that as you GRADUALLY increase EffexorXR, it WILL hit all three key receptors. That is why it is not an SSRI, but an SRI. It's a tricky one vs. some of the "purer" ones like Celexa and Lexapro, which are more narrowly targeted just at Serotonin.
So, it could take many weeks for you to get up to a dose of EffexorXR that is hitting the particular receptors you need. For example, if you need Dopamine hit, it will take a long time to get up high enough on EffexorXR for it to affect Dopamine.
Also, a word of warning - at 300+mg/day of EffexorXR you have to watch for high blood pressure.
I hope this is of help. Anyone reading this who can correct anything inaccurate, please do so!
Good luck. Give the EffexorXR some time in gradual increments of higher doses.
Posted by T_R_D on April 2, 2003, at 10:00:26
In reply to New to Effexor XR « Ssunflower, posted by Dr. Bob on April 1, 2003, at 22:58:34
> [Posted by Ssunflower on April 1, 2003, at 12:46:54]
>
> > Hi...I just started effexor a week ago and am not too familiar with it as my Dr. did not go into much detail. He told me to take 37.5 mgs for a week and if I did not feel better to keep increasing it each week but yet others tell me that it can take up to six weeks to notice changes...not a week. My Dr. was not very informative at all and I am venturing to find a new one. Could you please enlighten me as to the pros and cons of this med. I've stuggled with depression off and on for years and this is the 6th med that I am trying. I went without meds for years because I did not feel taking pills was the answer. I was totally relying on my faith but then I got worse so I had to go on something! Anyone else feel the same? Thank's in advance for your advice. God Bless...Ssunflower
>
>Hi Ssunflower, I was on Effexor for 4 years (but am in the process switching to something new.) One other reason you need to increased the dosages slowly are because of possible side effects. Unfortunately, anti-depressants can make you feel rather ill until they reach a therapeutic dose where they actually start doing some good. If you jumped right in at therapeutic minimum you might have side effects so severe you'd want to just forget the drug altogether...it could be intolerable!
Effexor is a good drug. It worked well for me for those years. I chose to stop taking it because either the drug or some breakthrough depression managed to crop up and cause some complications in my life. It's still an option for me if nothing else will work...I think I would go back on it.
Another key thing to remember is that our depressions and our body chemistries are all different. What might work for someone may not work for you. One person may find the side effects do not go away or are severe, one person may stay on the drug forever because it works so well. I know it's hard but it is SO important to have patience. I have something called Treatment Resistant Depression (hence my nickname on the board) and often suffer from breakthrough episodes. As a result, I was on 375mg of Effexor a day plus taking a thyroid drug to "boost" the anti-depressant. It got a little crazy at times but once I made some allowances everything went smoothly.
I'm not sure what more I should add. Oh yes, if you're feling uncomfortable with your doc', by all means, find someone else! A trusting relationship is so necessary when you're being treated for deression.
Good luck and keep us "post"ed!
Karen
Posted by mmcasey on April 2, 2003, at 10:01:52
In reply to New to Effexor XR « Ssunflower, posted by Dr. Bob on April 1, 2003, at 22:58:34
Hi. I took Effexor for about 4 months - went all the way up to 300mg by gradual dose increases.
I've been off of it for a few weeks now. I never really noticed any positive effects from the drug, but
as I'm sure you know, everyone is different. The worst side effects I had
were mainly night sweating and also lightheadedness. I actually fainted once when I stood up.
I lost about 5 pounds, which I liked. My sister has taken Effexor for about 7 months,
and she found it to be somewhat more effective than me at a lower dose. However, she
also had problems with feeling like it made her sort of manic at higher doses (she takes it for anxiety).
Anyways, that's my experience with the drug. Good luck, I hope that it helps you!
Posted by Caleb462 on April 2, 2003, at 23:27:41
In reply to Re: New to Effexor XR « Ssunflower » Dr. Bob, posted by Janelle on April 1, 2003, at 23:49:15
> I think I can explain why you need to give EffexorXR a long time in gradually increased doses to see if it will work. I'll get to that in a minute, but I also want to say I have experience with it, but it's bad and I don't want to sway you with that.
>
> Okay, here's how EffexorXR works, you have to be at least at 75mg/day for it to hit Serotonin receptors, then 150mg/day it hits Serotonin AND Norepinephrine, then 225mg/day it hits Serotonin, Norepinephrine and Dopamine. I think these are the dose levels. I know that as you GRADUALLY increase EffexorXR, it WILL hit all three key receptors. That is why it is not an SSRI, but an SRI. It's a tricky one vs. some of the "purer" ones like Celexa and Lexapro, which are more narrowly targeted just at Serotonin.
>
> So, it could take many weeks for you to get up to a dose of EffexorXR that is hitting the particular receptors you need. For example, if you need Dopamine hit, it will take a long time to get up high enough on EffexorXR for it to affect Dopamine.
>
> Also, a word of warning - at 300+mg/day of EffexorXR you have to watch for high blood pressure.
>
> I hope this is of help. Anyone reading this who can correct anything inaccurate, please do so!
>
> Good luck. Give the EffexorXR some time in gradual increments of higher doses.
Effexor is a very weak inhibitor of dopamine reuptake, and 225mg would likely have no noticeable effect on dopamine.
Posted by Dr. Bob on April 5, 2003, at 9:36:37
In reply to New to Effexor XR « Ssunflower, posted by Dr. Bob on April 1, 2003, at 22:58:34
[Posted by meds on April 5, 2003, at 1:20:09]
> I too have been on anti meds for years now...I have taken several, it seems after a few years they dont work. so now i am trying effexor and alot of prayer. i have to wonder if i will be this way the rest of my life.
This is the end of the thread.
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