![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5986 to 6010 of 10407. Go back in thread:
Posted by maxx44 on January 3, 2004, at 19:36:51
In reply to re: atypical NMS, posted by Larry Hoover on January 3, 2004, at 18:37:58
see xxx or the 1st google page on NMS---rate of NMS =.2-2.2%--u of p is just one bit. there are many. i learned a lot from your post---re: muscle/bone damage, which searching led to atypicals and 'slow NMS'--exactly what got me. yet you have said 'zip' on ANMS. and if 'trials or stats' reveal up to 2.2% mortality in some NMS stats, i feel it reasonable that the actual number is higher. why did you quote the lowest figure possible? i've seen one reference to a teen with risperdal induced NMS and the accompyning statement indicateing a 7% rate of onset for teens. who would script risperdal for what ritalin was 'safely-used-for'? now known as lethal in significant numbers? a dr. the tech aspects of your response deserve a separate post. later--'playoffs, you know. the bucs may be dead, this year, so now i root for the panthers. best wishes
Posted by Larry Hoover on January 3, 2004, at 19:56:56
In reply to re: atypical NMS, posted by maxx44 on January 3, 2004, at 18:22:42
>furthermore, you address NMS, not ANMS---
There is not one single reference to atypical neuroleptic malignant syndrome on Pubmed/Medline. Forgive me for failing to find evidence for something that has not been published under peer review criteria.
I stand by my incidence statistics for NMS.
I am sorry you went through what you did.
Lar
Posted by maxx44 on January 3, 2004, at 20:11:53
In reply to re: atypical NMS » maxx44, posted by Larry Hoover on January 3, 2004, at 19:56:56
appeciation accepted---now keep searching---you have hardly exhausted your resources--you want truth or patronization?
Posted by Larry Hoover on January 3, 2004, at 20:35:28
In reply to re: atypical NMS, posted by maxx44 on January 3, 2004, at 19:36:51
why did you quote the lowest figure possible?
I didn't. I quoted one midspectrum, with a large N size. I tend to ignore outlier stats, or those based on small samples. I am a professional scientist, and I am using my scientific judgment. I originally quoted a median value.
I supplied a reference with a larger N, and a lower incidence, of 0.02%. (19 cases out of 78,708), but that is lower than the more typical figure.
Each reference with higher incidence had much much smaller N, some as few as 7 subjects.
Lar
Here's another with large sample, small incidence.
Can J Clin Pharmacol. 2003 Fall;10(3):111-3.
Neuroleptic malignant syndrome in Mexico.
Montoya A, Ocampo M, Torres-Ruiz A.
Brain Imaging Group, Douglas Hospital Research Centre, McGill University, 6875 Boulevard LaSalle, Verdun, Quebec H4H 1R3, Canada. alonzo.montoya@douglas.mcgill.ca
BACKGROUND: Neuroleptic Malignant Syndrome (NMS) is an uncommon but potentially fatal complication of antipsychotic and neuroleptic drug treatment. OBJECTIVES: This study estimated the frequency, clinical presentation, and outcome of NMS in a referral center for neurological, neurosurgical and psychiatric disorders in Mexico. METHODS: The authors conducted a thorough search of psychiatry, neurology, neurosurgery and intensive care unit records for cases of NMS during the 10-year period between 1990 and 1999. They examined the clinical features, course and treatment of the NMS episodes, and performed a follow-up survey for residual symptoms and clinical outcome. The mean time to follow-up assessment was 36 months. RESULTS: A total of eight of 4831 neuroleptic-treated patients had an episode of NMS (incidence 0.165%). Seven of the eight patients were treated with haloperidol. Other neuroleptics agents associated with NMS were depot pipotiazine palmitate and levomepromazine maleate. One patient received lithium concomitantly. No fatal outcome was found. Only one patient developed persistent clinical sequelae, consisting of extrapyramidal and cerebellar symptoms, three years after the NMS episode. CONCLUSIONS: The slightly low frequency of NMS found in this study compared with studies conducted in other countries may be attributable to the advent and use of newer atypical antipsychotics in Mexico, the rigorous demands for NMS diagnostic criteria and the lack of familiarity with the diagnosis between physicians.
Posted by maxx44 on January 3, 2004, at 20:49:28
In reply to re: atypical NMS » maxx44, posted by Larry Hoover on January 3, 2004, at 19:56:56
2 sources/ vs. hundewds and years tracking them? i have said i am no dr. if you have credentials, please state them. there are tons of ANMS articles and studies for all to see---just hear me out, mate---i've done 4 years of net research. ususally an abstract will do. sometimes you have to learn the jargon and history of a study. i don't know what to say to a post proclaiming validity from 2 web-sites. seems rather superfluous to the obvious conclusions of anyone knowing there are hundreds of related sites to quote. and learn from.
Posted by Larry Hoover on January 3, 2004, at 21:07:36
In reply to re: atypical NMS, posted by maxx44 on January 3, 2004, at 20:49:28
> i've done 4 years of net research.
I asked you for references, links....
> i don't know what to say to a post proclaiming validity from 2 web-sites.
????
> seems rather superfluous to the obvious conclusions of anyone knowing there are hundreds of related sites to quote. and learn from.
Then show me.
Posted by maxx44 on January 3, 2004, at 21:12:01
In reply to re: atypical NMS » maxx44, posted by Larry Hoover on January 3, 2004, at 20:35:28
i see your approach, your 'scientific' style. you are not 'involved' with these drugs personally---rather, looking at them. your flow of data is erudite---like a marine reading of combat vs. being there. and usually funded by the very cos. promoting the drug. i may bee a loof, but i an longer an academic fool.
Posted by Larry Hoover on January 3, 2004, at 21:42:31
In reply to re: atypical NMS, posted by maxx44 on January 3, 2004, at 21:12:01
> i may bee a loof, but i an longer an academic fool.
???
Posted by zinya on January 3, 2004, at 21:53:18
In reply to Re: effexor changes in brain funxn. Help?, posted by mom_cheeks on December 27, 2003, at 8:53:00
greetings after a few weeks' absence here, and happy new year to all (Kim D in particular - how goes it?),
As some hear will know but newcomers won't, i started Effexor last May 30 and probably hold the record to date for slowest titrations upward (splitting capsules to move up at slower increments than the "norm"), arriving at 150 mg by late July and staying there til Labor Day - 6 weeks at 150, and then 2 unrelenting SEs obliged me to realize they simply weren't going away - as they'd lasted 3 months and the 2nd of the two became alarming.
I just read two of your posts, already mc - and also gummybear's uptake (that's different from reinhibitor uptake :)) -- sorry, bad joke, lame head here, fairly flued out here in recent days ...
Anyway, i read your posts and i confess to having felt some envy. I had the same sense of 'crossroads' you did upon first embarking on Effexor, hoping against hope after numerous other failed AD attempts over 15 yrs off and on, and I am truly happy for you that it turned out to be exactly the best scenario. It's so important that such stories be told too. I've been monitoring this site off and on for over a year (at first it made me delay starting the Effexor for months in apprehension at teh SE's but then i came to a sense of hitting further 'bottom' and started also with a "what the hell" kind of "nothing ventured" added sense at the beginning.
But the two biggies for me in SEs include one that's relevant to your post here, so i write to suggest a modification to a statement of yours to mMarie...
Namely, regarding the sweats. For me they started at 37.5, which was my 2nd level (I started with half a min. dose - 19 mg - half the granules of a capsule) ... They started to taper off after a couple of weeks at 37.5 (staying at least 2 weeks at each new level) and then going up next to 56 first before on to 75, but from 75 mg onward, the sweating was daily and relentless. Night sweats to the point of waking me at 3 am having to change clothes cuz nightshirt, undies, sheets, pillow . everything just sopping... By day, i couldn't even dress to go somewhere at times because i'd put on clothes and sweat inside them so much i couldn't stand it and would have to just rip (well...) my clothes off and call to cancel the whatever and return to wearing virtually nothing. I couldn't even dust a shelf without an instant sweat that would start dropping sweat on the furniture and making the enterprise counterproductive, and so i'd quit. That level of sweating lasted from some point in June until Labor Day and beyond.
At Labor Day (roughly) a second phenom added alarm to the overwhelming annoyance of the sweating. At 150 mg level in particular i started having heart rate/palpitations i'd never had (always low b.p.) to the point that just weekly gardening for an hour - i mean GARDENING for heaven's sake, a leisurely albeit exertion-using activity, was impacting me as if i'd just run the marathon. I not only would be dripping with sweat (at 5 pm, with ocean breezes etc) within 5 minutes but after working for an hour-plus, my heart would be racing so much i sometimes had to rest 15 min. befor continuing but i always ended up with such a scarily-exhausted palpitating heart that i had to start using a stool under the shower to sit on to then wash my hair for fair i would collapse, so heart-racing exhausted from the gardening. I began to realize i couldn't risk REAL aerobic exercise cuz the Effexor was turning non-aerobic into aerobic already... After a month-plus of that not letting up, that was, alas, I felt, a signal i could no longer think would go away.
The third thing was that i had yet to feel any boost to my energy, the very thing that had made my md. choose Effexor instead of other ADs so as to get the norep. effects for energy. Never felt a sustained energy though i did manage to rally for those weekly gardenings and -- some weeks -- able to walk daily on the non-gardening days, but then would have relapses energy-wise.
What makes me write here is hearing a global generalization. While i agree with those who have said here in recent posts, it's not productive to hear generalizations made to scare users, i also think it's ill-advised to make global assurances.
If there's one thing this board has taught me, it is just how truly unique each of our body chemistries are. There is literally no way of predicting whether one person is going to get over their sweats or not, lose sleep or not, gain weight or not, feel the postiive effects of E (or anything else) or not, etc etc. It's all gross generalizing that can set up expectations for that which winds up sabotaging -- either by discouraging some from trying or others from listening to their bodies when maybe they need to.
I don't know. I sure would have liked Effexor to work for me. It helps that i kept a journal of effects all the while so as to keep me from 'grass-is-greening' now as i think "gosh, maybe i could have stuck it out further and gotten to some "oasis" hurdle point. But i could also have prolonged the bad SEs dangerously. Who knows. Ultimately, it's judgment calls. And i think one thing each person needs to develop is real 'knowledge' of their own body, its signals, its antenna, its limits and capacities...
Because no one else can tell you whether *your* SEs will end or not, whether it would eventually start giving you rewards or not.
It's stunning really to realize just how unique each experience is although specific isolated SEs are shared ... but then not others, such that no one person has the same SET of pros and cons on these truly paradigm-shifting drugs for the brain...
I started tapering off at Labor Day, going down SOOO slowly that i'm still now not 100% off. I'm down to taking -- ready for this? -- 6 mg every 3-4 days. :)) ALMOST nothing, but not nothing. Cuz absolute nothing isn't quite ready yet. I start to feel a bit of brain zaps on day 3 or 4 since last dose, and realize i should take another... But a few weeks ago, that same was true of 9 mg and before that it was 9 mg every night still, 12 mg before that, 18mg ...
What this site had taught me was that going off was/is even trickier than going on, so i've taken my SLLLOOOOW-going entry and made an exponentially slower-going exit... For the most part, it's spared me the worst kind of brain zaps others had by exiting faster. I of course didn't miss all the brain zaps, but the never were "scary" at least.
And the thing that was scary - the racing heart after gardening - started leaving again by the time i got down to about 50 mg again... The sweating lingered on -- reduced but still annoying - to at least after 37.5 (not checking my journal here, from memory) ... I still occasionally getting a sweating thing that was unprecedented for me prior to Effexor, but nada compared to what those months on the Effexor onramp had been like.
2% of users, the bulletin says, quit Effexor in controlled studies due to sweating. So there's others out there having my response.
It happens, just like shit happens.
I hope this comes across mostly as supportive - as my intent is only to encourage everyone not to overgeneralize based on their own experience while being supportive for each other and helping each other recognize certain SEs as being, indeed SEs... rather than something else...
The whole sweat thing leads me to a quandry still though about the functioning of these drugs which is in reaction to the post of mMarie's which you are responding to. I'll post a separate reply to it in order to pose my confusion about something she said ...
wishing you all well and good '04s...
zinya
Posted by Larry Hoover on January 3, 2004, at 22:01:01
In reply to re: atypical NMS, posted by maxx44 on January 3, 2004, at 20:49:28
> there are hundreds of related sites to quote. and learn from.
How about supplying your favourites? From among the hundreds?
Lar
Posted by maxx44 on January 3, 2004, at 22:15:24
In reply to re: huh what? » maxx44, posted by Larry Hoover on January 3, 2004, at 21:42:31
typing and nfl playoffs don't mix, sometimes. i may be a loof, (anolog) but no longer an academic fool. living it surpasses reading of it. as for researchers? well they get special consideration. now---if you are this research scientist and your goal is helping the millions with infested nervous-systems---great. if not, why not shift your specialty to pathogen detection and whacking? we need real help, sir, asap. and you need ours as well. the fact you've 'quantified' your view, experimentaly, is commendable. i'm better an astro-physicist vs. this board. still, you're 'fudgeing'. 2 google references from many? there's so much more than that---from in-depth specialists works to nami---
Posted by zinya on January 3, 2004, at 22:26:05
In reply to effexor changes in brain funxn. Help?, posted by mMarie on December 26, 2003, at 14:45:24
hi Marie!
i've just given a long-winded re-intro of myself above... and where i prefaced how i was going to write you here with a question about this statement of yours:
>Hot flashes are directly linked to norepinephrine. Blocking NoreP will prevent the hot flash. Effexor has been successful in treating menopausal women b/c it is a >NoreP Reuptake Inhibitor. Like Serotonin, more NoreP floats around in the brain as it has been blocked from re-uptake. Atleast this is how I understand it.
My own entry into Effexor led me to try to understand the Norep. component most of all since it was <i>the</i> reason my md chose Effexor and the lure was that it would be an energy aide since my biggest single problem was ZERO energy. But this particular account confuses me, unless (and probably) it's just yet another sign of how much this same drug can have reverse effects on separate individuals.
For me, sweating occurred and remained (as i just described in some detail on previous post) while ON Effexor, and tapered off since quitting. So it's hard to see that as fitting with the above description of effects.
But, even without my own alternate experience, it's not clear to me (but this could all be the still flu-addled brain i'm trying to emerge from today) how the theory you described works. If BLOCKING Norep prevents hot flashes (and sweating, presumably), then that means Norep promotes it. So taking a "reuptake inhibitor" for Norep should mean (shouldn't it?) that more of it "floats around in the brain," wouldn't that precisely coincide with my experience of Norep promoting sweating ... And so WHY would it be prescribed for menopause???
Unless, again, it perversely has opposite effects for different individuals or different situations where maybe menopause is itself some unique biochemical circumstance which reverses cause-effect relations???
Well, i feel like i'm just babbling here, and understanding the theory of this probably interests only a few, but if anyone has any light to shed on this, i'd appreciate it.
>Question: Could the Effexor after 3 months of only 37.5mg have permanently altered my brain function? Could I be producing more NoreP--Could I be out of balance? >How long does it take the chemical substances in the brain to return to the state they were in PRE-Effexor OR CAN EFFEXOR CAUSE PERMANENT CHANGES?My own response to your query here, Marie, would be similar to what i just wrote in the post above (to moms_cheeks, i think it was - or Zellie, who both seemed to have similar experiences to date, if i recall right) ... Namely, yes and no :)) -- it might or it might not. That would be my best guess. :)
Sorry to suggest such an unhelpful response but i don't think anyone who's being honest (which most doctors alas, are not, and the drug co's certainly are not) they really don't know what the risks for a given individual are nor the potentials cuz we're in an area of brain chemistry here that is so profound and basic to the whole body functioning, so intersected with everything, that it's unknowable.
I'm essentially "off" Effexor again and i don't THINK i've had any 'permanent' personality or other changes from my six months total on it ... What i still deal with is zero -- or rare intermittent -- energy, which there was no sign the Effexor was really changing, but on balance i THINK it's right for me to be off of it, though god i wished it could have done for me what it seems to have for mom's cheeks and Zellie (if i'm remembering the right names, both of you being new to me, i think)...
well, that's it for now -- also stll dealing with carpal tunnel which seems to be an SE from Effexor as well and/or from Effexor withdrawal perhaps - it started back in October while i was on the downcycle at around 75 mg. It IS known to be associated in at least some studies with menopause suggesting it is estrogen-related, and the only previous time i had carpal tunnel i too had had an upheaval in my estrogen levels. I'm deducing from this reoccurrence that Effexor impacts our hormones' functioning too (how couldn't it?) and so the return of carpal tunnel after 3 yrs must not be a coincidence....
I've been quite vulnerable immune-system-wise lately, it seems - this latest flu hitting me hard being the latest example but it's been a whole year like that it seems... But who knows what's cause and what's effect?
good questing and living to you all,
zinya
Posted by maxx44 on January 3, 2004, at 22:30:40
In reply to Re: effexor changes in brain funxn. Help? » mom_cheeks, posted by zinya on January 3, 2004, at 21:53:18
generalizations designed to scare? then what is this tale of idiosycratic sweat, save the same? just honest reportage which may help. yes, it's negative---what sense in responding to happy solutions? no problem? no interest.
Posted by Zellie on January 3, 2004, at 23:28:27
In reply to Re: effexor changes in brain funxn. Help? » mom_cheeks, posted by zinya on January 3, 2004, at 21:53:18
Zinya:
I, too, have learned how varied each person's experience is. I also read (and was quite astounded by) the wide range of effects that people were experiencing from Effexor. I wanted to be very well informed before beginning (and during) any treatment regime I agreed to.
I am even more astounded by the number of people I have met and spoken with personally who have done no research, and are very ill-informed of the possible side-effects of the meds they have been put on. In some cases, their physicians seem equally ill-informed and even passed on to their patients info that is incorrect. In these cases, it was G.P.'s who were their docs. I have heard of many completely contradictory statements that have come from the doctors of several friends and aquaintances of mine.
My hope is that the medical profession will be continually trained in the science of the various drugs on the market. I hope that they will also be required to better inform their patients of side-effects that they may expect to experience (perhaps they are required already...I am not sure why some of my friends (and I in the distant past) have been prescribed meds for mood disorders with little or no mention of side-effects).
Moreover, I know of people (two of my sons, and myself included) who have been prescribed meds for mood disorders, with no requirement of a follow-up!! When the meds didn't seem to be working, we all just gave up on them. There was no telling us about titrating up, or anything. The docs just said,"Here, take this!" We didn't know to ask questions. We didn't know we had to book another appointment if the meds weren't strong enough to make a difference. We just thought the meds didn't work on us.
With the pdoc I now see, I am diligently followed up on, and he gave me homework before beginning any meds, consisting of digging in to various resources to find out about the potential side-effects and the possible benefits, of a number of different drugs (that was when I originally found this thread, early last spring).
Although I had certain fears and reservations about the Effexor, I still felt it was best suited to my needs. I have, indeed, been very fortunate that it has worked out so well for me. Although there were effects I had initially and some that I still am experiencing (sweats, too!), I am thrilled now to be able to function at a much, much improved level. I was so severly crippled by my disorders all my life, and although I tried to learn strategies to help me overcome, it was little help.
I am now utilizing not just therapy, strategies, coaching, support groups, etc. to help me, but I am also now taking meds that are making a huge difference. I can now learn, enjoy, live, share, love and help others much, much more than I ever dreamed possible.
My hope is that, if it is not Effexor that helps you improve your quality of life, that there will be some thing(s) that you will discover that will.
Kindest regards,
Zellie> greetings after a few weeks' absence here, and happy new year to all (Kim D in particular - how goes it?),
>
> As some hear will know but newcomers won't, i started Effexor last May 30 and probably hold the record to date for slowest titrations upward (splitting capsules to move up at slower increments than the "norm"), arriving at 150 mg by late July and staying there til Labor Day - 6 weeks at 150, and then 2 unrelenting SEs obliged me to realize they simply weren't going away - as they'd lasted 3 months and the 2nd of the two became alarming.
>
> I just read two of your posts, already mc - and also gummybear's uptake (that's different from reinhibitor uptake :)) -- sorry, bad joke, lame head here, fairly flued out here in recent days ...
>
> Anyway, i read your posts and i confess to having felt some envy. I had the same sense of 'crossroads' you did upon first embarking on Effexor, hoping against hope after numerous other failed AD attempts over 15 yrs off and on, and I am truly happy for you that it turned out to be exactly the best scenario. It's so important that such stories be told too. I've been monitoring this site off and on for over a year (at first it made me delay starting the Effexor for months in apprehension at teh SE's but then i came to a sense of hitting further 'bottom' and started also with a "what the hell" kind of "nothing ventured" added sense at the beginning.
>
> But the two biggies for me in SEs include one that's relevant to your post here, so i write to suggest a modification to a statement of yours to mMarie...
>
> Namely, regarding the sweats. For me they started at 37.5, which was my 2nd level (I started with half a min. dose - 19 mg - half the granules of a capsule) ... They started to taper off after a couple of weeks at 37.5 (staying at least 2 weeks at each new level) and then going up next to 56 first before on to 75, but from 75 mg onward, the sweating was daily and relentless. Night sweats to the point of waking me at 3 am having to change clothes cuz nightshirt, undies, sheets, pillow . everything just sopping... By day, i couldn't even dress to go somewhere at times because i'd put on clothes and sweat inside them so much i couldn't stand it and would have to just rip (well...) my clothes off and call to cancel the whatever and return to wearing virtually nothing. I couldn't even dust a shelf without an instant sweat that would start dropping sweat on the furniture and making the enterprise counterproductive, and so i'd quit. That level of sweating lasted from some point in June until Labor Day and beyond.
>
> At Labor Day (roughly) a second phenom added alarm to the overwhelming annoyance of the sweating. At 150 mg level in particular i started having heart rate/palpitations i'd never had (always low b.p.) to the point that just weekly gardening for an hour - i mean GARDENING for heaven's sake, a leisurely albeit exertion-using activity, was impacting me as if i'd just run the marathon. I not only would be dripping with sweat (at 5 pm, with ocean breezes etc) within 5 minutes but after working for an hour-plus, my heart would be racing so much i sometimes had to rest 15 min. befor continuing but i always ended up with such a scarily-exhausted palpitating heart that i had to start using a stool under the shower to sit on to then wash my hair for fair i would collapse, so heart-racing exhausted from the gardening. I began to realize i couldn't risk REAL aerobic exercise cuz the Effexor was turning non-aerobic into aerobic already... After a month-plus of that not letting up, that was, alas, I felt, a signal i could no longer think would go away.
>
> The third thing was that i had yet to feel any boost to my energy, the very thing that had made my md. choose Effexor instead of other ADs so as to get the norep. effects for energy. Never felt a sustained energy though i did manage to rally for those weekly gardenings and -- some weeks -- able to walk daily on the non-gardening days, but then would have relapses energy-wise.
>
> What makes me write here is hearing a global generalization. While i agree with those who have said here in recent posts, it's not productive to hear generalizations made to scare users, i also think it's ill-advised to make global assurances.
>
> If there's one thing this board has taught me, it is just how truly unique each of our body chemistries are. There is literally no way of predicting whether one person is going to get over their sweats or not, lose sleep or not, gain weight or not, feel the postiive effects of E (or anything else) or not, etc etc. It's all gross generalizing that can set up expectations for that which winds up sabotaging -- either by discouraging some from trying or others from listening to their bodies when maybe they need to.
>
> I don't know. I sure would have liked Effexor to work for me. It helps that i kept a journal of effects all the while so as to keep me from 'grass-is-greening' now as i think "gosh, maybe i could have stuck it out further and gotten to some "oasis" hurdle point. But i could also have prolonged the bad SEs dangerously. Who knows. Ultimately, it's judgment calls. And i think one thing each person needs to develop is real 'knowledge' of their own body, its signals, its antenna, its limits and capacities...
>
> Because no one else can tell you whether *your* SEs will end or not, whether it would eventually start giving you rewards or not.
>
> It's stunning really to realize just how unique each experience is although specific isolated SEs are shared ... but then not others, such that no one person has the same SET of pros and cons on these truly paradigm-shifting drugs for the brain...
>
> I started tapering off at Labor Day, going down SOOO slowly that i'm still now not 100% off. I'm down to taking -- ready for this? -- 6 mg every 3-4 days. :)) ALMOST nothing, but not nothing. Cuz absolute nothing isn't quite ready yet. I start to feel a bit of brain zaps on day 3 or 4 since last dose, and realize i should take another... But a few weeks ago, that same was true of 9 mg and before that it was 9 mg every night still, 12 mg before that, 18mg ...
>
> What this site had taught me was that going off was/is even trickier than going on, so i've taken my SLLLOOOOW-going entry and made an exponentially slower-going exit... For the most part, it's spared me the worst kind of brain zaps others had by exiting faster. I of course didn't miss all the brain zaps, but the never were "scary" at least.
>
> And the thing that was scary - the racing heart after gardening - started leaving again by the time i got down to about 50 mg again... The sweating lingered on -- reduced but still annoying - to at least after 37.5 (not checking my journal here, from memory) ... I still occasionally getting a sweating thing that was unprecedented for me prior to Effexor, but nada compared to what those months on the Effexor onramp had been like.
>
> 2% of users, the bulletin says, quit Effexor in controlled studies due to sweating. So there's others out there having my response.
>
> It happens, just like shit happens.
>
> I hope this comes across mostly as supportive - as my intent is only to encourage everyone not to overgeneralize based on their own experience while being supportive for each other and helping each other recognize certain SEs as being, indeed SEs... rather than something else...
>
> The whole sweat thing leads me to a quandry still though about the functioning of these drugs which is in reaction to the post of mMarie's which you are responding to. I'll post a separate reply to it in order to pose my confusion about something she said ...
>
> wishing you all well and good '04s...
>
> zinya
>
>
>
Posted by Dr. Bob on January 3, 2004, at 23:39:34
In reply to re: atypical NMS » maxx44, posted by Larry Hoover on January 3, 2004, at 22:01:01
> you seem to have a negative response to everything. You respond and contradict others' 'good' or 'helpful' advice/intentions and manage to make everything so negative. This response and many you have posted are totally unacceptable
>
> MercedesPlease be sensitive to the feelings of others and don't post anything that could lead them to feel accused. It's fine to give others feedback as long as its constructive. It tends to be more constructive if you put things in terms of what the other person might do better rather than what they did "wrong".
> Please do provide any information that you can about hardware wiping and demolished deep-brain production facilities, as I would very much like to become an informed consumer myself.
> I still am looking for data or arguments to support your previous declarations.
> I asked you for references, links....
> How about supplying your favourites?
>
> Larry HooverAlso, please don't pressure others, thanks.
Bob
Posted by Dr. Bob on January 3, 2004, at 23:41:12
In reply to re: huh what?, posted by maxx44 on January 3, 2004, at 22:15:24
> scared the sh[*]t out of me
> i must consider your response either immature or disengenuous. either way, your elegant response is rendered as 'flawed' by content.
> seems rather superfluous
> you're 'fudgeing'.
> see xxx
Please don't use language that could offend others, post anything that could lead others to feel accused or put down, or use this site to exchange information that could be used to obtain prescription medication without a prescription. The last time you were blocked it was for 1 week, so this time it's for 3.
Bob
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Posted by Lyrical13 on January 4, 2004, at 6:40:27
In reply to re: atypical NMS » maxx44, posted by Larry Hoover on January 3, 2004, at 20:35:28
Lar
Thank you for the detailed info re: NMS. I was starting to get very concerned based on Maxx's posts...they sounded alarmist but you never know. Your very readable, yet very knowledgable post debunking Maxx's post in detail put my mind at ease. I appreciate that your post was backed up with extensive citations of research. I am not a scientist by profession but I have done quite a bit of research in the past to get my master's and your data made sense to me.Thanks again for putting my mind at ease.
L13
PS I had fully intended to do my own research on atypical NMS in order to talk to my doctor about my concerns, but because of your post, I no longer feel I need to do that. I will however bring up that I want to ease off the Seroquel rather than go cold turkey like he seemed to suggest at our last appt.
Posted by Lyrical13 on January 4, 2004, at 7:00:30
In reply to Re: effexor changes in brain funxn. Help? » mom_cheeks, posted by zinya on January 3, 2004, at 21:53:18
Thank you for your post. Very good point about overgeneralizing, etc and listening to your own body. I think that is a very important thing to remember in any circumstance...listen to what your body is telling you, whether it be re: med effects and side effects or feeling run down in general. I've had a much healthier fall because I think I listened to my body...when it was telling me I needed more meds because the depression was so bad...and also when I was feeling kind of crummy and wiped out...I stayed home from yoga a couple times because I was so wiped out I felt I needed to just chill out and rest...that was a difficult choice..I had this inner dialog about deciding which healthy thing to do...yoga was good for me from a stress-reducing exercise point of view...but how smart would that be to go out in the crummy weather feeling icky already? I think I made the right choice by staying home and resting because I was able to avoid colds and flu when many others all around me were sick as dogs (I work in a school.. cold and flu central!) Taking that extra vitamin C probably played a role too.
I too experience sweating, though not to the degree that you experienced, thank goodness! It is very annoying though. I have tons of beautiful sweaters that I can't wear because I am so hot all the time. Long sleeve shirts are too much sometimes. I live in MI with its share of cold crummy weather..people all around me are in turtlenecks, sweaters and winter coats and I'm sweating in my long sleeve shirt. I will say that the sweating is much worse after increasing my dose and then abates some after a few weeks but it's still there. Also, my heart rate has increased some but not to the alarming rate yours did. Sounds like you're smart to get off of it (and slowly..your system seems VERY sensitive, at least to this med) I just keep tabs on my heart rate when exercising (10 second count at Curves...rate is usually up a couple beats more than usual) This helps me modify my amount of activity to stay within a safe zone. Luckily my BP and pulse are usually at the low end of normal so I don't have to be as concerned as someone with higher BP...just monitor and make sure it doesn't get too elevated. My resting heart rate and pulse are higher with Effexor than without based on stats at various dr visits.
But good point about the posts. I think it's very important for folks on this site to remember to not just blindly take the info as gospel...read it and think about it...do a little of your own research and/or read several posts from several different people to get an overall picture of how different body chemistrys react, then discuss with your pdoc and decide what's right for you.
Posted by Lyrical13 on January 4, 2004, at 7:24:59
In reply to Re: effexor changes in brain funxn. Help? » zinya, posted by Zellie on January 3, 2004, at 23:28:27
I just started with a new doc in Sept and am so glad I switched. In the past my pdocs gave me a little info about a couple different meds and then asked what I wanted to do. I felt like I was being an informed consumer with that info but was always struck by how much more info I got off the little Rx insert from the pharmacy. I thought maybe the pdoc didn't want to alarm me (a person who already had anxiety issues) with info about SEs that only rarely occured. But I also felt I should know about serious SEs that could occur and what to do about them, esp given my past hx of rxns to meds.
My new pdoc gives me info sheets on each med he mentions and tells me to check it out for myself on the net before making a decision. He explained the current thinking on treating chronic depression and various treatment options and then asked what I wanted to do. I admit it was overwhelming given my state of mind at the time and then info I was used to getting from a pdoc, but now I find it very refreshing and empowering. I feel like I am truly part of my own treatment team and that my thoughts and concerns are valid and important. I have always been followed by monthly appts during rough times with instructions to call if there are any questions or problems in the interim. When things are better, my appts are further apart (3 months max) but still occur to check status and progress.
I just recently learned that my sister doesn't have regular appts to check on meds with her doc. He is a pediatrician (she is 14) who is well-respected in the community. I checked him out with a few other mental health professionals that I know and they all said he was very competent and well-read, kept up on current data etc and had experience with dealing with these issues. Also has no qualms about referring pts on if he feels it's more difficult to treat than he has experience with. I felt reassured by that info, esp since it came from 3 separate sources. But I am concerned that she doesn't have regular appts to follow her on meds. She was able to get in to see him within a few days when she was having a great deal of difficulty. He upped her meds but there has been no follow-up since. I brought up this concern to her and my step-mom. Told them that she should be having regular appts. I feel that her meds are not doing as much as they should be for her. She's still having difficulty, albeit not as severe, but I don't think either of them realize that she doesn't have to settle for feeling "a little better" I don't know if she needs a higher level or a different med combo. I am hoping that they will take my advice to A) contact doc and get in for another appt to discuss progress and B) get back into counseling and stay in counseling.
Before I started with my current pdoc, I didn't realize what I was missing in terms of info and participation in treatment decisions. My pdoc was floored that no one had given me such info before. He says that he takes the same approach with every pt. He believes that an informed pt is a valuable part of the team. It's very empowering and I feel that approach gives the pt the most dignity. Feeling some control over the situation definitely makes dealing with mental health issues easier. I think that the feeling of powerlessness and helplessness that I often feel when I am going through a rough time is one of the most frustrating an debilitating aspects of this illness...also fear of the unknown.
Posted by Larry Hoover on January 4, 2004, at 8:09:03
In reply to re: atypical NMS, posted by Lyrical13 on January 4, 2004, at 6:40:27
> Lar
> Thank you for the detailed info re: NMS. I was starting to get very concerned based on Maxx's posts...they sounded alarmist but you never know. Your very readable, yet very knowledgable post debunking Maxx's post in detail put my mind at ease. I appreciate that your post was backed up with extensive citations of research. I am not a scientist by profession but I have done quite a bit of research in the past to get my master's and your data made sense to me.> Thanks again for putting my mind at ease.
You're very welcome, and that was my intent, to ease people's minds. I do want to be clear, thought, that what he describes does happen, but it is rare enough to be reported in the literature as case reports, the sort of thing analogous to "Boy, you should have seen the weird case came into emergency last week....had us all baffled." It is very hard to develop something like a conceptual pattern from these sporadic events. Moreover, we still don't have a clue why they happen at all.
> L13
>
> PS I had fully intended to do my own research on atypical NMS in order to talk to my doctor about my concerns, but because of your post, I no longer feel I need to do that. I will however bring up that I want to ease off the Seroquel rather than go cold turkey like he seemed to suggest at our last appt.Another point: atypical NMS is not a clearly defined entity. And what is described in the literature is not NMS....it's something bad, but I guess they should come up with a name and some consistent symptoms....that will come I'm sure, over time.
Tapering off any drug, escpecially one you've been on for a while, is just plain prudent. I would insist on tapering off Seroquel. I did when I came off it.
Lar
Posted by Mercedes on January 4, 2004, at 12:57:34
In reply to re: sweating and heart rate SEs, posted by Lyrical13 on January 4, 2004, at 7:00:30
I started reading this site last April. At that time, I was on 225 mgs of Effexor. (I was actually researching another med from which I had severe dizzy spells, and abdominal pains) then decided to "just" look up Effexor XR. At that time I was feeling just fine with E, except for the sweating. But I didn't mind the sweating as I felt I was doing a 'work-out' and possibly losing weight. This occured when I would do yard work or vacume, etc. Again, I didn't mind. I never had the night sweats as Zinya had. I did have the pounding heart rate increases during these chores, which alarmed me somewhat. I'd lost my appetite on Effexor, which was a good thing for me, since I'm overweight anyway.
When I was increased to 300mgs, and from about June LY through around Sept, I felt free from my depression and actually smiled and felt 'happy'. There were still SE's that I was feeling, like insomnia but it was a releif to feel 'un'depressed.
My blood pressure seemed to go higher and higher each visit with my MD, and I finally decided that the Effexor was causing this. I was put on BP medication and spoke with my Pdoc about it. He wanted to lower my dosage of Effexor and I said "No", I want off. I was tired of sleepless nights, which also caused confusion during the day, fatigue, clouded thinking, and I would fall asleep during the day without realizing I was going to. I'd just wake up and wonder what day it was???
So off Effexor I went, titrating downwards, but at a much faster pace than I should have YET I was following my Pdoc instructions. Now off completly, BP normal again, and I didn't want another AD, but the crying started for no apparent reason (it was depression) and my body told me that I needed something, so off to Pdoc I went, and was put on Lexapro. I sleep good at night, and no sweats. I sometimes feel a bit depressed (could also be holiday blue's) so the dose may need to get adjusted maybe not.
My point is that I too agree that we need to listen to our bodies and let our Pdocs know what we are experiencing. I also know that everyone's situation is different. Minds and body's are all, sooooooo different. What works for one may not work for another. That's a given.
Thank you both, Zinya and Lyrical for sharing your experiences and wishing all a heathier and happier 2004!
Mercedes
*********************************
> Thank you for your post. Very good point about overgeneralizing, etc and listening to your own body. I think that is a very important thing to remember in any circumstance...listen to what your body is telling you, whether it be re: med effects and side effects or feeling run down in general. I've had a much healthier fall because I think I listened to my body...when it was telling me I needed more meds because the depression was so bad...and also when I was feeling kind of crummy and wiped out...I stayed home from yoga a couple times because I was so wiped out I felt I needed to just chill out and rest...that was a difficult choice..I had this inner dialog about deciding which healthy thing to do...yoga was good for me from a stress-reducing exercise point of view...but how smart would that be to go out in the crummy weather feeling icky already? I think I made the right choice by staying home and resting because I was able to avoid colds and flu when many others all around me were sick as dogs (I work in a school.. cold and flu central!) Taking that extra vitamin C probably played a role too.
>
> I too experience sweating, though not to the degree that you experienced, thank goodness! It is very annoying though. I have tons of beautiful sweaters that I can't wear because I am so hot all the time. Long sleeve shirts are too much sometimes. I live in MI with its share of cold crummy weather..people all around me are in turtlenecks, sweaters and winter coats and I'm sweating in my long sleeve shirt. I will say that the sweating is much worse after increasing my dose and then abates some after a few weeks but it's still there. Also, my heart rate has increased some but not to the alarming rate yours did. Sounds like you're smart to get off of it (and slowly..your system seems VERY sensitive, at least to this med) I just keep tabs on my heart rate when exercising (10 second count at Curves...rate is usually up a couple beats more than usual) This helps me modify my amount of activity to stay within a safe zone. Luckily my BP and pulse are usually at the low end of normal so I don't have to be as concerned as someone with higher BP...just monitor and make sure it doesn't get too elevated. My resting heart rate and pulse are higher with Effexor than without based on stats at various dr visits.
>
> But good point about the posts. I think it's very important for folks on this site to remember to not just blindly take the info as gospel...read it and think about it...do a little of your own research and/or read several posts from several different people to get an overall picture of how different body chemistrys react, then discuss with your pdoc and decide what's right for you.
Posted by Lyrical13 on January 4, 2004, at 14:18:43
In reply to re: sweating and heart rate SEs » Lyrical13, posted by Mercedes on January 4, 2004, at 12:57:34
Mercedes,
I'm not sure if this is the case with you, but with me as it turns out, Effexor (or maybe my own biochemistry made me more prone to) made me hypomanic. My doc now thinks I'm BP2 and I think he's right because even on other ADs and even with no meds, I have this pattern. The depression pattern is very obvious..the hypomania is more subtle. I didn't even know there was such a thing as BP2 until he told me at my last appt.But, your post reminded me and I thought I should mention in case this is a possibility with you. My bad time of year is Aug thru Jan(we used to think it didn't start till Oct but now are picking up more subtle signs for the past 2 years in early Aug) From about March through June or July I usually am very good. feb so so.. depends on the year. I started on Effexor in Nov of 2002. Last spring (starting late Feb or so) I felt so WONDERFUL on Effexor...better than I ever remember feeling in my life! I felt ecstatic! But...also had difficulty sleeping.. Would sleep 2-4 hours per night (falling asleep was OK but would wake up) and be wide awake and on the go all day long without crashing until about 10 or so at night...go back to bed and repeat the whole pattern again...several days a week and then maybe sleep normally a couple nights and then several days with this constant on the go stuff. Also am hotter than usual always..not just during exercise. Now, I've had trouble with insomnia before but it's usually been during anxiety/depression time and I have a similar pattern...fall asleep OK but wake up a few hours later and can't get back to sleep... but in those times I don't have the tremendous energy during the day and I eventually feel wiped out..usually in late afternoon.
Looking back, I also have a pattern of having too many things on my plate...tons of projects (I counted 15 different projects that I started last spring/summer..all at about the same time) and spending sprees. This has been a pattern for several years, before Effexor and before any ADs. Now I've heard that some ADs can push you into hypomania whether you are BP or not so what you experienced may be just that. But I thought I would mention it. I always thought of BP as wild extremes and I never had full blown mania. But to hear that this actually could be BP2 and that I could get help for the "superwoman/ superspender phase is a big relief because I always felt so guilty and terrible for all the money I spend..especially when I didnt' even have the money to spend in the first place. Now, we're talking hundreds of dollars at a crack and not thousands...but when you're heavily in debt anyway from studente loans, etc and your husband is laid off, any overspending is a problem.
I'm going to be switching off Seroquel and probably starting Lamictal in the next month or so....
Well, the dog is bugging me to go for a walk so I'll sign off for now.
Posted by Gummybear on January 4, 2004, at 16:28:01
In reply to re: sweating and heart rate SEs, posted by Lyrical13 on January 4, 2004, at 14:18:43
Okay, I apologize upfront as this may be a rather sensitive "womanly" question - however it has me rather concerned and in an uncomfortable situation.
I have been on Effexor for a little over a month now - 37.5mg for a week, then 75mg for a week, then 150mg and now back down to 75mg since I think the jump was a little too sudden.
Anyway, I am on Alesse birthcontrol pills - which have very low hormone levels. However I still have over a week of birth control pills and THEN should be getting my period.... but suddenly I have developped the onset of my period - which is very odd.
Has anyone else noticed menstrual irregularities on Effexor?? I was told by my doc. that Effexor does not interact with hormone levels.... Is this true????
Anybody know anything about this???
G.Bear.
Posted by Larry Hoover on January 4, 2004, at 17:27:05
In reply to Womanly Question, posted by Gummybear on January 4, 2004, at 16:28:01
> Okay, I apologize upfront as this may be a rather sensitive "womanly" question - however it has me rather concerned and in an uncomfortable situation.
>
> I have been on Effexor for a little over a month now - 37.5mg for a week, then 75mg for a week, then 150mg and now back down to 75mg since I think the jump was a little too sudden.
>
> Anyway, I am on Alesse birthcontrol pills - which have very low hormone levels. However I still have over a week of birth control pills and THEN should be getting my period.... but suddenly I have developped the onset of my period - which is very odd.
>
> Has anyone else noticed menstrual irregularities on Effexor?? I was told by my doc. that Effexor does not interact with hormone levels.... Is this true????
>
> Anybody know anything about this???
>
> G.Bear.Both Effexor (venlafaxine) and ethinyl estradiol (the synthetic estrogen in Alesse) are substrates of the same enzyme, CYP3A4, but if there was an interaction between the two drugs, there would be an increased dose-effect for the birth control, not a failure of it.
I've searched all my databases, Pubmed, Rxlist,...I can't find anything that suggests this is a common, or even uncommon, side-effect or interaction between Effexor and Alesse. I can't find a mention of it all.
I wish I could be of more help.
Lar
Posted by Paco on January 4, 2004, at 18:01:30
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Hello. Been six months since I've been here.
Anyone experience brain zappage after missing one day or taking their dosage a few hours late?
I've been taking 150mg for something like 10 months now and haven't missed a day, and have had no problems with this med. This afternoon I was feeling this buzzing that was coming and going inside my head, and later thought it was either because I might have missed yesterday, but I doubt I did since I am such a creature of habit, and have a regular morning routine, or because I took it 8 hours late this morning, or because I had a couple of beers last night (unlikely that this is the reason, because I have done this a couple of times before with no side effects).
Any similar experiences?
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