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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6293 to 6317 of 10407. Go back in thread:
Posted by polar1 on February 4, 2004, at 19:40:49
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I have been diagnosed with bipolar disorder for a year now. I just started back on Effexor xr 1/9/04 at 150 mg a day. I have still been down and the doctor told me to go up to 225 mg. Is there anyone out there with bipolar that has taken a larger dose? I just want to feel better. I am also on Zyprexa and Depakote. Is there anything else I should try?
Posted by Dr. Bob on February 4, 2004, at 21:16:13
In reply to STAY OFF EFFEXOR IF YOU CAN, posted by on-the-wave on February 3, 2004, at 8:23:16
> Read a book called Prozac Backlash by Joseph Glen mullen.
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Dr. Bob on February 4, 2004, at 21:41:32
In reply to Re: does this go away? Is this normal » on-the-wave, posted by PoohBear on February 4, 2004, at 14:04:27
> THE SKY IS FALLING!!! THE SKY IS FALLING!!!
>
> KimberlyDi> SSRI's ... may work continously for mild cases (who would probably be fine with a mild tranquiliser and a holiday).
>
> on-the-wave> You obviously took my comments out of context to make your own point.
>
> PoohBearDifferent points of view are fine, and in fact encouraged, but please be sensitive to the feelings of others and don't jump to conclusions about them or post anything that could lead them to feel accused or put down.
If you have any questions about this or comments about posting policies in general, or are interested in alternative ways to express yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
or redirect a follow-up to Psycho-Babble Administration. Thanks,
Bob
Posted by Sad Panda on February 5, 2004, at 3:49:14
In reply to Re: does this go away? Is this normal, posted by on-the-wave on February 4, 2004, at 14:47:40
> My second pdoc told me i could take 800mg of effexor and it wouldn't harm me. Is this true. As above no-one knows the answer, but where did this pdoc get this information?
>I have heard of pdocs going up to 1000mg!
There is a great little read here http://www.psychotropical.com/notes/589.html about how Efexor barely qualifies as an SNRI.
Here is a snipet on NRI strength:
"Indeed, in vitro venlafaxine is a weaker noradrenalin reuptake inhibitor than is fluoxetine (and some other 'SSRIs'). Fluoxetine is of course marketed as an selective serotonin reuptake inhibitor.
In summary we have the anachronism that some drugs marketed as selective serotonin reuptake inhibitors are more potent noradrenalin reuptake inhibitors than venlafaxine, which is marketed as a serotonin and noradrenalin reuptake inhibitor (SNRI). This anachronism is only partly explained away by 'selectivity' (ie NA vs 5-HT potency) and different dose ranges.
Noradrenalin reuptake inhibitor potency ***
Desipramine 0.83 most potent
Amitriptyline 35
Fluoxetine 240
Venlafaxine 1060 weakest"A snipet on toxicity:
"Venlafaxine seems to have greater toxicity and more severe withdrawal effects.
Recent data (12/00) from 456 admissions with antidepressant poisoning; numbers:--
venlafaxine (51), tricyclic antidepressants (excluding dothiepin*) (172), SSRI (233), dothiepin (81).
* because it is so much more toxic than all the othersOdds ratios (95% CIs, p) for:--
Seizures
Venlafaxine vs TCAs-- 4.4 (1.2 – 16.6, p = 0.02)Prolonged QRS (to &Mac179; 100 ms)
SSRIs vs TCAs 0.3, (0.2 – 0.6, p < 0.0001)
TCAs vs venlafaxine 0.6 (0.3 – 1.4, p = 0.31)Serotonin syndrome
venlafaxine vs TCAs 35.4 (7.6 – 325.3, p < 0.0001)
SSRIs vs TCAs 20.4 (5.2 – 174.9, p < 0.0001)Conclusions: Venlafaxine in overdose seems to be pro-convulsant, even more than TCAs (whereas SSRIs are much less so) and also cardiotoxic.
Venlafaxine is also a lot more likely to cause serotonin syndrome than either TCAs or SSRIs; this is unexpected since it is generally a weaker SRI. This would fit with it having another mechanism of action as mooted above."I am taking Efexor 225mg + Remeron 30mg. Efexor is making me a whole lot happy than I use to be, but it is strugling to give me any motivation. I will go up to 375mg & then I will try something else.
Cheers,
Panda.
Posted by lupern on February 5, 2004, at 4:09:19
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I have been on Effexor for a little over a year...it saved my life...but recently, I have been having the symptoms usually associated with the withdrawl of the med...you know, that 'swishy head/dizzy" feeling. I am getting those symptoms occassionally throughtout the day....Am I building up a tolerance to my dose (150mg QD)?
Anyone else experience the same thing?
Thanks,
Lupe
Posted by semi-conscious on February 5, 2004, at 7:26:37
In reply to anyone needing up dose due to w/d like symptoms?, posted by lupern on February 5, 2004, at 4:09:19
When I first started taking Effexor it wasn't great, but it was okay, then it seemed to level off and we upped the dose. That happened twice. Now I'm going through major depression again with weakness and sadness, so I guess I have to go back and up the dose. I'm already on 175mg Effexor SR. Having a drug level off because you've gained a tolerance to it and having to take more then finding out that it has a terrible withdrawal and leaves your system within 12 hours, instead of having a half live like the other SSRI's, and then you go through hell for weeks, this sounds almost like a narcotic. How is it the DR.'s didn't inform the patients of this? This is a very addictive drug. It's my own fault for not asking enough questions. But my meds prescriber is a little intimidating. If I even mention that I learned something about a particular med on the internet, he says the internet is a bunch of bunk. I guess I'm going to have to up the dose. But what happens when I level off again? You can only go up to 300mg. I guess when you level off again, that's when you have to go off and go through the withdrawal. I'd rather do it now and get it over with. It's time to try a different anti-depressant. One not quite so addicting. I guess I've been a little long winded. It's just that I'm frustrated and want a competent Dr. who knows his stuff and actually cares about the patient, to him I'm just a series of records needed to be completed by the book for the HMO. They run us through that clinic like cattle. What are your symptoms? I'm experiencing depression, apathy, profound sadness, crying and don't get off the couch for a week at a time. I have blurred vision, weakness, shakiness and tremor like symptoms. This is all while taking the drug, along with 3 other nighttime anti-depressants for sleep. I'm afraid to go off. This meds situation makes me sad too. I had such high hopes and expectations in the beginning. Sorry for rambling on so long. Thank you for letting me vent. If there is anything I can do or if you need someone to talk to, just respond to this post. I hope I didn't scare you too bad. Not everyone reacts to the drug the same way. Goodluck Taylor
Posted by on-the-wave on February 5, 2004, at 8:57:40
In reply to THE SKY IS FALLING!!! THE SKY IS FALLING!!! (nm) » on-the-wave, posted by KimberlyDi on February 3, 2004, at 17:42:32
Once upon a time, in a land far, far away, there lived a little red hen. One day the little red hen was on her way to market when a passing breeze dislodged an acorn from a large oak tree. Tugged by the eternal forces of nature, the acorn fell earthwards, interrupted momentarily in its journey by a collision with the head of the little red hen.
Now the little red was shocked and traumatised by this incidence, she neither stopped to look about her, nor to investigate the cause of the dull throbbing sensation in her head. She raised one wing over her eyes and ran blindly along the path to tell the king that the sky was falling and would destroy the entire kingdom. Passing all manner of other animals along the way, she spread the terrible news of the impending calamity. The other animals, not being well educated in the ways of the world and want to believe any story that would make them feel important and unique in the large forest, concurred with her story. They joined her on her journey to the king, and helped spread the word to other animals in the forest. Some of them believed that the king would reward them with treasure if they were the ones to impart the bad news.
Now a cunning and wyethly fox, spying this exodus from the forest, hatched a cunning and evil plan. If he could convince this gullible bunch to enter into his lair he could extract great benefit from their ignorance. So approaching the erstwhile caravan, he made them great promises, showing them a secret path, which would curtail their lengthy journey and ease their now suffering legs. The animals, who, were by now exhausted by their journey, questioned not the fox’s intentions and being of a naive disposition, followed him into the lair.
On entering the lair, some of the animals saw the foolishness of their ways, and turned to run, but the pathway was narrow and thorns blocked the passage. Some of the animals were brave and fearing the worst kept going, however, some were fearful of the dangers of the path, and took refuge in the safety of the fox’s lair, comforted by their ignorant friends.
A while later, some of the animals who had escaped, gathered in a clearing in the forest to pass time of day. They spoke in hushed tones of the fearful day, and whispered apprehensively if any had seen those that had not escaped the lair. They had heard cries and screams in the night, seen feathers scattered here and there, but none of the animals that stayed in the lair had ever been seen again. They comforted each other, and swore to warn other animals of the wickedness of the fox in the hopes that one day the forest would be free of his evil behaviour.
The end
“Give not that which is holy unto the dogs, neither cast ye your pearls before swine, lest they trample them under their feet, and turn again and rend you.”
Matthew 7, ver. 6 (KJV)
Posted by on-the-wave on February 5, 2004, at 9:24:23
In reply to anyone needing up dose due to w/d like symptoms?, posted by lupern on February 5, 2004, at 4:09:19
It may be best to discuss this with your pdoc.
To answer your question re wd symptoms. Yes.
Posted by 2beornot2benuts on February 5, 2004, at 10:34:41
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Hello, I haven't been here in a while, I'm currently taking 150mg of zoloft and I'm afraid that I might have to increase the dose. If anybody out there has had a similiar situation, please post!!
Posted by PoohBear on February 5, 2004, at 11:42:44
In reply to Re: anyone needing up dose due to w/d like symptoms? » lupern, posted by semi-conscious on February 5, 2004, at 7:26:37
You should speak with your doctor about this. Do NOT allow him or her to initimidate you: this is about YOUR health and happiness, not THEIR'S...
I presented the same symptoms you did at higher doses of Effexor, though we were titrating up to find the right doseage, not because the drug had leveled off.
My doctor recognized the symptoms right away as an overdose and we titrated gradually back down to where I am now at 75mg per day.
It sounds like two things are happening:
1. You're showing signs of over-dose on Effexor
2. You're not getting relief of your depression and need to find an alternate treatment.Explain to your doctor what your going through, exactly as you did in your post. Write it out if necessary so that if you're intimidated, you won't forget something important.
Good luck!
Tony
> When I first started taking Effexor it wasn't great, but it was okay, then it seemed to level off and we upped the dose. That happened twice. Now I'm going through major depression again with weakness and sadness, so I guess I have to go back and up the dose. I'm already on 175mg Effexor SR. Having a drug level off because you've gained a tolerance to it and having to take more then finding out that it has a terrible withdrawal and leaves your system within 12 hours, instead of having a half live like the other SSRI's, and then you go through hell for weeks, this sounds almost like a narcotic. How is it the DR.'s didn't inform the patients of this? This is a very addictive drug. It's my own fault for not asking enough questions. But my meds prescriber is a little intimidating. If I even mention that I learned something about a particular med on the internet, he says the internet is a bunch of bunk. I guess I'm going to have to up the dose. But what happens when I level off again? You can only go up to 300mg. I guess when you level off again, that's when you have to go off and go through the withdrawal. I'd rather do it now and get it over with. It's time to try a different anti-depressant. One not quite so addicting. I guess I've been a little long winded. It's just that I'm frustrated and want a competent Dr. who knows his stuff and actually cares about the patient, to him I'm just a series of records needed to be completed by the book for the HMO. They run us through that clinic like cattle. What are your symptoms? I'm experiencing depression, apathy, profound sadness, crying and don't get off the couch for a week at a time. I have blurred vision, weakness, shakiness and tremor like symptoms. This is all while taking the drug, along with 3 other nighttime anti-depressants for sleep. I'm afraid to go off. This meds situation makes me sad too. I had such high hopes and expectations in the beginning. Sorry for rambling on so long. Thank you for letting me vent. If there is anything I can do or if you need someone to talk to, just respond to this post. I hope I didn't scare you too bad. Not everyone reacts to the drug the same way. Goodluck Taylor
Posted by on-the-wave on February 5, 2004, at 13:22:27
In reply to Re: anyone needing up dose due to w/d like symptoms? » semi-conscious, posted by PoohBear on February 5, 2004, at 11:42:44
This is the first time i have heard of overdosing and at levels most docs assume acceptable.
This is new to me. Is there more info on this somewhere.
Posted by PoohBear on February 5, 2004, at 14:15:43
In reply to Re: anyone needing up dose due to w/d like symptoms? » PoohBear, posted by on-the-wave on February 5, 2004, at 13:22:27
I'm going off what my PDoc (whose specialty is pyscho pharmachology) told me of what I went through. Not everyone's bodies tolerate the larger doses. Mine for instance, is very sensitive to small doses.
Tony
Posted by KimRN73 on February 5, 2004, at 17:09:16
In reply to Re: anyone needing up dose due to w/d like symptoms? » on-the-wave, posted by PoohBear on February 5, 2004, at 14:15:43
Okay, I have also experienced the "swooshy/lightheadedness" from 150mg daily of Effexor, which i have been on maybe almost 2 yrs.
It has just started happening since last summer.
I noticed mainly starts about a week or week 1/2 before I'm supposed to start my period. How can someone be having symptoms of overdose all of a sudden when i used to tolerate that dosage just fine.?!?!?! Maybe its cuz i turned 30 and my body is changing !!!!!! AHHHHH :)
I wanna wean off this med but im too scared.
Kim :)
Posted by Sad Panda on February 5, 2004, at 23:14:13
In reply to Re: anyone needing up dose due to w/d like symptoms? » PoohBear, posted by on-the-wave on February 5, 2004, at 13:22:27
> This is the first time i have heard of overdosing and at levels most docs assume acceptable.
>
> This is new to me. Is there more info on this somewhere.5 to 10 percent of caucasians have a gene which makes them poor metabolizers of drugs metabolized by the liver enzyme CYP2D6. Roughly 25% of all drugs are metabolized by this enzyme. Not having enough of this enzyme makes you blood level of the drug much higher than it would be for average people.
Cheers,
Panda.
Posted by delna on February 6, 2004, at 10:18:53
In reply to Anyone NOT had trouble getting off this med?, posted by KimRN73 on February 4, 2004, at 12:04:47
Hi
Coming off effexor is a problem and it was very hard. But I did it eventually with as the least amount of suffering as possible.I came off 300mg after 3 years.
I too did what you are planning to and yes it worked. But the very last piece- I had to wean myself off that slowly. I mean I couldnt just get rid of it, i had to take little bites daily, and slowly made them smaller till it was negligeble. then every second day for a while. so there was no sudden shock of totally No effexor.
That is the only thing that worked for me. I had been trying to come off it for months.
So my only point is that (for me) it was that last piece that made all the difference. Thats when you need to go so slow, slower than ever. i took a month to get off that.
good luck
d
Posted by sheri on February 7, 2004, at 1:26:00
In reply to Anyone NOT had trouble getting off this med?, posted by KimRN73 on February 4, 2004, at 12:04:47
HI: a friend just called because he is miserable and has been crying all day. his doctor told him it was fine to go off effexor cold turkey!! he was also surprised to learn that effexor is not an SSRI? I suggested that maybe some of crying could be part of the withdrawal. does this make sense to anyone? what else can I tell him? can anyone explain to me what effexor is if it is not an SSRI? he says he can not taper off because his effexor is in caps that he can not break apart. does that sound right? thank you!!! Sheri
Posted by 4peace on February 7, 2004, at 10:22:30
In reply to Re: Any good experience with Effexor? Scared now!, posted by Alittle Lost on January 30, 2004, at 21:38:48
First time I found this site. Lots of interesting comments. I went through a major episode, tried Zolof, Wellbutrin and then finally Effexor which worked like a dream. I do know that 24 hours if I accidently skip a dose, brings on nausia, headache, etc.
Now we want to try to have a second child, but I am REALLY scared of going off Effexor, from the side effects, other drugs I might take and if it will be ok while pregant (Dr rec,s Zolof also while breastfeeding).
Anyone out there been down this road or have some advice?
Thanks
Posted by jpmjcem on February 7, 2004, at 11:13:19
In reply to Going off Effexor to get Pregnant? Advice?, posted by 4peace on February 7, 2004, at 10:22:30
> First time I found this site. Lots of interesting comments. I went through a major episode, tried Zolof, Wellbutrin and then finally Effexor which worked like a dream. I do know that 24 hours if I accidently skip a dose, brings on nausia, headache, etc.
> Now we want to try to have a second child, but I am REALLY scared of going off Effexor, from the side effects, other drugs I might take and if it will be ok while pregant (Dr rec,s Zolof also while breastfeeding).
> Anyone out there been down this road or have some advice?
> ThanksPlease do not take Effexor when you are preg. I just had my baby in July of this past year and the doctors told me it was safe to take while preg and it was not. At all safe. My baby got dehydrated in the womb and had horrible withdrawl symptoms after he was born. He was failing to thrive and we almost lost him. Please please please do not take that med when preg! I went through ultimate hell with this.
If you want to email me for more info- jpm_jcem@direcway.com
Posted by justjustine on February 7, 2004, at 11:17:34
In reply to Re: Anyone NOT had trouble getting off this med?, posted by sheri on February 7, 2004, at 1:26:00
your friend's doctor doesn't have the proper experience in dealing with withdrawal from effexor.
please tell your friend to log in here and search the old posts - effexor withdrawal is a hellride, especially if you have rebound depression on top of the physical symptoms.
i was sick for a month and took vicodin to get through it. another person wrote here the other day they were taking lortab - that's how bad it can be.
also try this search engine www.vivisimo.com and search for venlafaxine withdrawal taper and other info.
if his effexor is the caplets, he only needs to get a razor blade and start shaving them down. save what he shaves off, for cost effectiveness. i had capsules and opened them up and poured it off.
but please emphasize to him that this is real and won't get better until it gets worse for at least a week or two. in fact, if he's only one day off, the withdrawals are only beginning to hit and aren't even close to peaked.
i'm praying for him!
> HI: a friend just called because he is miserable and has been crying all day. his doctor told him it was fine to go off effexor cold turkey!! he was also surprised to learn that effexor is not an SSRI? I suggested that maybe some of crying could be part of the withdrawal. does this make sense to anyone? what else can I tell him? can anyone explain to me what effexor is if it is not an SSRI? he says he can not taper off because his effexor is in caps that he can not break apart. does that sound right? thank you!!! Sheri
Posted by justjustine on February 7, 2004, at 11:24:21
In reply to Re: Going off Effexor to get Pregnant? Advice?, posted by jpmjcem on February 7, 2004, at 11:13:19
this is so sad, and i am so sorry you and your baby and family had to go through that. i just got off effexor, and thought that my opinion of this drug was as low as it could get. i was wrong.
what a nightmare. i know this drug helps some people, but i still don't see that outweighing the harm it does.
just my opinion...
> Please do not take Effexor when you are preg. I just had my baby in July of this past year and the doctors told me it was safe to take while preg and it was not. At all safe. My baby got dehydrated in the womb and had horrible withdrawl symptoms after he was born. He was failing to thrive and we almost lost him. Please please please do not take that med when preg! I went through ultimate hell with this.
> If you want to email me for more info- jpm_jcem@direcway.com
Posted by 4peace on February 7, 2004, at 11:42:23
In reply to Re: Going off Effexor to get Pregnant? Advice?, posted by jpmjcem on February 7, 2004, at 11:13:19
I certainly do not plan to be on Effexor when pregnant nor when breastfeeding, and all my Dr's have certainly made this clear to me. But is there anyone who has gone off to get pregant and took something else considerd "safe" like Zolof, which my Dr's are recommending. My therapist also says that the hormal changes may also keep me feeling better.
Any more thoughts....keep them coming...
Posted by sheri on February 7, 2004, at 12:30:51
In reply to Re: Anyone NOT had trouble getting off this med?, posted by justjustine on February 7, 2004, at 11:17:34
THANK YOU!! your message was really helpful. his brother is with him now so I think he is ok, and I read your message to his brother over the phone along with some other info I found based on your suggestions. Yet, he is hesitant to take a bit more effexor so he can then taper off without the approval of his doctor. so he has call into his doctor. he is going to ask his doctor about opening up the capsuls and taking some in order to tapper off. i guess he still sort of trusts this doctor for some reason, but is interested in finding a new doctor. but how does he find a new doctor? do you know of any web pages where people recommend doctors in different cities?? thank you again!! sheri
> your friend's doctor doesn't have the proper experience in dealing with withdrawal from effexor.
>
> please tell your friend to log in here and search the old posts - effexor withdrawal is a hellride, especially if you have rebound depression on top of the physical symptoms.
>
> i was sick for a month and took vicodin to get through it. another person wrote here the other day they were taking lortab - that's how bad it can be.
>
> also try this search engine www.vivisimo.com and search for venlafaxine withdrawal taper and other info.
>
> if his effexor is the caplets, he only needs to get a razor blade and start shaving them down. save what he shaves off, for cost effectiveness. i had capsules and opened them up and poured it off.
>
> but please emphasize to him that this is real and won't get better until it gets worse for at least a week or two. in fact, if he's only one day off, the withdrawals are only beginning to hit and aren't even close to peaked.
>
> i'm praying for him!
>
> > HI: a friend just called because he is miserable and has been crying all day. his doctor told him it was fine to go off effexor cold turkey!! he was also surprised to learn that effexor is not an SSRI? I suggested that maybe some of crying could be part of the withdrawal. does this make sense to anyone? what else can I tell him? can anyone explain to me what effexor is if it is not an SSRI? he says he can not taper off because his effexor is in caps that he can not break apart. does that sound right? thank you!!! Sheri
>
Posted by noa on February 7, 2004, at 13:17:33
In reply to Re: Going off Effexor to get Pregnant? Advice?, posted by 4peace on February 7, 2004, at 11:42:23
This is something I've discussed hypothetically with my pdoc. He has recommended in vitro fertilization to minimize the amount of time off the med--ie, eliminate the trying-to-get-pregnant period of time. But to get off the med, he says it would be a matter of tapering off. I had asked him about using Prozac to wean off, and he said he wouldn't recommend that for me but there are other strategies.
Posted by justjustine on February 7, 2004, at 13:57:15
In reply to Re: Anyone NOT had trouble getting off this med?, posted by sheri on February 7, 2004, at 12:30:51
regarding getting a new doctor - i don't know his financial or insurance situation, but i would just start calling around. look for a doctor who has dealt specifically with effexor withdrawal - or if they've dealt with paxil withdrawal they probably know enough.
i also got good results with an acupuncturist i knew who had experience dealing with other kinds of drug withdrawal.
anyway, i'm glad i could help - and i'm glad you guys are there to help your friend!
Posted by Dr. Bob on February 7, 2004, at 14:32:52
In reply to ODE TO A LITTLE RED HEN, posted by on-the-wave on February 5, 2004, at 8:57:40
> she neither stopped to look about her, nor to investigate the cause of the dull throbbing sensation in her head. She ... ran blindly along the path... The other animals, not being well educated in the ways of the world and want to believe any story that would make them feel important and unique in the large forest, concurred with her story.
Please don't post anything that could lead others to feel put down. I've asked you to be civil before, so now I'm going to block you from posting for a week.
If you have any questions about this or comments about posting policies in general, or are interested in alternative ways to express yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
or email me, or redirect a follow-up to Psycho-Babble Administration after your block is over. Thanks,
Bob
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