Psycho-Babble Medication Thread 326079

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

Bad Medical Advice? « nucase

Posted by Dr. Bob on March 19, 2004, at 13:54:33

In reply to Bad Medical Advice?, posted by nucase on March 18, 2004, at 17:58:21

> A month ago I went to see a Psychiatrist to have a medication evaluation. Prior to the visit I had taken Paxil 50mg for 2 years.
>
> The Doc told me to stop the paxil overnight and to start Effexor XR and Amitriptyline. It has been a month that I feel I am going insane. I have had terrible mood shifts, uncontrollable moods (e.g. sobbing), extremly suicidal urges, erratic behavior, panic attacks, irritability etc. These were not part of my behavior prior to taking the medication.
>
> Today I did some research and found that virtually everybody (that is the World Health Organization, The FDA, many others docs and reluctantly even paxil manufacturers) agrees that paxil should be weaned off gradually over time. In fact there were several (winning) lawsuits against the manufacturer for not having initially stressed the paxil withdrawal symptoms. The law suit list all the side effects I have had (and a score more). I found that some medical journal have documented these as well.
>
> I am FURIOUS! I have been going through hell for the last month. I went to the ER and could have easily done serious damage to myself (whether by killing myself, leaving my partner or loosing a job). What I am furious about of course is not that paxil is addictive but rather that there was plenty of abundant information out there (including something as simple as the paxil's instructions) that paxil should not be stopped cold turkey at once.
> I think my psychiatrist was irresponsible, misinformed and did not bother to find out when I told him how I felt.
>
> I just would like an external opinion. Does this make sense? Am I indeed justified in feeling this way?
>
> Moral of the story for you folks: whatever the credentials of the person who prescribed your meds, do your homework. Don't assumed that because your doctor is qualified and charges your insurance $$$ that he'll even bother to spent five minute researching on your case! Yes, it's outrageous and inexcusable but that's the way it is.
>

 

Re: Bad Medical Advice?

Posted by Sebastian on March 19, 2004, at 18:54:49

In reply to Bad Medical Advice? « nucase, posted by Dr. Bob on March 19, 2004, at 13:54:33

I agree that any psychotropic medicine, addictive or not should be decreased slowely. What ever method is most theraputic to the pashont. Especialy depending on the length on the med. You should tell the doctor that you want some more paxil at half the dose because of the withdraw you are having. Unless there is some reason that you can't take the medicine all of a sudden, they should understand.

 

Re: Bad Medical Advice?

Posted by Sad Panda on March 20, 2004, at 0:39:18

In reply to Bad Medical Advice? « nucase, posted by Dr. Bob on March 19, 2004, at 13:54:33

> > A month ago I went to see a Psychiatrist to have a medication evaluation. Prior to the visit I had taken Paxil 50mg for 2 years.
> >
> > The Doc told me to stop the paxil overnight and to start Effexor XR and Amitriptyline. It has been a month that I feel I am going insane. I have had terrible mood shifts, uncontrollable moods (e.g. sobbing), extremly suicidal urges, erratic behavior, panic attacks, irritability etc. These were not part of my behavior prior to taking the medication.
> >
> > Today I did some research and found that virtually everybody (that is the World Health Organization, The FDA, many others docs and reluctantly even paxil manufacturers) agrees that paxil should be weaned off gradually over time. In fact there were several (winning) lawsuits against the manufacturer for not having initially stressed the paxil withdrawal symptoms. The law suit list all the side effects I have had (and a score more). I found that some medical journal have documented these as well.
> >
> > I am FURIOUS! I have been going through hell for the last month. I went to the ER and could have easily done serious damage to myself (whether by killing myself, leaving my partner or loosing a job). What I am furious about of course is not that paxil is addictive but rather that there was plenty of abundant information out there (including something as simple as the paxil's instructions) that paxil should not be stopped cold turkey at once.
> > I think my psychiatrist was irresponsible, misinformed and did not bother to find out when I told him how I felt.
> >
> > I just would like an external opinion. Does this make sense? Am I indeed justified in feeling this way?
> >
> > Moral of the story for you folks: whatever the credentials of the person who prescribed your meds, do your homework. Don't assumed that because your doctor is qualified and charges your insurance $$$ that he'll even bother to spent five minute researching on your case! Yes, it's outrageous and inexcusable but that's the way it is.
> >
>
>

Paxil should easily be swaped with Effexor & Amitriptyline. Paxil is anticholinergic, so Amitrpityline would take care of that & Effexor would take care of the Serotonin withdrawl, so it appears that your pdoc knows his drugs.

What you are experiencing sounds like a paradoxial reaction to Effexor. I would phone him ASAP & see if he would change Effexor for Zoloft or Lexapro.

Cheers,
Panda.


 

Re: Bad Medical Advice? » Dr. Bob

Posted by King Vultan on March 20, 2004, at 10:18:51

In reply to Bad Medical Advice? « nucase, posted by Dr. Bob on March 19, 2004, at 13:54:33

Depending on the dosage, substituting Effexor should mitigate Paxil withdrawal symptoms, as Effexor also blockades serotonin reuptake just as Paxil does. The withdrawal symptoms one can experience when dropping drugs like Paxil or Effexor are caused by the loss of serotonin available for transmission. The body adapts to the excess of serotonin made available when taking an SSRI or Effexor, and when these drugs are stopped, there can be noticeable physiological (and psychological) effects. It may be that the dosage of Effexor is not high enough to effectively counter the Paxil withdrawal symptoms, or perhaps something else is going on.

Todd

 

Re: Bad Medical Advice?

Posted by Bill LL on March 22, 2004, at 9:07:16

In reply to Bad Medical Advice? « nucase, posted by Dr. Bob on March 19, 2004, at 13:54:33

I think that from the point of view of assessing the doctor's culpability, there are some issues to consider:

1) Why did he take you off of Paxi? When you initially went to the doctor, did you tell him that the Paxil was not working very well?

2) When you started to feel bad after stopping Paxil, did you call the doctor to let him know?

3) When and why did you go to the ER? And why the ER instead of your regular doctor or your pdoc?

When I consulted with a pdoc a few years a go, he had never heard that a side effect of Paxil was weight gain! I have read many posts about weight gain with Paxil.

 

Re: Bad Medical Advice?

Posted by nucase on March 24, 2004, at 11:23:33

In reply to Re: Bad Medical Advice?, posted by Bill LL on March 22, 2004, at 9:07:16

>I think that from the point of view of assessing >the doctor's culpability, there are some issues >to consider:

>1) Why did he take you off of Paxi?
Paxil was no longer very effective for me.

>2) When you started to feel bad after stopping >Paxil, did you call the doctor to let him know?
Yes. He only works 4days/week and has no cover.

>3) When and why did you go to the ER? And why >the ER instead of your regular doctor or your >pdoc?

I went to the ER on the advice of my therapist because I could not contact my pdoc.

 

Re: Bad Medical Advice?

Posted by Bill LL on March 24, 2004, at 14:47:24

In reply to Re: Bad Medical Advice?, posted by nucase on March 24, 2004, at 11:23:33

I don't know enough about legal issues to predict if you have a case. But a doctor should be available to a patient after a change in medication. This issue has just recently re-surfaced in the FDA discussions about AD's and suicide.

They stressed that a doctor should closely monitor a patient immediately following either the start of a new antidepressant, or a dosage change.

If you called the doctor after he started you on Effexor, and you left a message and he didn't return your calls, that's pretty bad.



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