![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 776 to 800 of 1313. Go back in thread:
Posted by SLS on May 1, 2004, at 8:04:49
In reply to Re: are these posts representative? » noa, posted by TanyaJean on April 30, 2004, at 21:49:44
> Is it just me, or has EFFEXOR risen in popularity over the past couple of years? I hadn't heard of it until I was prescribed it.
I really don't know whether or not Effexor is being prescribed more often. It would not surprise me though. Like it or not, Effexor gets more people well than any of the SSRIs, and for those whom respond, promotes a greater degree of improvement. The chances of being brought into complete remission is significantly higher with Effexor than with Prozac, Zoloft, Paxil, Luvox, Celexa, and Lexapro.
There are a bunch more.
These results are supported by a double-blind study of over 2000 patients conducted in 2001.
http://bjp.rcpsych.org/cgi/content/full/178/3/234
- Scott
Posted by Dr. Bob on May 1, 2004, at 8:06:23
In reply to Re: please be civil » chemist, posted by TanyaJean on May 1, 2004, at 2:10:54
> Why do people have such a problem with EFFEXOR and anti depressant side effects being so well publicized?
I'd like to redirect follow-ups regarding posting policies to Psycho-Babble Administration. My own response is at:
http://www.dr-bob.org/babble/admin/20040307/msgs/342111.html
Thanks,
Bob
Posted by Dr. Bob on May 1, 2004, at 8:07:57
In reply to Re: please be civil, posted by Sinnielou on April 30, 2004, at 23:20:22
Posted by seeknsolace on May 1, 2004, at 12:20:09
In reply to Does it ever end? When?, posted by seeknsolace on April 30, 2004, at 5:33:17
I read some stuff today about 5-htp, some woman decribed the ill effects of coming off effexor and how much 5-htp helped her thru the transition and with the depression in general. Still feeling like shit from effexor withdrawals, a little more tolerable today, I think in some ways I go mentally numb trying not to do too much, think too much, and also trying to disconnect from the hell ravaging my body, but in only is working slightly, in truth body still aches.. I wonder if this is what fibromyalgia or arthritis feels like, and still have the electric shocks, its very cool out today and my fingers hurt from the cold, mind you its in the 40s maybe 50s, not too extreme, just extra sensitive for whatever reason.
So anyways, gonna dive into the 5-htp tonite, 50 mgs.. will let ya know how it works, its key ingredient is tryptophan, sounds as bad as taking meth, not that I know, just tired of depending on drugs to dictate what my quality of life is going to be!
Posted by SLS on May 1, 2004, at 12:50:55
In reply to Re: Does it ever end? When?, posted by seeknsolace on May 1, 2004, at 12:20:09
> I read some stuff today about 5-htp, some woman decribed the ill effects of coming off effexor and how much 5-htp helped her thru the transition and with the depression in general.
> So anyways, gonna dive into the 5-htp tonite, 50 mgs.. will let ya know how it works,
Good luck. I hope things get better for you soon
:-)
- Scott
Posted by maxziggy2002 on May 1, 2004, at 13:01:21
In reply to Re: TELL OPRAH YOU HATE EFFEXORSinnielou » maxziggy2002, posted by noa on May 1, 2004, at 6:56:16
Yes I do have a vested interest in several of Effexors competitors: therapy, proper nutrition, and exercise.
Posted by SLS on May 1, 2004, at 13:48:17
In reply to Re: please be civil}}Dr Bob, posted by maxziggy2002 on May 1, 2004, at 12:59:25
> But if we want to actually DO something about, like alert the public, force the manufacturer to fully disclose side effects, or even start a lawsuit, then we are overgeneralizing and jumping to conclusions?
Hi.
Dr. Bob will hopefully redirect this post over to the Administration board for further discussion. I might be sticking my nose in where it doesn't belong, but I wanted to suggest to you that you continue posting here if you would like. I won't write too much here, but the following is my perspective on things.
I think what you are trying to do is admirable.
> > Effexor and its maker are monsters.
This site is moderated in a way that attempts to foster support and education in a pointed and focused way. It is a dialogue. An effort is made by posters to refine their language such that this can occur without personal attacks and exaggerated unsupported claims.
> > Or maybe you work for one of the advertising agencies that makes a bundle peddling this crack on behalf of Wyeth.
It does take some practice to write posts that don't over-generalize things as if they were absolute fact and applicable to all. Also, it takes some time to learn how to word things so that they don't accuse or judge others, even if only indirectly. The FAQ link at the top of this page offers some suggestions. You can look here:
http://www.dr-bob.org/babble/faq.html#civil
Good luck.
Bye the way, what did you think of the links I posted regarding the relative efficacy of Effexor to the SSRIs?
- Scott
Posted by maxziggy2002 on May 1, 2004, at 14:53:15
In reply to Re: please be civil}}Dr Bob » maxziggy2002, posted by SLS on May 1, 2004, at 13:48:17
What I found interesting about these abstracts was that none of the studies lasted more than 8 weeks.
The first 8 weeks I was on effexor were nothing short of fantastic. But why aren't they conducting studies on the long-term benefits/problems? By 6 months, I was a walking zombie, and it took me another 6 months to realize it.
I lost 2 years of my life to this drug. Why aren't they studying that?? I think it's because they already know the answer, and they don't want it made public.
Posted by SLS on May 1, 2004, at 16:41:39
In reply to relative efficacy of Effexor to the SSRIs }} SLS, posted by maxziggy2002 on May 1, 2004, at 14:53:15
Hi again.
> What I found interesting about these abstracts was that none of the studies lasted more than 8 weeks.
You make an excellent, excellent point. The brevity of clinical investigations has always been a peeve of mine.
> The first 8 weeks I was on effexor were nothing short of fantastic.What was the highest dosage you took?
> But why aren't they conducting studies on the long-term benefits/problems?
There are some, but not nearly enough that have been published, I don't think.
> I lost 2 years of my life to this drug. Why aren't they studying that??
In your situation, I would say that it is the clinical judgment of your doctor that should be called into question.
> I think it's because they already know the answer, and they don't want it made public.
What do you think the answer would be if you had the ability to independently study the question?
I know you are angry, but I don't know if it is justifiable to generalize your experience with Effexor to the majority. Of course I don't know for sure, but I don't think there is a conspiracy pushing for the continued use of Effexor.
- Scott
Posted by seeknsolace on May 1, 2004, at 17:03:41
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » maxziggy2002, posted by SLS on May 1, 2004, at 16:41:39
Hey Scott.. you seem like a nice guy.. are you married??? :) Btw, Thanks for the encouragement!
amy
Posted by Douglas T. on May 1, 2004, at 17:56:48
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » SLS, posted by seeknsolace on May 1, 2004, at 17:03:41
I have been through the withdraral period (13 weeks of hell)
after 5 years on Effexor. I was in a fog for all of that time.
I am still not myself after almost a year. My site, dougtyler.com
has a lot of information and a way to get involved if you're like me
and want the idiots who make this stuff to pay us all back for what
we've been through. I am NOT selling anything.
Go to Effexor link at the bottom of the page. thanks and be well.
Posted by chemist on May 1, 2004, at 18:57:54
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS, posted by Douglas T. on May 1, 2004, at 17:56:48
> I have been through the withdraral period (13 weeks of hell)
> after 5 years on Effexor. I was in a fog for all of that time.
> I am still not myself after almost a year. My site, dougtyler.com
> has a lot of information and a way to get involved if you're like me
> and want the idiots who make this stuff to pay us all back for what
> we've been through. I am NOT selling anything.
> Go to Effexor link at the bottom of the page. thanks and be well....and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist
Posted by Raggy on May 1, 2004, at 19:29:09
In reply to Re: are these posts representative?, posted by SLS on May 1, 2004, at 8:04:49
I read the other day where Wyeth lost a case for fen-phen and the jury awarded the family of the women who died 3 billion dollars, which they are going to fight. In the same article it said that Effexor sales are up 31 % this year.
Posted by seeknsolace on May 1, 2004, at 20:35:23
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » Douglas T., posted by chemist on May 1, 2004, at 18:57:54
> > I have been through the withdraral period (13 weeks of hell)
> > after 5 years on Effexor. I was in a fog for all of that time.
> > I am still not myself after almost a year. My site, dougtyler.com
> > has a lot of information and a way to get involved if you're like me
> > and want the idiots who make this stuff to pay us all back for what
> > we've been through. I am NOT selling anything.
> > Go to Effexor link at the bottom of the page. thanks and be well.
>
> ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist
I agree with you chemist but at the same time understand the underlying anger doug has. However, monetary settlement isnt going to give any justice to the withdrawl hell we have endured or for those to have yet go thru with it.Life isnt fair for the healthy minded or for us, chronically depressed. Money isnt going to deliver any of us, taking effexor off the market isnt going to solve anything either.
I'm sure no dr maliciously gave us effexor so that we would suffer its effects, they are human too and even if Wyeth knows of the withdrawal reactions, in some sense they have done a good thing in creating the drug. I mean it did help most of us right? Even if it was only in the beginning.. at least for a passing moment, we got to embrace life.
I know in truth, if it wasnt for effexor, taking the edge off of being bipolar, having anxiety disorder/panick attacks and seasonal effective disorder, I wouldnt have gained the strength and knowledge I learned in understanding myself, my emotions, ways to cope, especially now with the dark seasons approaching, being that bipolar is forever and it hits worse come the late fall season.
Ok just rambling now. To wrap this up, just saying there is no monetary value that give the dream and hope of being free from depression and I would give a billion dollars to know what it is to feel alive.. consistantly.
Posted by TanyaJean on May 1, 2004, at 21:14:37
In reply to Re: please be civil}}Dr Bob » maxziggy2002, posted by SLS on May 1, 2004, at 13:48:17
> Bye the way, what did you think of the links I posted regarding the relative efficacy of Effexor to the SSRIs?
>
>
> - Scott
I don't know if you're talking to Dr. Bob or to another post-er. I'm still reading through them a little at a time. Ok, so this is probably my second to last post. This caught my attention:
"Venlafaxine was significantly more effective than SSRIs in improving depression, perhaps due to enhancing both serotonin and norepinephrine."
My doctor had told me I was crashing so hard when missing a dose of PAXIL because it was just enhancing the serotonin. He put me on EFFEXOR because he said it enhanced both the serotonin and norepinephrine pathways. He said if I missed a dose, I wouldn't have such ill effects. So I wonder why I did then? I'd say it was twice as bad as when I missed the PAXIL. I also found it interesting that people with major depression fared pretty well on EFFEXOR.Thank you so much for the post-er asking "Hey Scott, are you married?" That was funny. There needs to be some levity in here and I was thinking the same thing.
Posted by TanyaJean on May 1, 2004, at 21:18:32
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » Douglas T., posted by chemist on May 1, 2004, at 18:57:54
> > I have been through the withdraral period (13 weeks of hell)
> > after 5 years on Effexor. I was in a fog for all of that time.
> > I am still not myself after almost a year. My site, dougtyler.com
> > has a lot of information and a way to get involved if you're like me
> > and want the idiots who make this stuff to pay us all back for what
> > we've been through. I am NOT selling anything.
> > Go to Effexor link at the bottom of the page. thanks and be well.
>
>" ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist"**What was that??
Posted by seeknsolace on May 1, 2004, at 21:22:38
In reply to Re: please be civil}}Dr Bob » SLS, posted by TanyaJean on May 1, 2004, at 21:14:37
> > Bye the way, what did you think of the links I posted regarding the relative efficacy of Effexor to the SSRIs?
> >
> >
> > - Scott
>
>
> I don't know if you're talking to Dr. Bob or to another post-er. I'm still reading through them a little at a time. Ok, so this is probably my second to last post. This caught my attention:
>
> "Venlafaxine was significantly more effective than SSRIs in improving depression, perhaps due to enhancing both serotonin and norepinephrine."
>
> My doctor had told me I was crashing so hard when missing a dose of PAXIL because it was just enhancing the serotonin. He put me on EFFEXOR because he said it enhanced both the serotonin and norepinephrine pathways. He said if I missed a dose, I wouldn't have such ill effects. So I wonder why I did then? I'd say it was twice as bad as when I missed the PAXIL. I also found it interesting that people with major depression fared pretty well on EFFEXOR.
>
> Thank you so much for the post-er asking "Hey Scott, are you married?" That was funny. There needs to be some levity in here and I was thinking the same thing.That came from me tonyajean, but he still hasnt answered *sniff*! ;)
Posted by chemist on May 1, 2004, at 22:04:44
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS, posted by seeknsolace on May 1, 2004, at 20:35:23
> > > I have been through the withdraral period (13 weeks of hell)
> > > after 5 years on Effexor. I was in a fog for all of that time.
> > > I am still not myself after almost a year. My site, dougtyler.com
> > > has a lot of information and a way to get involved if you're like me
> > > and want the idiots who make this stuff to pay us all back for what
> > > we've been through. I am NOT selling anything.
> > > Go to Effexor link at the bottom of the page. thanks and be well.
> >
> > ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist
>
>
> I agree with you chemist but at the same time understand the underlying anger doug has. However, monetary settlement isnt going to give any justice to the withdrawl hell we have endured or for those to have yet go thru with it.
>
> Life isnt fair for the healthy minded or for us, chronically depressed. Money isnt going to deliver any of us, taking effexor off the market isnt going to solve anything either.
>
> I'm sure no dr maliciously gave us effexor so that we would suffer its effects, they are human too and even if Wyeth knows of the withdrawal reactions, in some sense they have done a good thing in creating the drug. I mean it did help most of us right? Even if it was only in the beginning.. at least for a passing moment, we got to embrace life.
>
> I know in truth, if it wasnt for effexor, taking the edge off of being bipolar, having anxiety disorder/panick attacks and seasonal effective disorder, I wouldnt have gained the strength and knowledge I learned in understanding myself, my emotions, ways to cope, especially now with the dark seasons approaching, being that bipolar is forever and it hits worse come the late fall season.
>
> Ok just rambling now. To wrap this up, just saying there is no monetary value that give the dream and hope of being free from depression and I would give a billion dollars to know what it is to feel alive.. consistantly.
>
i concur. for those who have not picked up on my personal history, i have been on the development end and the receiving end of psychopharmaceuticals. and i don't mean marketing. improperly diagnosed as unipolar depression with agoraphobia and GAD over 10 years ago, i ran the gamut from luvox to remeron to celexa to parnate to paxil, and not in that order. additionally, there was tegretol, trileptal, topamax, neurontin, depakote. and then there were (concurrently) ambien, xanax, restoril, dalmane, halcion, klonopin, valium, and ativan. i am certain i missed a few, but it took a psychotic break while on parnate and a visit to a leading authority on bipolar (details for anyone who wants to know; involved with DSM-III and is a proponent of verapamil) to get things kind of straight. did i mention geodon and dexedrine? probably not.....or ritalin, come to think of it....you and the rest of us are not alone. and as you point out, effexor and countless other meds have helped many, and the last thing any drug manufacturer wants is for their product to fail, and that is for financial reasons. we, their target audience, also want success, because our lives can be (at least) marginally better if the right combination is found. it is not to anyone's benefit to go after drug companies, and citing a dearth of long-term studies is usually because the drug has not been on the market for long-term, randomized, controlled longitudinal studies. want a target? health insurance companies. preexisting conditions ranging from ``have you seen a mental healthcare practicioner in the past five years?'' to ``do you have high cholesterol?'' put you in the high-risk category. i am looking at the recent insert from a script i had filled yesterday for 60 2 mg generic alprazolam (xanax) tablets from a common pharmacy in a grocery store: my savings vs. the brand-name was $173.48, and i do not have prescription coverage. instead of being on the hook for $196.56, i strolled out for $23.08. yet i digress: doug's anger is misdirected, and i am no stranger to anger, but i know where to draw the line. if you don't like your therapist, try another. if your shrink is predisposed to prescribing for you a drug that is ineffective, try another. the greatest realization we have within ourselves is the ability to instigate change and not feel victimized by an industry that, on the whole, has done more good than harm. all the best, chemist
Posted by chemist on May 2, 2004, at 0:06:14
In reply to Re: relative efficacy of Effexor to the SSRIs }} S, posted by TanyaJean on May 1, 2004, at 21:18:32
> > > I have been through the withdraral period (13 weeks of hell)
> > > after 5 years on Effexor. I was in a fog for all of that time.
> > > I am still not myself after almost a year. My site, dougtyler.com
> > > has a lot of information and a way to get involved if you're like me
> > > and want the idiots who make this stuff to pay us all back for what
> > > we've been through. I am NOT selling anything.
> > > Go to Effexor link at the bottom of the page. thanks and be well.
> >
> >" ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist"
>
> **What was that??hi tanyjean, chemist here...in response to ``what was that?,'' it was my take on doug's vendetta that is way beyond the limit of ``it's your fault, not mine.'' if you take a drug for 5 years - and we are not getting the full story, naturally (e.g., alcohol use, other meds, etc.) - and post 3 messages to enjoin a person in proceeding with legal action against doctors, therapists, and pharmaceutical companies, you are being asked to be part of a money-making scheme. and that is all there is to it. all the best, chemist
>
Posted by Carlos C on May 2, 2004, at 1:40:51
In reply to Re: TELL OPRAH YOU HATE EFFEXOR, posted by Bill LL on April 29, 2004, at 9:09:12
Along with about 7 other ADs that have not helped me but made things worse.
Posted by seeknsolace on May 2, 2004, at 6:13:19
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » seeknsolace, posted by chemist on May 1, 2004, at 22:04:44
I applaude you chemist.. I've only been on about 4 antidepressants: zoloft, buspar, topamax, lithium, and lastly effexor.. ok thats more than four.
Now I understand only the past few years that I'm bipolar and been diagnosed as such, realized I've been so since adolescence.
I'm not being sarcastic towards you either, I could never endure as much as you have. I do not plan on returning to any meds.. maybe its the mania speaking :) Actually life has been so difficult, dont have many manic times, at least during those times, life was "great"!
Your a strong and very intelligent person. Theres a bible scripture that says "those who endure to the end, shall be saved". I think its appropriate to apply it towards our condition.
I had a hard time reading your post, maybe cuz its so early in the morn, but wanted to say.. my doc once told me, bipolar people are some of the smartest people in the world! :) So I conclude with, maybe thats our problem.. we're just too damn smart! ;)
> i concur. for those who have not picked up on my personal history, i have been on the development end and the receiving end of psychopharmaceuticals. and i don't mean marketing. improperly diagnosed as unipolar depression with agoraphobia and GAD over 10 years ago, i ran the gamut from luvox to remeron to celexa to parnate to paxil, and not in that order. additionally, there was tegretol, trileptal, topamax, neurontin, depakote. and then there were (concurrently) ambien, xanax, restoril, dalmane, halcion, klonopin, valium, and ativan. i am certain i missed a few, but it took a psychotic break while on parnate and a visit to a leading authority on bipolar (details for anyone who wants to know; involved with DSM-III and is a proponent of verapamil) to get things kind of straight. did i mention geodon and dexedrine? probably not.....or ritalin, come to think of it....you and the rest of us are not alone. and as you point out, effexor and countless other meds have helped many, and the last thing any drug manufacturer wants is for their product to fail, and that is for financial reasons. we, their target audience, also want success, because our lives can be (at least) marginally better if the right combination is found. it is not to anyone's benefit to go after drug companies, and citing a dearth of long-term studies is usually because the drug has not been on the market for long-term, randomized, controlled longitudinal studies. want a target? health insurance companies. preexisting conditions ranging from ``have you seen a mental healthcare practicioner in the past five years?'' to ``do you have high cholesterol?'' put you in the high-risk category. i am looking at the recent insert from a script i had filled yesterday for 60 2 mg generic alprazolam (xanax) tablets from a common pharmacy in a grocery store: my savings vs. the brand-name was $173.48, and i do not have prescription coverage. instead of being on the hook for $196.56, i strolled out for $23.08. yet i digress: doug's anger is misdirected, and i am no stranger to anger, but i know where to draw the line. if you don't like your therapist, try another. if your shrink is predisposed to prescribing for you a drug that is ineffective, try another. the greatest realization we have within ourselves is the ability to instigate change and not feel victimized by an industry that, on the whole, has done more good than harm. all the best, chemist
Posted by SLS on May 2, 2004, at 8:22:20
In reply to Re: please be civil}}Dr Bob » SLS, posted by TanyaJean on May 1, 2004, at 21:14:37
> My doctor had told me I was crashing so hard when missing a dose of PAXIL because it was just enhancing the serotonin. He put me on EFFEXOR because he said it enhanced both the serotonin and norepinephrine pathways. He said if I missed a dose, I wouldn't have such ill effects. So I wonder why I did then?
Your doctor is wrong for two reasons:1. He is wrong.
2. He is wrong.
:-)
1. The tendency for a withdrawal syndrome to occur upon missing doses has been observed for both Paxil and Effexor and is well known.
2. There is no medical foundation for concluding that Effexor will not produce this phenomenon simply because it inhibits the reuptake of norepinephrine (NE) in addition to serotonin (5-HT).
I am really appalled that this kind of ignorance and misinformation still exists. Even if a doctor doesn't want to read the most current medical literature, he must certainly come in contact with doctors who do.
The following is a citation on Medline from 1997. The authors are from Harvard / Massachusetts General Hospital. They are by no means obscure. Nor is the journal that published them, J Clin Psychiatry.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9219493
Here is something that can easily be found on the Web:
http://remedyfind.com/rem.asp?ID=3948&lPageNum=3
"
However, as Venlafaxine has a short half-life (approx. 5 hours), compared to say, Fluoxetine (2-3 days), sudden discontinuation or missed doses can result in serious side-effects. Withdrawal side-effects may include fatigue, nausea, dizziness, headache, insomnia, and nervousness. Venlafaxine withdrawal symptoms can be so significant that in March 2000, the U.S. FDA required manufacturer Wyeth-Ayerst to add additional labeling which states, “Abrupt discontinuation or dose reduction of venlafaxine at various doses has been found to be associated with the appearance of new symptoms, the frequency of which increased with increased dose level and with longer duration of treatment..... It is therefore recommended that the dosage of Effexor be tapered gradually and the patient monitored. The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
"The labelling of the drug manufacturer is unambiguous.
- Scott
Posted by chemist on May 2, 2004, at 11:53:58
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS, posted by seeknsolace on May 2, 2004, at 6:13:19
well, thanks!...i think your stance in re: not taking any more meds is refreshing, as i, too, limit the regimen to the least amount of meds for the most effective response...an interesting thing about bipolar is that it goes for years undiagnosed or misdiagnosed, and this is in a way a ``fault'' of the malady itself: if you're manic/hypomanic, you don't feel any need to seek out help - everything is fine. when you get dysphoric/depressed, then you go see a psychiatrist, and naturally you present with those symptoms. so, out you go with a script for an antidepressant. then the cycle begins. the antidepressant makes you manic/hypomanic and insomnia, anxiety, and agitaton set in. so back you go, and come away with a less-activating antidepressant, a benzo, and maybe some ambien for sleep. and that combo brings you back down. as so on and so forth...as for enduring, on my part it largely has to do with self-education and taking matters into my own hands: instead of blaming the (admittedly lousy) healthcare system, the doctors, and the pharmaceutical companies, i switch therapists/psychiatrists. i also have a passion for my work, and have no intention of letting bumps in the road get in the way, no matter how large. it sounds to me like you are that kind of person, too(?). forums like this one are exceptionally good outlets for discourses like this one, i.e., to hear how others have dealt with their condition in a proactive way....all the best, chemist
> I applaude you chemist.. I've only been on about 4 antidepressants: zoloft, buspar, topamax, lithium, and lastly effexor.. ok thats more than four.
>
> Now I understand only the past few years that I'm bipolar and been diagnosed as such, realized I've been so since adolescence.
>
> I'm not being sarcastic towards you either, I could never endure as much as you have. I do not plan on returning to any meds.. maybe its the mania speaking :) Actually life has been so difficult, dont have many manic times, at least during those times, life was "great"!
>
> Your a strong and very intelligent person. Theres a bible scripture that says "those who endure to the end, shall be saved". I think its appropriate to apply it towards our condition.
>
> I had a hard time reading your post, maybe cuz its so early in the morn, but wanted to say.. my doc once told me, bipolar people are some of the smartest people in the world! :) So I conclude with, maybe thats our problem.. we're just too damn smart! ;)
> > i concur. for those who have not picked up on my personal history, i have been on the development end and the receiving end of psychopharmaceuticals. and i don't mean marketing. improperly diagnosed as unipolar depression with agoraphobia and GAD over 10 years ago, i ran the gamut from luvox to remeron to celexa to parnate to paxil, and not in that order. additionally, there was tegretol, trileptal, topamax, neurontin, depakote. and then there were (concurrently) ambien, xanax, restoril, dalmane, halcion, klonopin, valium, and ativan. i am certain i missed a few, but it took a psychotic break while on parnate and a visit to a leading authority on bipolar (details for anyone who wants to know; involved with DSM-III and is a proponent of verapamil) to get things kind of straight. did i mention geodon and dexedrine? probably not.....or ritalin, come to think of it....you and the rest of us are not alone. and as you point out, effexor and countless other meds have helped many, and the last thing any drug manufacturer wants is for their product to fail, and that is for financial reasons. we, their target audience, also want success, because our lives can be (at least) marginally better if the right combination is found. it is not to anyone's benefit to go after drug companies, and citing a dearth of long-term studies is usually because the drug has not been on the market for long-term, randomized, controlled longitudinal studies. want a target? health insurance companies. preexisting conditions ranging from ``have you seen a mental healthcare practicioner in the past five years?'' to ``do you have high cholesterol?'' put you in the high-risk category. i am looking at the recent insert from a script i had filled yesterday for 60 2 mg generic alprazolam (xanax) tablets from a common pharmacy in a grocery store: my savings vs. the brand-name was $173.48, and i do not have prescription coverage. instead of being on the hook for $196.56, i strolled out for $23.08. yet i digress: doug's anger is misdirected, and i am no stranger to anger, but i know where to draw the line. if you don't like your therapist, try another. if your shrink is predisposed to prescribing for you a drug that is ineffective, try another. the greatest realization we have within ourselves is the ability to instigate change and not feel victimized by an industry that, on the whole, has done more good than harm. all the best, chemist
>
>
Posted by TanyaJean on May 2, 2004, at 12:01:40
In reply to Re: please be civil}}Dr Bob » TanyaJean, posted by SLS on May 2, 2004, at 8:22:20
"The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
I would have thought 4+ months of tapering and being on a low dose for over a month would be sufficient enough to not have all the side effects listed. Then I can assume the thought is that my body was just not creating seratonin?
Posted by SLS on May 2, 2004, at 14:51:17
In reply to Re: please be civil, posted by TanyaJean on May 2, 2004, at 12:01:40
Regarding the discontinuation of Effexor:
> > "The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
> I would have thought 4+ months of tapering and being on a low dose for over a month would be sufficient enough to not have all the side effects listed.
Me too.
How much were you taking during that last month before you discontinued it? How much did you take as your very last dose? How would you describe your experience during those several months that you were tapering?
> Then I can assume the thought is that my body was just not creating seratonin
Well, actually, the reverse might have been true. There might have been a temporary increase in the production and release of serotonin. However, being exposed to artificially elevated concentrations of serotonin through reuptake inhibition can lead to a decrease in the sensitivity of receptors along the cell membrane. Neurons try to regulate themselves by changing the settings of their "thermostats". I really don't know what the dynamics are that produce the withdrawal syndrome and which variables take precedence in producing it.
If, while looking up at the stars in a planetarium, someone were to shine a bright flashlight in your eyes, you would no longer be able to see the stars immediately after the light is removed. The sensitivity of your eyes has been decreased in response to having been exposed to the bright light. In order to see the stars again, either the planetarium projector would have to make the stars shine brighter or one would need to allow the passage of a certain amount of time before the eyes adjust to the dark again. The variables would be things like how bright were the stars, how bright was the flashlight, how long was the flashlight on for, and how much time it takes for the sensitivity of the eyes (rods and cones of the retina) to adjust.
If you are unfamiliar with planetariums, then just substitute the planetarium with a dark night sky and the projector with God. :-)
Cast of characters:
stars = serotonin
retina = postsynaptic neuron (receiver) membrane
rods and cones of the retina = serotonin receptors
flashlight = reuptake inhibition (Effexor)
projector = presynaptic neuron (sender) serotonin synthesis and release
- Scott
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