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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by gr8red on October 20, 2004, at 10:38:01
My son is on 75 of Effexor. He missed his dose yesterday morning and had the day/night from HELL. Is that normal? He was extremely anxiety ridden, angry, agitated, I would say manic. He took the meds this morning. Whew! Will today be like yesterday until his system gets the meds????? I hope not!!! He had to come home from school yesterday because he was so out of sorts. Thank you for your help
Posted by jboud24 on October 20, 2004, at 13:08:11
In reply to Effexor/ Missed 1 dose, posted by gr8red on October 20, 2004, at 10:38:01
Why did he miss the dose? Yes I would think that is normal for effexor due to its relatively short plasma half-life. Try not to miss any doses, and if it is a matter of running out, ask your doc to write your son a 'backup' script as a buffer in case you run out again.
The same phenomena happened to me when I would miss my daily dose of Paxil. Alternately, you could ask your doc for Cymbalta, which has a longer half-life but similar pharmacodynamic qualities as effexor, or ask for Zoloft, Celexa, or Prozac which all stay in the system for a longer length of time. I have personal experience with celexa and zoloft, and missing a dose one day won't give those unplesant discontinuation side-effects.
Good Luck,
Justin
Posted by gr8red on October 20, 2004, at 13:14:40
In reply to Re: Effexor/ Missed 1 dose, posted by jboud24 on October 20, 2004, at 13:08:11
He missed a dose cause we were running late yesterday morning and I dropped the ball. Totally my fault. He has tried Zoloft, but none of the other drugs. I would rather keep him on Effexor and REALLY make sure that he takes it everyday instead of changing meds. These seem to be working so very well with his depression and social anxiety. He was just bumped up from 37.5 to 75 2 weeks ago and I am amazed at the difference in him. He has some MAJOR issues with focus, tho. We are working on that.
Posted by jboud24 on October 20, 2004, at 15:16:22
In reply to Re: Effexor/ Missed 1 dose, posted by gr8red on October 20, 2004, at 13:14:40
Posted by Sad Panda on October 21, 2004, at 10:22:09
In reply to Re: Effexor/ Missed 1 dose, posted by gr8red on October 20, 2004, at 13:14:40
> He missed a dose cause we were running late yesterday morning and I dropped the ball. Totally my fault. He has tried Zoloft, but none of the other drugs. I would rather keep him on Effexor and REALLY make sure that he takes it everyday instead of changing meds. These seem to be working so very well with his depression and social anxiety. He was just bumped up from 37.5 to 75 2 weeks ago and I am amazed at the difference in him. He has some MAJOR issues with focus, tho. We are working on that.
>
>Hi there,
I take Effexor, it's a pretty good antidepressant, but missing a doseage is horrible. If he is happy with Effexor, I would see no reason to want to change away from it. If he has ADD symptoms I would try adding a TCA such as Desipramine or Nortriptyline before moving on to Strattera & the stimulants.
Cheers,
Paul.
Posted by jboud24 on October 22, 2004, at 14:48:55
In reply to Re: Effexor/ Missed 1 dose, posted by Sad Panda on October 21, 2004, at 10:22:09
Paul,
Curious as to why you said that you'd try desipramine or nortryptiline before a stimulant like Strattera. Is Strattera significantly different than these 2 tricyclics in terms of stimulation/ADD qualities? I've been curious about this for awhile, just hoping you or someone else could clear it up for me.
Thanks,
Justin
Posted by Sad Panda on October 24, 2004, at 10:21:59
In reply to Strattera vs. Desipramine/Nortyp., posted by jboud24 on October 22, 2004, at 14:48:55
> Paul,
>
> Curious as to why you said that you'd try desipramine or nortryptiline before a stimulant like Strattera. Is Strattera significantly different than these 2 tricyclics in terms of stimulation/ADD qualities? I've been curious about this for awhile, just hoping you or someone else could clear it up for me.
>
> Thanks,
> Justin
>
>They, especially Nortriptyline, have efficacy as antidepressants. Nortriptyline can counter a lot of Effexor's side effects too. If you have ADD, but no other problems, then Strattera would be what I would try first.
Cheers,
Paul.
Posted by jboud24 on October 24, 2004, at 14:58:53
In reply to Re: Strattera vs. Desipramine/Nortyp. » jboud24, posted by Sad Panda on October 24, 2004, at 10:21:59
Okay, thanks.
I still dont get how it is that NRI's like desipramine or nortryptiline possess any significant anti-depressant action over that of Strattera. I know they're all NRI's, and especially desipramine and strattera are pretty selective for the NRI effect. Wouldn't strattera have subjective effects similar or identical to that of Strattera?
Thanks,
Justin
Posted by Sad Panda on October 26, 2004, at 9:22:50
In reply to Re: Strattera vs. Desipramine/Nortyp. » Sad Panda, posted by jboud24 on October 24, 2004, at 14:58:53
Desipramine & Strattera are probably fairly similar with one noteable exception being that Desipramine has a fairly long half life of 1 & 1/2 days while Strattera is pretty short at just 5 hours. If I had ADD/ADHD symptoms(which I don't) I would see if I could tolerate Desipramine or Nortriptyline & use one as the base & then add on an amphetamine or Ritalin.
Cheers,
Paul.
Posted by jboud24 on October 26, 2004, at 12:28:55
In reply to Re: Strattera vs. Desipramine/Nortyp. » jboud24, posted by Sad Panda on October 26, 2004, at 9:22:50
This is the end of the thread.
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