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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by ed_uk on December 10, 2004, at 10:24:02
Barbiturates introduced as being non-addictive, .......this was wrong.
Non-barbitutes hypnotics introduced as non-addictive replacements for the barbiturates (eg. Quaalude)... they were addictive.
Meprobamate introduced as a non-addictive anxiolytic, it produced addiction and/or dependence.
Antipsychotics introduced.... they can cause withdrawal symptoms.
Benzodiazepines introduced as non-addictive replacements for earlier anxiolytics and hypnotics. They are capable of producing profound dependence.
TCAs introduced. Reports of withdrawal symptoms quicky appeared (but were generally ignored).
SSRIs introduced, the possibility of dependence was dismissed..... they can cause severe withdrawal symtoms.
Has anyone noticed that the potential severity of withdrawal symptoms is only widely acknowledged when 'replacements' are introduced. In the UK, benzos were widely prescribed for anxiety before being virtually replaced by the SSRIs. Doctors who used to claim that the benzos were completely safe now view them as the devil's drugs.
I've even heard some people say that Cymbalta won't ever produce withdrawal symptoms..... who are they kidding!
Ed.
Posted by linkadge on December 10, 2004, at 10:50:44
In reply to Why do we never learn from the past???, posted by ed_uk on December 10, 2004, at 10:24:02
YOu need to make sure you make the distinction between addicting in the sence that you need to continue increasing the dose in order to achieve an effect, or addicting in the sence that there are withdrawl effects.
The benzo's/sedatives (for many) need to be continually increased in order to achieve an effect. A smaller proportion of SSRI users need to increase their dose in order to achieve a clinical effect.
Linkadge
Posted by ed_uk on December 10, 2004, at 11:29:59
In reply to Re: Why do we never learn from the past???, posted by linkadge on December 10, 2004, at 10:50:44
Thank you Linkadge, I am aware of that distinction. Perhaps my post was not very clear.
What I am saying is that every time a new drug is introduced we are told that it will not cause major withdrawal symptoms........... with the possible exception of buspirone this has rarely been correct. The medical profession consistently fails to learn from the past.
Regards,
Ed.
Posted by Dan Perkins on December 10, 2004, at 14:20:05
In reply to Why do we never learn from the past???, posted by ed_uk on December 10, 2004, at 10:24:02
ed_uk,
You are 100% correct with everything in your post. Fact is that this is standard pharmaceutical industry practice for all of their meds, not just ones involving mental health. As one class of drugs is coming off of patent and profits are about to evaporate, they both trumpet a new class of drugs as being superior and do a hatchet job on the outgoing meds which were once trumpeted as being superior themselves.
It really is amazing how we, the drug takers, never seem to notice this pattern and just line up to take the newest drug. Cymbalta now is supposed to be the answer to our prayers, but many of us seem to have forgotten that the same promises new hope and of a better drug have been made to us so many times before.
Drug companies are for-profit entities whose only responsibility is to maximize value for their shareholders, not to do what is in the best interest of their customers. How many more broken promises and Vioxx-type scandals (tally so far is 55,000 Americans killed by Vioxx - roughly same number of Americans killed in Vietnam) will it take for us to wisen up and be a little bit more skeptical about promises made by drug companies?
Posted by RetiredYoung on December 10, 2004, at 16:08:36
In reply to Re: Why do we never learn from the past???, posted by Dan Perkins on December 10, 2004, at 14:20:05
55,000 people have died as a result of Vioxx? I know all about the recall, but had never seen a figure like that before. Could you please share a source with me on that? Thanks..
Posted by Dan Perkins on December 10, 2004, at 16:43:13
In reply to Re: Why do we never learn from the past??? » Dan Perkins, posted by RetiredYoung on December 10, 2004, at 16:08:36
The figure of up to 55,000 deaths (as well as 159,000 heart attacks) attributable to Vioxx comes from FDA scientist David Graham's testimonial before Congress. Here are a couple of articles that address Graham's comment:
http://www.kansas.com/mld/kansas/2004/11/19/living/10220598.htm
http://www.newstarget.com/002458.htmlI know this seems like it's been a pretty big story in the news, but I still don't think it has gotten nearly enough attention, and both the FDA and Merck have been unwilling to accept any responsibility for the fact that this drug remained on the market so long after it's harmful effects were discovered (they were actually know about before the drug was even approved).
To put the number of 55,000 deaths into perspective, it is about the same number of Americans killed in Vietnam (~58,000) or, to use a more recent comparison, it is over ten times the number of people killed on 9/11 and in the first and second Gulf Wars and the war in Afghanistan combined. And it looks like not a single person is going to even lose their job over this scandal.
Posted by RetiredYoung on December 10, 2004, at 17:02:41
In reply to Vioxx - 55,000 (sources), posted by Dan Perkins on December 10, 2004, at 16:43:13
Stunning. I had no idea of the magnitude. Thank you for the extra information.
Jim
Posted by linkadge on December 11, 2004, at 12:58:15
In reply to Re: Vioxx - 55,000 (sources) » Dan Perkins, posted by RetiredYoung on December 10, 2004, at 17:02:41
I'd hate to wonder how many heart attacks were related to the use of effexor. It is well know that it can raise blood pressure. It gave me (a 21 year old) chest pain, and rapid heartbeat)
The thing is this: Many people who have had recent corinary events can become depressed. Antidepressants could be highly used among this population. I would not be surprised if effexor could be linked to more than one cardiac event.
Personally I think the drug companies knew all along that there were discontinuation syndromes attributed to antidepressants. I think their reason for not explaining this is the fear that this might alter ones decision about weather to take the drug or not.
Linakdge
Posted by ed_uk on December 11, 2004, at 15:13:23
In reply to effexor related heart events, posted by linkadge on December 11, 2004, at 12:58:15
AD withdrawal symptoms were recognised many years ago.... but no one seemed to take any notice!
Am J Psychiatry. 1961 Dec;118:549-50.
Withdrawal symptoms following dicontinuation of imipramine therapy.
Ed.
Posted by linkadge on December 11, 2004, at 16:27:01
In reply to Re: Withdrawal symptoms, posted by ed_uk on December 11, 2004, at 15:13:23
I don't think that "mainstream doctors" were ever denying discontinuation syndrome/withdrawl. I have a book from the 80's which says to slowly taper from and TCA because abrupt discontinuation will cause "significant withdrawl symptoms".
When my mom took doxepin in 84 she was warned that suddenly stopping the medication would cause severe side effects.
I don't think that it was ever "totally denied". I think it was just never "focused on".
In the past when amitryptaline was given for depression, it was rarely prescribed for more than 6-8 months. I know of 10+ people who took TCA's temporaraly, and recovered.
We've sort of phased into a "life time" of medicating regime. Many patients are told that they will need to take their medications for life, when in the past people got better from their depression, and the bandaid was removed.
I don't know what's up. But maybe the doctors have something to do with this life time prescribing idea.
Linkadge
Posted by ed_uk on December 11, 2004, at 17:01:42
In reply to Re: Withdrawal symptoms, posted by linkadge on December 11, 2004, at 16:27:01
Hi,
Although some doctors may have known about AD withdrawal symptoms, many of them would not. Also, most doctors refuse to believe that AD withdrawal symptoms can be severe, even with tapering in some cases. I have seen psychopharmacology textbooks that don't even mention withdrawal symptoms.
Ed.
Posted by KaraS on December 11, 2004, at 19:57:20
In reply to Re: Withdrawal symptoms, posted by ed_uk on December 11, 2004, at 17:01:42
I have encountered doctors who don't believe in the withdrawal problems or who downgrade the severity of the symptoms. I have gone to others who have had a healthy respect for the problem however.
Posted by KaraS on December 11, 2004, at 20:03:40
In reply to Re: Withdrawal symptoms, posted by linkadge on December 11, 2004, at 16:27:01
> I don't think that "mainstream doctors" were ever denying discontinuation syndrome/withdrawl. I have a book from the 80's which says to slowly taper from and TCA because abrupt discontinuation will cause "significant withdrawl symptoms".
>
> When my mom took doxepin in 84 she was warned that suddenly stopping the medication would cause severe side effects.
>
> I don't think that it was ever "totally denied". I think it was just never "focused on".
>
> In the past when amitryptaline was given for depression, it was rarely prescribed for more than 6-8 months. I know of 10+ people who took TCA's temporaraly, and recovered.
>
> We've sort of phased into a "life time" of medicating regime. Many patients are told that they will need to take their medications for life, when in the past people got better from their depression, and the bandaid was removed.
>
> I don't know what's up. But maybe the doctors have something to do with this life time prescribing idea.
>
>
> Linkadge
>I should have added in my previous post that I was including doctors going all the way back to the late 70's.
In terms of medicating for life, I think it really depends on the individuals involved. I know of several people whose basic chemistry is quite healthy and they function quite well in the world normally. Then they may go through something horrible with unusual stress involved and they fall into a depression. Those type of people seem to do quite well on an SSRI. They reset their chemistry back to a more normal state. They are on the drug for several months and they are fine when they go off of it.
OTOH, there are people like me whose basic chemistry is not healthy. If I'm not on medication I become seriously depressed and I start getting panic disorder symptoms. I am convinced that I have to be on medication for the rest of my life. While I am not naive in terms of the workings and motivations of the drug companies and even some doctors, I know that in many cases, they are right when they talk about people who need medication for life.
Posted by Dan Perkins on December 12, 2004, at 2:43:33
In reply to Re: Withdrawal symptoms » linkadge, posted by KaraS on December 11, 2004, at 20:03:40
gotta love those doctors who refuse to believe problems that their patients report!
Posted by linkadge on December 12, 2004, at 9:18:37
In reply to Re: Withdrawal symptoms, posted by Dan Perkins on December 12, 2004, at 2:43:33
I guess what I'm trying to say is that, the drug companies would love for us to need to stay on the medications for life.
Linkadge
Posted by ed_uk on December 12, 2004, at 9:49:30
In reply to Re: Withdrawal symptoms, posted by linkadge on December 12, 2004, at 9:18:37
You're so right!
Ed.
Posted by Dan Perkins on December 12, 2004, at 11:20:33
In reply to Re: Withdrawal symptoms, posted by linkadge on December 12, 2004, at 9:18:37
> I guess what I'm trying to say is that, the drug companies would love for us to need to stay on the medications for life.
>
>
> LinkadgeAnd when we do stay on these medications for life (or even just for several months) we are in officialy unchartered territory b/c most of the studies used to approve these drugs, the ones listed on the package inserts that were used to determine side effects, last only a couple of months.
That's why message boards like these are so important b/c, for one thing, they provide information on longer term use of drugs that the pharmaceutical companies have no information about.
Posted by dancingstar on December 13, 2004, at 19:44:57
In reply to Re: Withdrawal symptoms, posted by Dan Perkins on December 12, 2004, at 11:20:33
I had no idea whatsoever that stopping taking Effexor would be a problem as I only began to take it on a "whim" in the first place. I asked the family practice doctor, my friend's brother, if that little package of antidepressants could help my fatigue. I don't think he thought there was anything wrong with me and said I could try it.
I asked if there were any side effects, and he said there were some sexual side effects, but that they would probably not be a problem for me.
I asked him why.
He just shrugged and said he just didn't think that they would, that it was a new drug and supposed to be a good one.I remember this as though it were yesterday, and it was a good three years ago.
I quit cold turkey at the end of September. I haven't been able to sleep lately, and my body has been hurting all over in the last week and a half or so. Nothing seems to take away the pain. I've also had these sharp, tingling, feeings, and a bit of a rash on my back as if I were taking an antibiotic that I am allergic to; and for the very first time in my life, I've started to feel a bit of panic for not much reason, like at a party, with friends, when in the kitchen with people that I know and love.
Because of the rash and a bit of nausea, I pulled out the Benadryl, which I had stopped taking, and decided to take one this afternoon. Guess what? My pain vanished! The same pain that even a mild narcotic would not touch. Does anyone think that this is strange? Nothing would take this hair-raising pain away.
So, okay, I've got this horrible taste in my mouth, non-stop trips to the restroom, some kind of prickly feeling, a bit of a rash on my back, pain in every cell of my body, my muscles are sore in my back and neck. I'm nauseous, my throat feels a little closed, I'm anxious, exhausted, can't sleep at night, I'm sweating, freezing during the day -- all day -- roasting at night, and Benadryl takes away a lot of my symptoms even after almost three months of being off of Effexor. Oh, and I've started taking pharmaceutical grade tryptophan, St. John's Wort, Enzymatic Therapy From Fatigued to Fantasic (good vitamints w/great B's)
Does this sound like it might be an allergy to anyone besides me? And no, I am not in menopause if you were wondering as even I wondered, but I'm not -- besides, I'm freezing all day. It doesn't seem like the doctors know this stuff...at least mine doesn't, but I'm just today beginning to think that my body is trying to get a toxin out of its system to regain homeostasis and I am having an allergic reaction that the Benadryl is helping.
Does anyone else have anything like this?
Posted by MKB on December 13, 2004, at 21:28:44
In reply to Re: Withdrawal symptoms, posted by dancingstar on December 13, 2004, at 19:44:57
Bebe,
I still have the rash too. I think it's fairly common when discontinuing antidepressants, as I had the same thing happen when I discontinued Zoloft.
Posted by PoohBear on December 15, 2004, at 14:46:41
In reply to effexor related heart events, posted by linkadge on December 11, 2004, at 12:58:15
> I'd hate to wonder how many heart attacks were related to the use of effexor. It is well know that it can raise blood pressure. It gave me (a 21 year old) chest pain, and rapid heartbeat)
>
> The thing is this: Many people who have had recent corinary events can become depressed. Antidepressants could be highly used among this population. I would not be surprised if effexor could be linked to more than one cardiac event.
>
> Personally I think the drug companies knew all along that there were discontinuation syndromes attributed to antidepressants. I think their reason for not explaining this is the fear that this might alter ones decision about weather to take the drug or not.
>
>
>
>
> LinakdgeI have been experiencing cardiac arrhythmia for the past three months. I went to see my GP before Thanksgiving and she ordered a 24 hour Holter monitor. I had been having 4-6 events per day, but of course when monitored, I only had one event...
Nevertheless, she said ther results were not unusual and to cut down on caffiene and chocolate. Neither of us really suspected the Effexor, as I tolder her that I'd been on it for almost a year before any of this started.
Cutting back did NOT change the effects...
Needless to say, the events have increased in number and intensity. It IS worrisome. I was resigned to not do anything about it until reading an article last week on the 'net regarding a British study that said that there was an increased risk of developing arrhythmia when using Effexor.
I showed this to my psychiatrist and he told me he wanted me off Effexor NOW! I got him to give me a prescription for a month's worth of Prozac (I know more about the withdrawal stuff than he does 'cause I hang out here...) and will be ramping down over the next two to three weeks.
I'm trying to keep a positive attitude about it and not expect anything bad. Board members have said that Prozac helps with the transition, plus I have Benadryl and SAMe as well to supplement if needed.
Just thought people should know. I know I'm just one out of millions, and I'm certain that dancingstar will say "I told you so", but it looks like Effexor is the culpret this time...
Tony
Posted by KaraS on December 15, 2004, at 21:22:58
In reply to Re: Withdrawal symptoms, posted by dancingstar on December 13, 2004, at 19:44:57
I had a reaction to the "From Fatigued to Fantastic" vitamins. I don't know if you'd call it an allergic reaction but I got a horrible headache each time I took it (and I rarely get headaches and I never got them this bad). I wonder about the excipients in those vitamins.
Posted by dancingstar on December 16, 2004, at 14:11:53
In reply to Re: Withdrawal symptoms » dancingstar, posted by KaraS on December 15, 2004, at 21:22:58
Hi Kara,
I'm sorry to hear that you have had trouble with the vitamins. I have been taking others like them for a very long time and haven't noticed a specific reaction to these. When I was taking Effexor, I had to limit my food intake to nearly nothing, just to keep my weight down to 140; so in order to keep my nutrients up, I always kept my supplements at a high level. These didn't specifically bother me as much as what seems like a generalized permanent withdrawal pain.
I guess we are all a little different, and not everything works for all of us. The thing that I am totally freaked out by is that Benadryl actually takes away my pain for a limited amount of time. I cannot for the life of me understand how Benadryl can take away the pain in my stomach, muscles, and joints.
I also have to give some props to the pharmaceutical grade L-tryptophane since it's been just about a week now since I began to take it, and I am beginning to feel a tiny bit more like I have some mastery over my nervous system, i.e. I can take a deep breath.
I hope your bad headache goes away soon and that you never have one again!!!...but you do need the B vitamins that Enzymatic Therapy is providing. Please make sure that you always take any kind of B vitamin about a half an hour after you have eaten, and maybe choose a less potent source of B vitamin product unless you are sure you are getting a sufficient amount of B in your diet.
Bebe
Posted by KaraS on December 16, 2004, at 22:51:34
In reply to Re: Withdrawal symptoms » KaraS, posted by dancingstar on December 16, 2004, at 14:11:53
> Hi Kara,
>
> I'm sorry to hear that you have had trouble with the vitamins. I have been taking others like them for a very long time and haven't noticed a specific reaction to these. When I was taking Effexor, I had to limit my food intake to nearly nothing, just to keep my weight down to 140; so in order to keep my nutrients up, I always kept my supplements at a high level. These didn't specifically bother me as much as what seems like a generalized permanent withdrawal pain.
>
> I guess we are all a little different, and not everything works for all of us. The thing that I am totally freaked out by is that Benadryl actually takes away my pain for a limited amount of time. I cannot for the life of me understand how Benadryl can take away the pain in my stomach, muscles, and joints.
>
> I also have to give some props to the pharmaceutical grade L-tryptophane since it's been just about a week now since I began to take it, and I am beginning to feel a tiny bit more like I have some mastery over my nervous system, i.e. I can take a deep breath.
>
> I hope your bad headache goes away soon and that you never have one again!!!...but you do need the B vitamins that Enzymatic Therapy is providing. Please make sure that you always take any kind of B vitamin about a half an hour after you have eaten, and maybe choose a less potent source of B vitamin product unless you are sure you are getting a sufficient amount of B in your diet.
>
> Bebe
Hi Bebe,It is curious that Benadryl is able to help with so many things. Anyway, maybe the tryptophan will help with the withdrawl symptoms as well.
I am not currently on the "Fatigued to Fantastic" vitamins so I'm not having any more of those headaches. It was many months ago that I tried that particular brand of vitamins. Now I take a different multiple now along with a separate B-complex.
I've also recently had the panic/anxiety issues you speak of. Niacinamide has really helped me with that. I know exactly what you mean when you say that you can finally take a deep breath again. When you can't it's the most frustrating thing. You'd given anything to be able to breathe normally again.
Take care and glad to hear that you're doing better.
This is the end of the thread.
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