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Dr. Bob is Robert Hsiung, MD,
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Posted by gadman on March 12, 2005, at 17:11:25
My doc just switched me from Effexor XR 75 mg to Effexor Immediate Release twice a day (50 mg split in half ea dose)
We did this to be able to drop my dose to 50 and see how I do on it and possibly add Wellbutrin later...
I took my first dose at 8:00 am and took my second at 4:00 pm... I feel REALLY strange...
Does anyone have any experience with this? Right now I feel very on edge and slightly depressed? Do you think this is from the lack of E or the XR vs the immediate release?
Any help would be appreciated...
gadman
Posted by gadman on March 12, 2005, at 20:55:15
In reply to Re: Effexor XR vs Effexor Immediate Release (nm), posted by Phillipa on March 12, 2005, at 17:16:35
Can anyone answer this???? If I use to take 75 mg of E XR in the AM...
How can I closest resemble that same regime with Effexor Immediate release?
I took it at 8:00 am and 4:00 pm and my heart is still racing from the 4:00 pm dose. Would it be closer to 8:00 am and Noon to be like XR?
gadman
Posted by SLS on March 12, 2005, at 21:08:26
In reply to Re: Effexor XR vs Effexor Immediate Release, posted by gadman on March 12, 2005, at 20:55:15
> Can anyone answer this???? If I use to take 75 mg of E XR in the AM...
>
> How can I closest resemble that same regime with Effexor Immediate release?
>
> I took it at 8:00 am and 4:00 pm and my heart is still racing from the 4:00 pm dose. Would it be closer to 8:00 am and Noon to be like XR?
>
> gadmanHow about trying it every 12 hours?
- Scott
Posted by gadman on March 12, 2005, at 21:15:10
In reply to Re: Effexor XR vs Effexor Immediate Release, posted by SLS on March 12, 2005, at 21:08:26
Hmmmm... I never thought to even further spread it apart... I presumed the XR was extended throughout a 4-6 hour period, not longer...
I am afraid if I take it too close to bed, I will never go to sleep (Like tonight)
gadman
Posted by SLS on March 12, 2005, at 21:26:27
In reply to Re: Effexor XR vs Effexor Immediate Release » SLS, posted by gadman on March 12, 2005, at 21:15:10
Hi.
> Hmmmm... I never thought to even further spread it apart... I presumed the XR was extended throughout a 4-6 hour period, not longer...
I understand. The half-life of Effexor is 5-7 hours. That might work. I never really looked into how the XR version extends the time until the drug reaches its trough.
> I am afraid if I take it too close to bed, I will never go to sleep (Like tonight)
You'll never know unless you try. Understand that some of the side effects of Effexor are only temporary. Perhaps you will be able to tolerate dosing at breakfast and dinner.
I wish you the best.
- Scott
Posted by gadman on March 12, 2005, at 21:40:14
In reply to Re: Effexor XR vs Effexor Immediate Release, posted by SLS on March 12, 2005, at 21:26:27
Thanks Scott... I just wish they made an 50 mg XR version... I wouldn't have to be messing with this...
The answer lies in the below text... I am just trying to decipher it right now. Time to max concentrations for XR is 5.5 hours and 2 hours for immediate release... I am assuming that means XR is delaying the release only by 3.5 hours?
-----------------------------------------------
Administration of Effexor XR (150 mg q24 hours) generally resulted in lower Cmax (150 ng/mL
for venlafaxine and 260 ng/mL for ODV) and later Tmax (5.5 hours for venlafaxine and 9 hours
for ODV) than for immediate release venlafaxine tablets (Cmax’s for immediate release 75 mg
q12 hours were 225 ng/mL for venlafaxine and 290 ng/mL for ODV; Tmax’s were 2 hours for
venlafaxine and 3 hours for ODV). When equal daily doses of venlafaxine were administered as
either an immediate release tablet or the extended-release capsule, the exposure to both
venlafaxine and ODV was similar for the two treatments, and the fluctuation in plasma
concentrations was slightly lower with the Effexor XR capsule. Effexor XR, therefore, provides a slower rate of absorption, but the same extent of absorption compared with the immediate release tablet.
Posted by SLS on March 13, 2005, at 7:00:34
In reply to Re: Effexor XR vs Effexor Immediate Release » SLS, posted by gadman on March 12, 2005, at 21:40:14
> Thanks Scott... I just wish they made an 50 mg XR version... I wouldn't have to be messing with this...
> The answer lies in the below text... I am just trying to decipher it right now. Time to max concentrations for XR is 5.5 hours and 2 hours for immediate release... I am assuming that means XR is delaying the release only by 3.5 hours?
After reading this, I am under the same impression that you are. It looks like the XR version smooths things out a bit, but doesn't extend the time it spends in the body by much over the course of a day. However, for the immediate release version, the magnitude of peak concentration must surely be higher. Either you are reacting to a higher concentration of Effexor perfusing into brain tissues, experienceing withdrawal symptoms, or you are beginning to relapse into depression. Without knowing anything more about the history behind your treatment, this would be a difficult thing to guess at. I would try dosing 12 hours apart and see if things are made worse or made better. That will give you more information to work with.
- Scott
> -----------------------------------------------
> Administration of Effexor XR (150 mg q24 hours) generally resulted in lower Cmax (150 ng/mL
> for venlafaxine and 260 ng/mL for ODV) and later Tmax (5.5 hours for venlafaxine and 9 hours
> for ODV) than for immediate release venlafaxine tablets (Cmax’s for immediate release 75 mg
> q12 hours were 225 ng/mL for venlafaxine and 290 ng/mL for ODV; Tmax’s were 2 hours for
> venlafaxine and 3 hours for ODV). When equal daily doses of venlafaxine were administered as
> either an immediate release tablet or the extended-release capsule, the exposure to both
> venlafaxine and ODV was similar for the two treatments, and the fluctuation in plasma
> concentrations was slightly lower with the Effexor XR capsule. Effexor XR, therefore, provides a slower rate of absorption, but the same extent of absorption compared with the immediate release tablet.
Posted by gadman on March 13, 2005, at 7:19:05
In reply to Re: Effexor XR vs Effexor Immediate Release » gadman, posted by SLS on March 13, 2005, at 7:00:34
Yeah, I originally wanted to try and dose 12 hours apart, but I don't think so...
I think I am experiencing the higher peak concentrations as you are suggesting... Very odd... I know it is not depression...
I took my immediate release dose at 4:00 pm yesterday and was still wired at midnight. I took my Xanax and a Restoril and still did not fall asleep until after 2:00 AM. This is why I am VERY hesitant to take it any later...
gadman
Posted by SLS on March 13, 2005, at 8:10:57
In reply to Re: Effexor XR vs Effexor Immediate Release » SLS, posted by gadman on March 13, 2005, at 7:19:05
You know your own body best. It is truly amazing how differently Effexor treats you as the IR compared to the XR. I hope the insomnia mitigates over time. It is hard to imagine that it wouldn't.
I'm very glad to hear that you are not feeling an increase of depression. I don't know if it is you intention to combine the two, but I have seen people respond very favorable to the combination of Effexor and Wellbutrin when they did not with either alone.
Good luck!!!
- Scott
Posted by cubic_me on March 13, 2005, at 8:11:14
In reply to Re: Effexor XR vs Effexor Immediate Release » gadman, posted by SLS on March 13, 2005, at 7:00:34
> The answer lies in the below text... I am just trying to decipher it right now. Time to max concentrations for XR is 5.5 hours and 2 hours for immediate release... I am assuming that means XR is delaying the release only by 3.5 hours?
Yes, but this is only the half life (ie half of the XR is left after 3.5 hours, half of that half (ie a quater) iis left after 7 hours, etc), so XR will, in the end, be in your body for much longer than the immediate release.
Are you going down to 50mg at the same time as changing from XR? You could try your normal 75mg dose with the immediate release before reducing the dose, so that you are not changing 2 things at once.
Posted by gadman on March 13, 2005, at 8:45:39
In reply to Re: Effexor XR vs Effexor Immediate Release, posted by cubic_me on March 13, 2005, at 8:11:14
I think I could simulate the action of the XR by cutting the Dose in 4 and taking it 2-3 hours apart... But that wouldn't be very convenient.
I think I am going to call the PDoc today and go to a 37.5 mg of XR and possibly supplement with the immediate release to make up the difference.
gadman
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