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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by jasmineneroli on March 28, 2005, at 19:18:49
Hello everyone:
I was wondering if any of you that are dx'ed with any variation of the BPII (thru' VI) Spectrum OR soft BPII etc. have found Effexor to be helpful at all?
What dose were you on?
What other drugs were used (if any) to augment?
How long before it helped?OR,
Did it make symptoms worse?
If so, how?
Was this dose-related?Really appreciate any feedback. This is not for me, but someone close to me who has been prescribed Effexor by their GP, whilst waiting for the first Pdoc assessment app't. GP basing Rx on anxious depression. Patient thinks she might be BPII and is afraid to start the Effexor.
Has to wait 6 weeks for the Pdoc app't. In the meantime, moods cycling fast with a lot of anxiety and irritabilty. Worried she will make things worse with Effexor.
Advice???
Thanks you guys, luv y'all!
Jas
Posted by med_empowered on March 28, 2005, at 22:00:47
In reply to ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell?, posted by jasmineneroli on March 28, 2005, at 19:18:49
hey! *ANY* anti-depressant for a bipolar person could push that person into mania/hypomania or speed up the "cycling" process, among other things. Soo...ADs for bipolars/suspected bipolars are best used with caution, and should *ideally* be used with a mood-stabilizer. That said, Effexor, in my experience, is really popular for Bipolar Disorder; it seems to be second to Wellbutrin in this use (wellbutrin is pretty good when it comes to mania/hypomania. I only did low-dose Effexor for about 6months, along with a mood-stabilizer (Trileptal), Klonopin, and as-needed sleep aids (I think it was Neurontin at the time). It worked reasonably well, and the withdrawal wasn't all that bad (although *lots* of people have bad withdrawal from Effexor). Effexor is supposedly good stuff for "resistant" or "atypical" depression, and is also used for anxiety treatment. Unfortunately, its impossible to predict just how your friend will react to Effexor or any other anti-depressant...keep in mind that even people who have *never* had signs of bipolar disorder can have drug-induced manias/hypomanias and occasionally psychotic episodes on anti-depressants. Sucks, but it happens. My personal recommendation would be to see if a doc will RX a short-term supply of benzodiazepenes and/or an as-needed sleeping pill until the visit with the new shrink. These meds won't stabilize the mood as well as, say, lithium, but they are very effective and safer to use in bipolars than antidepressants.
Posted by Ritch on March 29, 2005, at 10:33:58
In reply to ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell?, posted by jasmineneroli on March 28, 2005, at 19:18:49
> Hello everyone:
> I was wondering if any of you that are dx'ed with any variation of the BPII (thru' VI) Spectrum OR soft BPII etc. have found Effexor to be helpful at all?
> What dose were you on?
> What other drugs were used (if any) to augment?
> How long before it helped?
>
> OR,
> Did it make symptoms worse?
> If so, how?
> Was this dose-related?
>
> Really appreciate any feedback. This is not for me, but someone close to me who has been prescribed Effexor by their GP, whilst waiting for the first Pdoc assessment app't. GP basing Rx on anxious depression. Patient thinks she might be BPII and is afraid to start the Effexor.
> Has to wait 6 weeks for the Pdoc app't. In the meantime, moods cycling fast with a lot of anxiety and irritabilty. Worried she will make things worse with Effexor.
> Advice???
> Thanks you guys, luv y'all!
> Jas
>
I was on Effexor for about three years with Depakote. However, the dose was *really* low. If she tries it I would go the "pelletizing" route and take a very low dose, a standard dose might be really de-stabilizing.
Posted by jasmineneroli on March 29, 2005, at 14:30:53
In reply to Re: ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell? » jasmineneroli, posted by Ritch on March 29, 2005, at 10:33:58
>>
> I was on Effexor for about three years with Depakote. However, the dose was *really* low. If she tries it I would go the "pelletizing" route and take a very low dose, a standard dose might be really de-stabilizing.
>Hi Ritch,
Thanks so much for the response!
What do you mean by "pelletizing route"?I'm assuming you mean breaking open the capsule and taking some of the pellet contents, but how exactly do you do this in a controlled, measured way?
And how do you consume them? Straight on to the tongue, or mixed in a liquid?
Apppreciate your feedback.
Best regards,
JasPS: Oh, and how low is "really low"? She's been told to start at 37.5mg for 7 days then go up to 75mg. She has a sample packet that doses that way.
Is 37.5mg too high to start, do you think? She does have (and is taking currently, as monotherapy, for the anxiety) Klonopin .25mg b.i.d.. I'm recommending she continue with that.
What do you think?
Posted by jasmineneroli on March 29, 2005, at 14:36:09
In reply to Re: ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell?, posted by med_empowered on March 28, 2005, at 22:00:47
Thanks a lot ME!
Yes, she does have a prescription of Klonopiin which she is taking at .25mg b.i.d. which is sufficient to take the edge of the anxiety and helps a little to even out her moods during the day. So I will recommend to her to continue.I understand and agree with what you say about AD's setting off manic episodes, this is her main concern. She's trying to maintain a new job!!!! That's why I was asking for opinions.
What do you consider to be a really low dose of Effexor? She currently has a sample pack that starts at 37.5mg for 7 days, titrating up to 75mg for another week, plus a prescription for more 75mg. She's afraid to start it.
Thanks again & best regards,
Jas
Posted by Ritch on March 30, 2005, at 0:29:23
In reply to Re: ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell? » Ritch, posted by jasmineneroli on March 29, 2005, at 14:30:53
> >>
> > I was on Effexor for about three years with Depakote. However, the dose was *really* low. If she tries it I would go the "pelletizing" route and take a very low dose, a standard dose might be really de-stabilizing.
> >
>
> Hi Ritch,
> Thanks so much for the response!
> What do you mean by "pelletizing route"?
>
> I'm assuming you mean breaking open the capsule and taking some of the pellet contents, but how exactly do you do this in a controlled, measured way?
> And how do you consume them? Straight on to the tongue, or mixed in a liquid?
> Apppreciate your feedback.
> Best regards,
> Jas
>
> PS: Oh, and how low is "really low"? She's been told to start at 37.5mg for 7 days then go up to 75mg. She has a sample packet that doses that way.
> Is 37.5mg too high to start, do you think? She does have (and is taking currently, as monotherapy, for the anxiety) Klonopin .25mg b.i.d.. I'm recommending she continue with that.
> What do you think?
Sorry for not explaining! Yes, the "usual" routine is the starter-pack of 37.5mg XR and then straight on to 75mg XR. When I was given those back in 1998 for the first time, my pdoc told me right away (knowing how med-sensitive and prone to manic symptoms I am), to .. "water that down", "uh, water this down a LOT, and see how that goes for a while". He knew that I would divide it up somehow, something I had been doing with Prozac for several years at that time already. I found that the 75mg XR capsules have a little over a hundred pellets in there.. bottom line.. I only took 12.5mg of XR pellets (1/3 of a 37.5mg XR capsule) every day for quite a while and found that to be plenty at that time. I just lick my finger and stick that onto the segregated pellet pile and wash it down with a full glass of water. Did that for years.
Posted by KaraS on March 30, 2005, at 1:53:41
In reply to ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell?, posted by jasmineneroli on March 28, 2005, at 19:18:49
Hi Jas,
I don't know if my story will help you. I am probably soft bipolar. I took Effexor for several years. At one point I was taking as much as 225 mg. It helped me - raised my mood somewhat (maybe 50 %, there was plenty of room for improvement) and alleviated all anxiety problems. I was never hypomanic but then I never have had classic hypomania. I get periods of more agitation but they can be quite subtle. I wish I had tried it with a mood stabilizer but I may do that in the future.K
Posted by ed_uk on March 30, 2005, at 8:27:53
In reply to Re: ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell? » jasmineneroli, posted by Ritch on March 30, 2005, at 0:29:23
Hi Mitch!
>the "usual" routine is the starter-pack of 37.5mg XR.......
We don't have the 37.5mg XR here, everyone gets started on 75mg XR!
Regards,
Ed.
Posted by jasmineneroli on March 31, 2005, at 15:40:51
In reply to ATTN: BP Spectr/Soft BP'ers - Effexor help/ hell?, posted by jasmineneroli on March 28, 2005, at 19:18:49
For your help and input.
She is going back to her GP today, armed with those opinions, and will try to get a quicker referral to our local mental health clinic on-call Pdoc, from the GP. (Canadian medical system).
Hopefully, she can be assessed asap, before assuming care under the originally referred pdoc in mid-May.Thanks again!
Jas
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