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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by honeybee on June 9, 2006, at 16:16:04
Say you went on one drug, then you went off of it. Then you tried to go back on it and you had a weird and freaky side effect that you didn't have on it last time around? Then you went off it because of that side effect.
If the first trial was successful, but the second was not, would you give it another go?
Of course, I'm asking because my pdoc (who I don't have much faith in), has suggested that's the conservative thing to do. Now, the side effect was tachycardia, and I have a high resting pulse as it is (lately, it's in the range of 80-84; goodness knows why, maybe low blood volume?). Anyway, I'm squeamish about going back on even though I'm also desperate to. In retrospect, I sort of loved my years on this drug; naive, ignoramus that I was back then, so unknowing of the potential risks and so blase about the side effects.
Ahhhh. Youth.
Posted by yxibow on June 10, 2006, at 1:17:52
In reply to Can an annoying side effect that you had once...., posted by honeybee on June 9, 2006, at 16:16:04
> Say you went on one drug, then you went off of it. Then you tried to go back on it and you had a weird and freaky side effect that you didn't have on it last time around? Then you went off it because of that side effect.
>
> If the first trial was successful, but the second was not, would you give it another go?
>
> Of course, I'm asking because my pdoc (who I don't have much faith in), has suggested that's the conservative thing to do. Now, the side effect was tachycardia, and I have a high resting pulse as it is (lately, it's in the range of 80-84; goodness knows why, maybe low blood volume?). Anyway, I'm squeamish about going back on even though I'm also desperate to. In retrospect, I sort of loved my years on this drug; naive, ignoramus that I was back then, so unknowing of the potential risks and so blase about the side effects.
>
> Ahhhh. Youth.
You do mention a wistfulness for youth -- I ask this because 84 is not tachycardia -- I have a normal resting rate of around 80. Your heart rate may recede with age to some extent, thats why I ask.Tachycardia only enters when your BPM exceeds 100, and that is simple, or sinus tachycardia. Your heart is fine, but it is beating more rapidly.
Serious tachycardia is Ventrical Tachycardia, which is in the range of 150+ and is a life threatening condition.
If you're around 80, you're doing quite fine, but if it makes you feel uncomfortable, a very small dose of atenolol would probably quash it. Additionally, 30-60 minutes of walking or jogging a day would help to lower it as well.
- tidings
Jay
Posted by honeybee on June 10, 2006, at 10:43:32
In reply to Re: Can an annoying side effect that you had once. » honeybee, posted by yxibow on June 10, 2006, at 1:17:52
Jay, this is useful.
I'm 32, so not exactly a spring chicken, and my resting pulse is generally always 80-84 (although one perfect summer day last year, it was 74). When I went on effexor, my heart felt like it was racing all the time, and I went to the pdoc and, sitting there in a chair, he took my pulse about half way in the session and it was about 120. I don't know if that's the kind of effect that I want to retry, or not. I am rather (hyper?)sensitive about these things. The more I learn about the ADs and their effects the more I'm squeamish about taking them. Without a medical degree, it's tough for me to do a sensible risk-benefit analysis of the meds. Without being on the outside, I have a tough time explaining to myself that it's not likely that the effexor caused my mitral valve prolapse, or that the excess serotonin in my system is somehow going to wreck my heart. Trying to think over the issue of the best course of action is a bit like trying to find myself out of a very sophisticated all of mirrors.
Have you had any cardiac response to your meds? How do you do the risk-benefit analysis of what meds you'll take?
Posted by yxibow on June 10, 2006, at 14:35:39
In reply to Re: Can an annoying side effect that you had once. » yxibow, posted by honeybee on June 10, 2006, at 10:43:32
> Jay, this is useful.
>
> I'm 32, so not exactly a spring chicken, and my resting pulse is generally always 80-84 (although one perfect summer day last year, it was 74). When I went on effexor, my heart felt like it was racing all the time, and I went to the pdoc and, sitting there in a chair, he took my pulse about half way in the session and it was about 120. I don't know if that's the kind of effect that I want to retry, or not. I am rather (hyper?)sensitive about these things. The more I learn about the ADs and their effects the more I'm squeamish about taking them. Without a medical degree, it's tough for me to do a sensible risk-benefit analysis of the meds. Without being on the outside, I have a tough time explaining to myself that it's not likely that the effexor caused my mitral valve prolapse, or that the excess serotonin in my system is somehow going to wreck my heart. Trying to think over the issue of the best course of action is a bit like trying to find myself out of a very sophisticated all of mirrors.
>
> Have you had any cardiac response to your meds? How do you do the risk-benefit analysis of what meds you'll take?It is conceivable that my heart rate has been slightly heightened by Cymbalta, but my blood pressure has been lowered by Seroquel. So it is a mixed bag.
You are right, it is a risk-benefit thing -- if you're in the 120 range though -- and mind you, there is always the "doctor syndrome" of taking blood pressure and pulse which can raise the count a bit unless the patient is at absolute calm rest and sort of "oblivious" to the measurement -- that is starting to get into tachycardia I would say.
(I'm 30, so there's nothing out of the blue about a pulse of 80, I've had normal EKGs.) Have you tried Cymbalta, because for me, it is a "kinder, gentler" version of Effexor by far for those who react like I did to Effexor?
I can understand reading up on medications, and I do the same -- just don't fall into the pitfalls of "medical student syndrome" where you imagine that you will get every single side effect including sprouting extra limbs (humor) and whatever else the PI or PDR mentions.
But for you, perhaps Effexor is not the right medication. You may need a more sedating one like Cymbalta, or perhaps a sedating SSRI like Luvox -- I don't know what you are taking it for, depression, or an anxiety complex, but I'm just grasping at straws.-- Jay
Posted by Jost on June 10, 2006, at 19:50:25
In reply to Re: Can an annoying side effect that you had once. » honeybee, posted by yxibow on June 10, 2006, at 14:35:39
>
>
> But for you, perhaps Effexor is not the right medication. You may need a more sedating one like Cymbalta, or perhaps a sedating SSRI like Luvox -- I don't know what you are taking it for, depression, or an anxiety complex, but I'm just grasping at straws.
>
> -- JayCymbalta isn't considered a sedating drug, in general. It's more on the activating side, for most people.
One reason why Cymbalta was hoped tobe more effective than Effexor is that while they raise levels of serotonin and noradrenaline, cymbalta raises noradrenaline much more than effexor, which doesn't do much of that at lower doses.
Jost
Posted by honeybee on June 11, 2006, at 11:06:26
In reply to Re: Can an annoying side effect that you had once. » honeybee, posted by yxibow on June 10, 2006, at 14:35:39
Jay,
I think you're giving good advice. Probably what happened is that, in the midst of the worst, absolute scraping my belly on the bottom of the ocean bad, depression of my life, I went on effexor, had an elevated heart rate, and then went bonkers for the next million or so months (basically until now) monitoring it, following up on it, trying to figure out ways to lower it (on the one hand, while avoiding activities that raise it--stupid, I know).
My pcp is wary of me trying effexor again, and I have to say that Cymbalta was my other of my choices. I don't mind the activiting antidepressants--in fact, I *loved* the way that Effexor made me feel--it's just that I would like to avoid that slightly exhausted feeling of having run up the stairs when I've only moved part way across the room. That was a little annoying (and the last time, when it caused tachycardia). Other than that I've really only tried SAM-e and Lexapro, which made me super tired.
Basically, I'm looking forward to the change in my hair color from brown to pink, the warbling of canaries that will follow me wherever I go, and whatever other side effects I'm *guaranteed* to get by going on Cymbalta or Luvox or whatever.... hah. When I can fly, I'll make sure to let everyone know.
Posted by yxibow on June 12, 2006, at 6:05:04
In reply to Re: Can an annoying side effect that you had once. » yxibow, posted by honeybee on June 11, 2006, at 11:06:26
> Jay,
>
> I think you're giving good advice. Probably what happened is that, in the midst of the worst, absolute scraping my belly on the bottom of the ocean bad, depression of my life, I went on effexor, had an elevated heart rate, and then went bonkers for the next million or so months (basically until now) monitoring it, following up on it, trying to figure out ways to lower it (on the one hand, while avoiding activities that raise it--stupid, I know).The more you hit your head against the wall... no, its not your fault, you may be very sensitive to Effexor. And if you think about purple elephants enough....
> My pcp is wary of me trying effexor again, and I have to say that Cymbalta was my other of my choices. I don't mind the activiting antidepressants--in fact, I *loved* the way that Effexor made me feel--it's just that I would like to avoid that slightly exhausted feeling of having run up the stairs when I've only moved part way across the room. That was a little annoying (and the last time, when it caused tachycardia). Other than that I've really only tried SAM-e and Lexapro, which made me super tired.
Some people respond to stimulants for anxiety, some respond to calming agents -- I tend to be more to the down of things. I must say that (well I do take a fairly substantial amount of benzodiazepines so that may partially cover up things) even at 110 I'm just starting to barely notice effects of Cymbalta.
From what my psychopharmacologist has said actually a lot of people find Cymbalta sedating. I have found it neither way really -- maybe a minor elevation from say 75-80 to 85bpm, but nothing significant. I do have propranolol on hand though for those emergency situations where one of my countless medications does something wierd.
> Basically, I'm looking forward to the change in my hair color from brown to pink, the warbling of canaries that will follow me wherever I go, and whatever other side effects I'm *guaranteed* to get by going on Cymbalta or Luvox or whatever.... hah. When I can fly, I'll make sure to let everyone know.Yes, please do give us the secret to zen levitation... j/k... no, that's a good outlook on things
-- tidings
Jay
This is the end of the thread.
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