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Dr. Bob is Robert Hsiung, MD,
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Posted by Frank Sanello on June 28, 2010, at 13:47:06
In reply to Re: is anyone taking a low dose of Effexor (37.5mg)? » Frank Sanello, posted by Phillipa on June 26, 2010, at 19:16:04
> Are you serious? And you're saying zoloft worked for you? Do you take any meds today? Phillipa
Yes, well-conducted surveys indicate that Zoloft is the top-selling psychotropic in this country.
I'm only taking 150 mcg of Zoloft tablets and plan to go off 2 mg of Risperdal beause they are causing painful joint swelling or stiffness.
Zoloft also works very well on OCDs like excessive hair-pulling, compulsive hand-washing. But remember: anti-depressants affect each patient in his or her own unique way. Your experience with Fluxor may be just one exmaple of a drug having a different affect on you than on me. And my nightmare "trip" on Effexor may be the reason I had such a bad reaction. There's no such thing as a bad drug. There are new psychotropics coming out monthly, it seems, and one of them will provide perfect medication for your malfunctioning brain, which is a criticism of the primitive stage of psychotropic development, not criticism of neural synapses. Further, this may provide some solace: It took 17 years before I found a drug that worked.
Seven days after I went on the drug, I thought to myself, "Wow! So this is how you're supposed feel!" I had never experienced that sense of comfort and confidence I had that day.
Frank Sanello
Posted by Frank Sanello on June 28, 2010, at 14:00:13
In reply to Re: is anyone taking a low dose of Effexor (37.5mg)?, posted by Frank Sanello on June 26, 2010, at 12:39:23
> > Hi Babblers,
> >
> > I was wondering if anyone is taking the 37.5 mg dose of Effexor. I am a pretty small woman and I tend to be very sensitive to medication, so, based on previous experience with Effexor, my pdoc has decided to keep me at 37.5 mg for the foreseeable future. I've only been on for a little over a week, so I'm still going through the start-up phase with all of the negative side effects, but I was wondering if anyone here has had a positive mood effect with this dose.
> >
> > Thanks,
> > Blossom
>
> **************************************************
>
> Saturday, June 26, 2010
>
> Dear Blossom,
>
> To answer your above question, I did take the minimum recommended dosage of Effexor after the DEA approved the psychotropic drug. BIG MISTAKE! I didn't read the accompanying manufacturer's notes which warned that Effexor could cause "extreme lability."
>
> An hour after taking my first dose, I became suicidal and viciously insulted my boyfriend, who never forgave me. (I'm not a pharmacist or some other kind of medical professional, so I can't advise you on the beginning dose of Effexor.)
>
> But either your primary care physician or your pharmacist can answer your question about the correct dosage of Effexor to start out with based on your height, weight, and body frame. I wish someone had warned me about the drug's toxic side effects, and/or I had taken the time to Google Effexor's disastrous mood swings.
>
> Before I began taking Effexor, my boyfriend and I never had a single fight because we both had codependent tendencies, but this time he refused to accept my profuse apologies.
>
> Now I'm in recovery for two things: the abrupt breakup with the love of my life and the emotional drainage of a beautiful relationship ruined by my ignorance and laziness, which kept me from reading the microscopic literature about Effexors toxic effects.
> Best of luck! And remember, if Effexor doesnt have the positive effects you seek, go back to your doctor and ask him for a useful alternative.
> MOREFrank Sanello
> FSanello@aol.com
>
> In an unsuccessful attempt to reconcile with him, I finally got around to reading the literature the manufacturer included with the prescription. One of the side effects was "extreme liability," which is just psycho-babble for Effexor's ability to turn your new medication into a rollercoaster of violent mood swings -- alternating between the depth of despair and the ecstasy any consumer of the drug experiences.
>
> Stay away from this poison. It destroyed my relationship with the great love of my life, even though he was a primary care physician who already knew what extreme lability Effexor causes but refused to accept it as an explanation, not a justification for my rudeness I showed my lover, who ended our 20-year relationship, which had begun when I was 19.
>
> Zoloft is the most popular anti-depressant in terms of popularity and sales. Zoloft also freed me from a 30-year OCD (obsessive-compulsive) called trichotillomania, which had forced me to pluck out my eyelashes since I was six. It also treated my Post-traumatic Stress Disorder syndrome flashbacks to painful memories of an earlier and ongoing compulsion to defoliate my eyelids. :)In an unsuccessful attempt to reconcile with him, I finally got around to reading the literature the manufacturer included with the prescription. One of the side effects was "extreme liability," which is just psycho-babble for Effexor's ability to turn your new medication into a rollercoaster of violent mood swings -- alternating between the depth of despair and the ecstasy any consumer of the drug experiences.
Stay away from this poison. It destroyed my relationship with the great love of my life, even though he was a primary care physician who already knew what extreme lability Effexor causes but refused to accept it as an explanation, not a justification for my rudeness I showed my lover, who ended our 20-year relationship, which had begun when I was 19.Zoloft is the most popular anti-depressant in terms of popularity and sales. Zoloft also freed me from a 30-year OCD (obsessive-compulsive) called trichotillomania, which had forced me to pluck out my eyelashes since I was six. It also treated my Post-traumatic Stress Disorder syndrome flashbacks to painful memories of an earlier and ongoing compulsion to defoliate my eyelids. :)
Frank Sanello
email: FSanello@aol.com
>
> Frank Sanello
> email: FSanello@aol.com
>
>
Posted by Dr. Bob on June 29, 2010, at 17:41:07
In reply to Re: is anyone taking a low dose of Effexor (37.5mg)?, posted by Frank Sanello on June 26, 2010, at 12:39:23
> this poison.
Please don't exaggerate.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person, and I'm sorry if this hurts you.
More information about posting policies and tips on alternative ways to express oneself, including a link to a nice post by Dinah on I-statements, are in the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by Dr. Bob on July 1, 2010, at 15:39:12
In reply to Re: please be civil » Frank Sanello, posted by Dr. Bob on June 29, 2010, at 17:41:07
> Follow-ups regarding these issues should be redirected to Psycho-Babble Administration.
Here's a link:
http://www.dr-bob.org/babble/admin/20100321/msgs/952852.html
Thanks,
Bob
Posted by orbital on October 16, 2010, at 0:06:40
I'm considering asking my doc for the dreaded Effexor. My depression has gotten so completely out of hand, I simply cannot function anymore. Right now I can barely get out of bed, never mind show up for work.
So I've searched for info on Effexor here at Babble, and keep pulling horror stories.
Is this med effective or, at the very least, even worth considering? Or should I give it a miss?
Any advice appreciated, thanks in advance :)
Posted by Phillipa on October 16, 2010, at 0:38:45
In reply to Effexor: is it worth it?, posted by orbital on October 16, 2010, at 0:06:40
Personally when it came out four days was all I could handle. My neighbor about a year ago was on it for a while and had horrible withdrawal coming off it she is never taking an ad again. She just takes xanax. She's a teacher and very high functioning. You might babblemail dancingstar as she will answer. Just talked with her Phillipa
Posted by floatingbridge on October 16, 2010, at 2:05:13
In reply to Re: Effexor: is it worth it? » orbital, posted by Phillipa on October 16, 2010, at 0:38:45
Orbital, I don't know for you.
When I was younger, I had a good run with it. Withdrawal is noted to be horrible, and mine was, however, some people do not withdraw properly. They cold turkey it or their doctor doesn't believe how hard it can be, though I think they are generally now more savvy due to a trickle down effect of information.
Why do you think effexor might work for you?
Posted by bleauberry on October 16, 2010, at 5:28:22
In reply to Effexor: is it worth it?, posted by orbital on October 16, 2010, at 0:06:40
I think a good approach would be to closely inspect what meds and combos you have done thus far, and then make choices that are not close repeats of those. For example, someone who has tried several SSRIs, but none of them in combination with Nortriptyline, Desipramine, or Ritalin, I think would have much better potential by doing that instead of taking on an SNRI like Effexor. Which with very little effect on NE really is a stretch to call it a SNRI anyway.
That said, Effexor does once in a while prove to be a magical drug for some people. Even the lowest dose of 37.5mg has worked great for some.Statistically speaking, effexor has no more of a chance of getting you well than anything else. You could pretty much flip a coin blindly. Some studies show it about the same as other meds, with some studies showing it a few percentage points better....either way, in the same ballpark as all the others. It's a risk/benefit choice.
If you have not had experience with the plants of the world, I would try Rhodiola Rosea, St Johns Wort, or SAMe (all three separately) before venturing deeper into the treacherous psychiatric world. Rhodiola or SAMe work especially fast, which is something you need. So you don't need to devote as much time to trials as you do on pharmaceuticals. All three of them have a multitude of other biological benefits to them, making them healthy depression choices.
If you want an SNRI (assuming you do since you are considering effexor), then instead do Zoloft+Nortriptyline.
The plants first.
Effexor last.
IMO.
Posted by SLS on October 16, 2010, at 6:31:41
In reply to Re: Effexor: is it worth it?, posted by bleauberry on October 16, 2010, at 5:28:22
> Statistically speaking, effexor has no more of a chance of getting you well than anything else.
http://www.biopsychiatry.com/veneffex.html
http://bjp.rcpsych.org/cgi/content/full/178/3/234
There are more.
Venlafaxine is not a perfect drug, of course, but studies have indicated that it will get more people well than SSRIs, and that the quality of response is greater. Studies are not perfect either. I would want to do more research before guaranteeing somebody that all antidepressants are therapeutically equivalent.
- Scott
Posted by SLS on October 16, 2010, at 6:35:50
In reply to Effexor: is it worth it?, posted by orbital on October 16, 2010, at 0:06:40
> So I've searched for info on Effexor here at Babble, and keep pulling horror stories.
Are the horror stories related to ongoing treatment with Effexor or its withdrawal effects?
> Is this med effective or, at the very least, even worth considering?
I think Effexor is worth considering, particularly if you have exhausted alternatives.
Tricyclics? MAOIs?
- Scott
Posted by linkadge on October 16, 2010, at 8:51:25
In reply to Re: Effexor: is it worth it?, posted by SLS on October 16, 2010, at 6:31:41
Some studies have doubted whether there really is a efficacy advantage to "dual acting" agents.
I didn't mind venlafaxine, but I couln't get beyond 37.5mg. At 75mg my heart always felt overworked and I had a tight chest feeling.
Linkadge
Posted by SLS on October 16, 2010, at 9:33:23
In reply to Re: Effexor: is it worth it?, posted by linkadge on October 16, 2010, at 8:51:25
> Some studies have doubted whether there really is a efficacy advantage to "dual acting" agents.
There are a few commentaries questioning the work that was done 10 years ago.
Effexor did more for me than any SSRI. It's too bad that the potential of having severe withdrawal reactions with Effexor must complicate the decision-making process.
- Scott
Posted by orbital on October 16, 2010, at 11:14:24
In reply to Re: Effexor: is it worth it? » orbital, posted by Phillipa on October 16, 2010, at 0:38:45
Thanks for the info, Phillipa :) I did fine taking just Klonopin for a year, until my former doc talked me into adding an AD. And so it began.
> Personally when it came out four days was all I could handle. My neighbor about a year ago was on it for a while and had horrible withdrawal coming off it she is never taking an ad again. She just takes xanax. She's a teacher and very high functioning. You might babblemail dancingstar as she will answer. Just talked with her Phillipa
Posted by orbital on October 16, 2010, at 11:20:46
In reply to Re: Effexor: is it worth it? » Phillipa, posted by floatingbridge on October 16, 2010, at 2:05:13
Hi FB :) I have no real reason to believe Effexor might work for me, I've just refused it every time my doc suggested it because the withdrawal sounds pretty terrible.
I wonder if people who use Prozac to wean off other meds take too low a dose. I know someone who quit Effexor by crossing over to 60mg Prozac for a week, then tapered off that - it worked fine for her.
> Orbital, I don't know for you.
>
> When I was younger, I had a good run with it. Withdrawal is noted to be horrible, and mine was, however, some people do not withdraw properly. They cold turkey it or their doctor doesn't believe how hard it can be, though I think they are generally now more savvy due to a trickle down effect of information.
>
> Why do you think effexor might work for you?
>
Posted by orbital on October 16, 2010, at 11:30:42
In reply to Re: Effexor: is it worth it?, posted by bleauberry on October 16, 2010, at 5:28:22
Bleauberry, mirtazapine is the one med that undoubtedly worked for me, I felt amazingly well on it. The effect was short lived though, just a week or so, and I was never able to replicate it.
I'm open to trying different approaches. I'm currently on escitalopram and sulbutiamine, but would gladly switch to something else. SAMe in particular sounds interesting, can it be added to SSRIs or -eventually- SJW?
> I think a good approach would be to closely inspect what meds and combos you have done thus far, and then make choices that are not close repeats of those. For example, someone who has tried several SSRIs, but none of them in combination with Nortriptyline, Desipramine, or Ritalin, I think would have much better potential by doing that instead of taking on an SNRI like Effexor. Which with very little effect on NE really is a stretch to call it a SNRI anyway.
> That said, Effexor does once in a while prove to be a magical drug for some people. Even the lowest dose of 37.5mg has worked great for some.
>
> Statistically speaking, effexor has no more of a chance of getting you well than anything else. You could pretty much flip a coin blindly. Some studies show it about the same as other meds, with some studies showing it a few percentage points better....either way, in the same ballpark as all the others. It's a risk/benefit choice.
>
> If you have not had experience with the plants of the world, I would try Rhodiola Rosea, St Johns Wort, or SAMe (all three separately) before venturing deeper into the treacherous psychiatric world. Rhodiola or SAMe work especially fast, which is something you need. So you don't need to devote as much time to trials as you do on pharmaceuticals. All three of them have a multitude of other biological benefits to them, making them healthy depression choices.
>
> If you want an SNRI (assuming you do since you are considering effexor), then instead do Zoloft+Nortriptyline.
>
> The plants first.
>
> Effexor last.
>
> IMO.
Posted by orbital on October 16, 2010, at 11:36:34
In reply to Re: Effexor: is it worth it? » orbital, posted by SLS on October 16, 2010, at 6:35:50
Scott, I've had trouble finding Effexor success stories, most tend to center on the withdrawal thing.
My experience with TCAs is limited, as I have very low blood pressure and the tricyclics really mess with that.
Might discuss MAOIs during my next appointment, while I'm at it.
> > So I've searched for info on Effexor here at Babble, and keep pulling horror stories.
>
> Are the horror stories related to ongoing treatment with Effexor or its withdrawal effects?
>
> > Is this med effective or, at the very least, even worth considering?
>
> I think Effexor is worth considering, particularly if you have exhausted alternatives.
>
> Tricyclics? MAOIs?
>
>
> - Scott
Posted by orbital on October 16, 2010, at 11:39:55
In reply to Re: Effexor: is it worth it?, posted by linkadge on October 16, 2010, at 8:51:25
Link, did the 37.5mg dose do anything at all for you? If I do wind up trying venlafaxine, I'd try to keep the dose as low as possible.
> Some studies have doubted whether there really is a efficacy advantage to "dual acting" agents.
>
> I didn't mind venlafaxine, but I couln't get beyond 37.5mg. At 75mg my heart always felt overworked and I had a tight chest feeling.
>
> Linkadge
Posted by linkadge on October 16, 2010, at 15:06:18
In reply to Re: Effexor: is it worth it? » linkadge, posted by orbital on October 16, 2010, at 11:39:55
Orbital, I never went above 75mg. Actually 37.5mg was not too bad. I felt pretty good on a cross taper between effexor and celexa. I wonder if a low dose of both would work for me.
Also, FYI I didn't have much withdrawl from effexor. I switched from 75mg of effexor to 50mg of zoloft in one swoop, no withdrawl, infact I felt better as my heart started to slow down over the next few days.
Linkadge
Posted by floatingbridge on October 16, 2010, at 15:17:29
In reply to Effexor: is it worth it?, posted by orbital on October 16, 2010, at 0:06:40
Orbital, I wanted to add some anecdotal info. I do know a few (maybe about 5) that do well on effexor. Side effects are intolerable for some--I did not experience them myself. Because I had done well on effexor in the past, we chose pristiq to which my response is less robust :(.
When I've considered trying an maoi, the pristiq withdrawal (really as bad as
effexor, though some docs don't know or acknowledge) has made the decision difficult. My doctor feels confident enough about doing it (prozac cross taper) but is concerned about my destabilization. It can be a lengthy taper done his way by the book. There may be other, faster ways. I don't know.
Posted by orbital on October 16, 2010, at 16:31:34
In reply to Re: Effexor: is it worth it?, posted by linkadge on October 16, 2010, at 15:06:18
Link, was the heart thing anxiety related?
I can usually handle side effects pretty well - GI problems don't bother me too much, ditto headaches, sexual stuff (couldn't care less!) fatigue, etc. But, along with emotional numbness, the one I simply can't tolerate is anxiety/insomnia. I do take clonazepam daily, but I'm trying to lower my dose, not up it.
I appreciate your reply :)
> Orbital, I never went above 75mg. Actually 37.5mg was not too bad. I felt pretty good on a cross taper between effexor and celexa. I wonder if a low dose of both would work for me.
>
> Also, FYI I didn't have much withdrawl from effexor. I switched from 75mg of effexor to 50mg of zoloft in one swoop, no withdrawl, infact I felt better as my heart started to slow down over the next few days.
>
> Linkadge
>
>
Posted by orbital on October 16, 2010, at 16:40:31
In reply to Re: Effexor: is it worth it? » orbital, posted by floatingbridge on October 16, 2010, at 15:17:29
FB, thanks for the info :)
I do know people who did well on Effexor, and came off it with little problems.
If you're going to do a Prozac taper, how will that affect your MAOI schedule? Will you have to wait for 6 weeks?
Personally, I think that docs aren't aggressive enough when using the Prozac taper method. For instance, I doubt that one 20mg dose will help much... Prozac is so weak to begin with, and its famed long half life only begins to occur after repeated doses (but not norfluoxetine's).
When I quit Paxil and.. Zoloft?... my doc gave me a good high dose of Prozac for several days.
Not sure if there's anything else involved in (des)venlafaxine's discontinuation that needs to be addressed, though.
> Orbital, I wanted to add some anecdotal info. I do know a few (maybe about 5) that do well on effexor. Side effects are intolerable for some--I did not experience them myself. Because I had done well on effexor in the past, we chose pristiq to which my response is less robust :(.
>
> When I've considered trying an maoi, the pristiq withdrawal (really as bad as
> effexor, though some docs don't know or acknowledge) has made the decision difficult. My doctor feels confident enough about doing it (prozac cross taper) but is concerned about my destabilization. It can be a lengthy taper done his way by the book. There may be other, faster ways. I don't know.
Posted by Lil'Deb on October 16, 2010, at 18:29:25
In reply to Effexor: is it worth it?, posted by orbital on October 16, 2010, at 0:06:40
Effexor did wonders for my depression for the first couple of years, then the effects decreased. I did try to go off the medication, but my anxiety and irritability increased, so I started taking it again. Starting the med was not easy - weird sensations and little sleep for the first 6 days after start, then after increase, which eased considerably. Only troublesome side effect has been increased sweating. Stopping the medication is difficult, but easier when weaned off slowly. Missing a dose can also cause mild *withdrawal* effect. Good luck~
Posted by floatingbridge on October 16, 2010, at 19:13:47
In reply to Effexor: is it worth it?, posted by orbital on October 16, 2010, at 0:06:40
Insomnia is/was exacerbated by effexor; a good concern to address.
Yeah, so my doc's would take about six weeks. That alone is enough to cause a mood destabilization :)
One *good* doc said it could be done more quickly. If I do decide, as much as I adore my personal pdoc, I'd have the other supervise.
Would you let us know what you decide and how it is going? Good luck to you :)
Posted by linkadge on October 16, 2010, at 20:31:37
In reply to Re: Effexor: is it worth it? » linkadge, posted by orbital on October 16, 2010, at 16:31:34
Effexor just made my heart beat faster. I was less anxious, generally, but there were still those cardiac effects.
Linkadge
Posted by Phillipa on October 16, 2010, at 22:08:11
In reply to Re: Effexor: is it worth it?, posted by orbital on October 16, 2010, at 11:14:24
Sorry late answer just home. But if you did well on klonopin for a year why did he add an ad as mine did the same only years later? Phillipa ps relief was what I felt when I stopped the 37.5 after four days. Just was glad to be off an ad again
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