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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by benbetter on February 22, 2006, at 23:44:24
Hi Bob or others who have answers...
I received a a comment asking if I hurt my brain more by going cold turkey rather than going slowly and doing it the "right way". I dont know anything about medical anything... But I do have questions that I hope to god that some one can answer. I really dont want people to respond that are people that think they know or have some caddy advice.. I want a person or people that study this stuff to answer these questions...
So the questions I have..
A.If a doctor throws me on to 75 milligrams of effexor with out a small warm up dose.. is this not identical to the stress of me coming off of 75 mgs with out a taper down?
Does this not cause the same amount of damage? Why Or why not.
Should there not be some sort of lable on the bottles of your pillls stating that these pills are very difficult ot get off of? Especially when one of the side effects are to become more fragile than you were going onto the drug?
Is there any reason this drug may make you manic when you hop off?
Thank you
Benbetter
Posted by SLS on February 23, 2006, at 7:37:13
In reply to Doctor Bob we want to know!, posted by benbetter on February 22, 2006, at 23:44:24
I don't know if you would like anyone other than Dr. Bob to answer your questions, however, the package label of Effexor does include the following:
"PRECAUTIONS
General
Discontinuation of Treatment with Effexor
Discontinuation symptoms have been systematically evaluated in patients taking venlafaxine, to include prospective analyses of clinical trials in Generalized Anxiety Disorder and retrospective surveys of trials in major depressive disorder. Abrupt discontinuation or dose reduction of venlafaxine at various doses has been found to be associated with the appearance of new symptoms, the frequency of which increased with increased dose level and with longer duration of treatment. Reported symptoms include agitation, anorexia, anxiety, confusion, coordination impaired, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting.
During marketing of Effexor (venlafaxine hydrochloride) tablets, other SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), and SSRIs (Selective Serotonin Reuptake Inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g. paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.
Patients should be monitored for these symptoms when discontinuing treatment with Effexor. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate (see DOSAGE AND ADMINISTRATION)."
I find this to be a very responsible and sufficient inclusion in the manufacturer's labelling.
- Scott
Posted by benbetter on February 23, 2006, at 11:23:10
In reply to Re: Doctor Bob we want to know!, posted by SLS on February 23, 2006, at 7:37:13
Thanks SLS,
That does help...
I do welcome more than Bobs input. Please note the first several statements.I am still wondering why isnt it harmful to your brain to get on this drug abruptly as it is to go off abruptly... Is there a difference? I did have side effects going on to these drugs... Shortness of breath dry mouth Head aches etc.. The problems going on were not as difficult I admit.. But none the less why not a slowly increased dose to go on?? Why cant you get off at the same place you got on?
Posted by SLS on February 24, 2006, at 7:07:52
In reply to Re: Doctor Bob we want to know!, posted by benbetter on February 23, 2006, at 11:23:10
> Thanks SLS,
>
> That does help...
> I do welcome more than Bobs input. Please note the first several statements.
>
> I am still wondering why isnt it harmful to your brain to get on this drug abruptly as it is to go off abruptly... Is there a difference?That's a great, logical question.
Without getting too deeply involved with biological stuff, I would use the example of alcohol withdrawal as an analogy. One can start right off drinking themselves to inebriation and experience only drunkeness on a daily basis. However, once the chronic ingestion of alcohol is discontinued abruptly, one can experience the delerium tremens, a withdrawal syndrome that includes hallucinations and other altered cognitive states, irritability, insomnia, agitation, tachycardia, hyperthermia, hypertension, tachypnea, diaphoresis, tremor, mydriasis, and generalized seizures. It is a potentially fatal reaction. Usually, none of these things occur on the way up in dosage, but on the way down. Much is the case when working with many of the psychotropic medications.
The biology of drug tolerance and withdrawal syndromes often involves the increase or decrease in the sensitivity of neurotransmitter receptors. With the initial exposure to Effexor and SSRIs, serotonin receptors on nerves are placed in a position of overstimulation. The brain responds by reducing their sensitivity. When the drug is taken away, this reduced sensitivity can last for weeks during which a withdrawal syndrome can appear and persist. What is more, this condition can lead to the dysregulation and runaway stimulation of those nerves that are meant to be inhibited by the now underactive serotonin nerves.
- Scott
Posted by Benbetter on February 24, 2006, at 7:47:38
In reply to Re: Doctor Bob we want to know!, posted by SLS on February 24, 2006, at 7:07:52
So with when this happens is this damage permanent? I guess what I am asking... Lets say you miss 2 days... We both know that there are withdrawls going on... Most people go back on the drug and voila.. The withdrawls go away ( if this happens 20 times in 3 years does this accumulate? Or... So lets say you quit cold turkey for eight days... you cant take it any more you go back on the drug... My guess is that your brain has been damaged.... So you go back on and taper off... is this only slowing he damage you have already created? Or is there probably no real damage and when you taper you are helping reconstruct the demolition...
Yes I know this is a lot of questions... But this is the guts of what we should be finding out.
Benbetter
This is the end of the thread.
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