![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Robert Fairburn on September 27, 2003, at 3:39:49
I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
Anyones thoughts would be well appreciated
Posted by pixygoth on September 27, 2003, at 13:38:22
In reply to Effexor XR need advice from other users, posted by Robert Fairburn on September 27, 2003, at 3:39:49
I have felt like that through the course of my using Efxr XR. I'm coming off it cos it seems to not be doing much for me anymore - although I did get up to 225mg before coming to that conclusion. No one offers me any kind of relaxing thing, even though I'm anxious by nature, and correct me if I'm wrong, Efxr is agitating in itself? Grr.
Good luck
Posted by Camille Dumont on September 27, 2003, at 18:10:13
In reply to Effexor XR need advice from other users, posted by Robert Fairburn on September 27, 2003, at 3:39:49
When I started effexor I got overly nervous ... with hot flashes and twitches but after a couble of weeks (4 or 5) everything disappeared.
Posted by jrbecker on September 27, 2003, at 20:00:08
In reply to Effexor XR need advice from other users, posted by Robert Fairburn on September 27, 2003, at 3:39:49
hang in there robert.
yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
couple questions...
1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
2) what is your current dose of effexor?
3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.good luck
JRB
> I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
>
> Anyones thoughts would be well appreciated
Posted by loolot on September 27, 2003, at 22:22:03
In reply to Effexor XR need advice from other users, posted by Robert Fairburn on September 27, 2003, at 3:39:49
Posted by Robert Fairburn on September 28, 2003, at 5:17:11
In reply to Re: Effexor XR need advice from other users, posted by jrbecker on September 27, 2003, at 20:00:08
In reply to your questions1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
2 I am taking the 75 mg at dinnertime
3 I am feeling very anxious depressed
Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
Thanks for your reply JRB Im interested in what you have to say from my answers
Regards Robert
> hang in there robert.
>
> yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
>
> couple questions...
>
> 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
>
> 2) what is your current dose of effexor?
> 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
>
> Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
>
>
> as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
>
> good luck
>
> JRB
>
>
>
>
> > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> >
> > Anyones thoughts would be well appreciated
>
>
Posted by jrbecker on September 29, 2003, at 15:45:28
In reply to Re: Effexor XR need advice from other users, posted by Robert Fairburn on September 28, 2003, at 5:17:11
Hi Robert,
you might be right in that the effexor is worsening your anxiousness, and perhaps even exacerbate your depression. but it's hard to tell. even though you have high levels of noradrenaline (norepinpehrine), this doesn't mean that taking effexor (a serotonin and norephiprine reuptake inhibitor) is going to make your depression worse.
this is because, currently, the research is sort of unclear on whether depressive sufferers have increased or decreased norepinephrine (NE) levels. Most studies that have drawn blood sample have shown increased norepinephrine BLOOD levels (like yourself). However, this is only a measure of peripheral NE, not NE in the BRAIN. See, increased NE in the periphery can definitely cause ~physical~
symptoms of anxiety (sweating, heart palpiations, startle effect). However, it is unclear whether increased NE in the brain is helping or hindering anxiety/depression -- currently there is good evidence that NE drugs increase neurogenesis - which is thought to be the route of depression.Since this is sort of a more complicated topic, I'd suggest you read this article (it provides a good summary on the role of NE as well as how it's tied to the stress system, the HPA)...
http://www.sciam.com/search/search_result.cfm
Back to addressing your concerns about effexor,
many people have problems beginning on effexor. you should read the Tips section on Effexor (you can find the link at the top of the psycho-babble page). Perhaps you should cut back to 37.5mg tablets and go slow. I would also advise you to take it in the morning if it is disrupting your sleep. Once again, I can assure you that the side effects will decrease, by how much, well I can't tell you since that's individually determined.couple other notes...
Effexor is a great drug, and it usually works better in cases of atypical depression, not regular unipolar (melancholic) depression. Most melancholics find that an SSRI usually works best. This is a general theory, not a rule. But there was probably a reason why your doc put you on effexor besides effexor being known to be good for GAD and depression, can you infer what those reasons were? were there any other options discussed?
Have you been taking benzo's and have they been helping?
I'd suggest you stick it out for 2-3 weeks and then see if you're fairing better. If not, maybe a simple SSRI, like Lexapro, Celexa, or Paxil is better for you.
good luck, keep in touch with us.
JRB
> In reply to your questions
>
> 1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
>
> 2 I am taking the 75 mg at dinnertime
>
> 3 I am feeling very anxious depressed
>
> Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
>
>
> Thanks for your reply JRB Im interested in what you have to say from my answers
>
>
> Regards Robert
> > hang in there robert.
> >
> > yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
> >
> > couple questions...
> >
> > 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
> >
> > 2) what is your current dose of effexor?
> > 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
> >
> > Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
> >
> >
> > as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
> >
> > good luck
> >
> > JRB
> >
> >
> >
> >
> > > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> > >
> > > Anyones thoughts would be well appreciated
> >
> >
>
>
Posted by Robert Fairburn on October 2, 2003, at 18:22:43
In reply to Re: Effexor XR need advice from other users » Robert Fairburn, posted by jrbecker on September 29, 2003, at 15:45:28
Ghankyou JRB for a reply to my email
I appreciate your well documented and thought out replies. Believe me It helps to get a response from someone who is knowledgable about drugs.
At the moment I have been off effexor for 5 days and I have been depressed. However I am not surprised by this due to the fact that effexor really effected my system. Im going to give you a list of drugs that I have taken and there results in the hope that you can see a common thread
Peroxtine - Good results for 2.5 years slowly got ineffective finished using 30/12/2002
Lexapro - Didn't upset me however I didn't fix panic attacks (2 months) mind due the panic attacks were not that bad, sometimes I would feel agitated during some days, however I gave it up thinking that maybee another drug would give me a miracle cure. Boy was I dumb in believing such a thing
Prozac - I almost wanted to slash my wrists docter tried increasing the dose which made things very much worse ( 2 months)
Imipramine - had an interesting result, got improvement in depression caused from bad result with prozac. It seemd to work (in regards to depression) at lower doses, however at higher doses it made me feel depressed, this was due to when I tried to do relaxtion exercises it would agrevate me highly.In short doses below 50mg helped a little while doses over 50 mg ie 75 or 100 mg made me easily depressed. It also increased depression after a panic attack.
Dothiepin took this for a month, it didn't help my anxiety and any attempt to work on my anxiety would create a panic attack,( Ihad done breathing exercises when taking peroxtine and didn't get such a extreme reaction or even why I wasn't even on drugs) did get one good result which was that I got a good night sleep, didn't make me feel depressed on average, docter suggested trying another drug to work on my GAD and panic attacks. After stopping this drug I did have trouble getting to sleep
Effexor - what a mistake worse experience I have ever had with a drug could only take 19 days before having to completly stop taking it, still feeling very much worse with a inability to stop worrying about being OCD or becoming OCD
I have been feeling very depressed and might need to try another drug
So what drug should I try ?? Im sort of guessing between Fluvoxamine (Luvax) or Zoloft or Citalopram ( cant be much different to lexapro)
Or I could try taking peroxtine again
However I am a bit worried about trying anything that raises both seratonin and neophinphrine at the same time like the tricyclics which have a tendancy to make me feel worse at high doses. I am also coming to the conclusion that I might be very dose sensitive and higher doses make me worse while smaller amounts help a little
Ok guys what do you think
Im especially interesed in what you have to say JRB
> Hi Robert,
>
> you might be right in that the effexor is worsening your anxiousness, and perhaps even exacerbate your depression. but it's hard to tell. even though you have high levels of noradrenaline (norepinpehrine), this doesn't mean that taking effexor (a serotonin and norephiprine reuptake inhibitor) is going to make your depression worse.
>
> this is because, currently, the research is sort of unclear on whether depressive sufferers have increased or decreased norepinephrine (NE) levels. Most studies that have drawn blood sample have shown increased norepinephrine BLOOD levels (like yourself). However, this is only a measure of peripheral NE, not NE in the BRAIN. See, increased NE in the periphery can definitely cause ~physical~
> symptoms of anxiety (sweating, heart palpiations, startle effect). However, it is unclear whether increased NE in the brain is helping or hindering anxiety/depression -- currently there is good evidence that NE drugs increase neurogenesis - which is thought to be the route of depression.
>
> Since this is sort of a more complicated topic, I'd suggest you read this article (it provides a good summary on the role of NE as well as how it's tied to the stress system, the HPA)...
>
> http://www.sciam.com/search/search_result.cfm
>
> Back to addressing your concerns about effexor,
> many people have problems beginning on effexor. you should read the Tips section on Effexor (you can find the link at the top of the psycho-babble page). Perhaps you should cut back to 37.5mg tablets and go slow. I would also advise you to take it in the morning if it is disrupting your sleep. Once again, I can assure you that the side effects will decrease, by how much, well I can't tell you since that's individually determined.
>
> couple other notes...
>
> Effexor is a great drug, and it usually works better in cases of atypical depression, not regular unipolar (melancholic) depression. Most melancholics find that an SSRI usually works best. This is a general theory, not a rule. But there was probably a reason why your doc put you on effexor besides effexor being known to be good for GAD and depression, can you infer what those reasons were? were there any other options discussed?
>
> Have you been taking benzo's and have they been helping?
>
> I'd suggest you stick it out for 2-3 weeks and then see if you're fairing better. If not, maybe a simple SSRI, like Lexapro, Celexa, or Paxil is better for you.
>
> good luck, keep in touch with us.
>
> JRB
>
>
>
>
>
>
>
>
>
>
> > In reply to your questions
> >
> > 1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
> >
> > 2 I am taking the 75 mg at dinnertime
> >
> > 3 I am feeling very anxious depressed
> >
> > Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
> >
> >
> > Thanks for your reply JRB Im interested in what you have to say from my answers
> >
> >
> > Regards Robert
> > > hang in there robert.
> > >
> > > yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
> > >
> > > couple questions...
> > >
> > > 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
> > >
> > > 2) what is your current dose of effexor?
> > > 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
> > >
> > > Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
> > >
> > >
> > > as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
> > >
> > > good luck
> > >
> > > JRB
> > >
> > >
> > >
> > >
> > > > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> > > >
> > > > Anyones thoughts would be well appreciated
> > >
> > >
> >
> >
>
>
Posted by jrbecker on October 3, 2003, at 10:43:27
In reply to Re: Effexor XR need advice from other users, posted by Robert Fairburn on October 2, 2003, at 18:22:43
Robert,
first things first.
does your doc know your off the effexor. who's helping to make these pharmacological decisions?
Do you and your doc have a plan to get you off effexor? did you taper off? are you using benzo's for the withdrawal.are you cross-tapering onto something else?
effexor withdrawal is not as horrible as many on this board might claim, however, it can be a very bad transition period - even up to a month for some, especially if you're not tapering off right and going onto something else.
thanks for the meds rundown. you mentioned panic attacks. do you suffer from GAD (generalized anxiety) or do you have full-fledged panic attacks? Secondly how bad is the OCD normally (not on effexor and when on other ADs)?Are you aware of the diagnostic distinction between regular (melancholic) depression and atypical depression, or mixed (if mixed, which side is more prevalent)? Which one describes your symptoms. please explain your top five symptoms in descending order. Try to keep the symptoms as objective as possible.
> Ghankyou JRB for a reply to my email
>
> I appreciate your well documented and thought out replies. Believe me It helps to get a response from someone who is knowledgable about drugs.
>
> At the moment I have been off effexor for 5 days and I have been depressed. However I am not surprised by this due to the fact that effexor really effected my system. Im going to give you a list of drugs that I have taken and there results in the hope that you can see a common thread
>
> Peroxtine - Good results for 2.5 years slowly got ineffective finished using 30/12/2002
>
> Lexapro - Didn't upset me however I didn't fix panic attacks (2 months) mind due the panic attacks were not that bad, sometimes I would feel agitated during some days, however I gave it up thinking that maybee another drug would give me a miracle cure. Boy was I dumb in believing such a thing
>
> Prozac - I almost wanted to slash my wrists docter tried increasing the dose which made things very much worse ( 2 months)
>
> Imipramine - had an interesting result, got improvement in depression caused from bad result with prozac. It seemd to work (in regards to depression) at lower doses, however at higher doses it made me feel depressed, this was due to when I tried to do relaxtion exercises it would agrevate me highly.In short doses below 50mg helped a little while doses over 50 mg ie 75 or 100 mg made me easily depressed. It also increased depression after a panic attack.
>
> Dothiepin took this for a month, it didn't help my anxiety and any attempt to work on my anxiety would create a panic attack,( Ihad done breathing exercises when taking peroxtine and didn't get such a extreme reaction or even why I wasn't even on drugs) did get one good result which was that I got a good night sleep, didn't make me feel depressed on average, docter suggested trying another drug to work on my GAD and panic attacks. After stopping this drug I did have trouble getting to sleep
>
> Effexor - what a mistake worse experience I have ever had with a drug could only take 19 days before having to completly stop taking it, still feeling very much worse with a inability to stop worrying about being OCD or becoming OCD
>
> I have been feeling very depressed and might need to try another drug
>
> So what drug should I try ?? Im sort of guessing between Fluvoxamine (Luvax) or Zoloft or Citalopram ( cant be much different to lexapro)
>
> Or I could try taking peroxtine again
>
> However I am a bit worried about trying anything that raises both seratonin and neophinphrine at the same time like the tricyclics which have a tendancy to make me feel worse at high doses. I am also coming to the conclusion that I might be very dose sensitive and higher doses make me worse while smaller amounts help a little
>
> Ok guys what do you think
>
> Im especially interesed in what you have to say JRB
>
>
>
>
>
>
> > Hi Robert,
> >
> > you might be right in that the effexor is worsening your anxiousness, and perhaps even exacerbate your depression. but it's hard to tell. even though you have high levels of noradrenaline (norepinpehrine), this doesn't mean that taking effexor (a serotonin and norephiprine reuptake inhibitor) is going to make your depression worse.
> >
> > this is because, currently, the research is sort of unclear on whether depressive sufferers have increased or decreased norepinephrine (NE) levels. Most studies that have drawn blood sample have shown increased norepinephrine BLOOD levels (like yourself). However, this is only a measure of peripheral NE, not NE in the BRAIN. See, increased NE in the periphery can definitely cause ~physical~
> > symptoms of anxiety (sweating, heart palpiations, startle effect). However, it is unclear whether increased NE in the brain is helping or hindering anxiety/depression -- currently there is good evidence that NE drugs increase neurogenesis - which is thought to be the route of depression.
> >
> > Since this is sort of a more complicated topic, I'd suggest you read this article (it provides a good summary on the role of NE as well as how it's tied to the stress system, the HPA)...
> >
> > http://www.sciam.com/search/search_result.cfm
> >
> > Back to addressing your concerns about effexor,
> > many people have problems beginning on effexor. you should read the Tips section on Effexor (you can find the link at the top of the psycho-babble page). Perhaps you should cut back to 37.5mg tablets and go slow. I would also advise you to take it in the morning if it is disrupting your sleep. Once again, I can assure you that the side effects will decrease, by how much, well I can't tell you since that's individually determined.
> >
> > couple other notes...
> >
> > Effexor is a great drug, and it usually works better in cases of atypical depression, not regular unipolar (melancholic) depression. Most melancholics find that an SSRI usually works best. This is a general theory, not a rule. But there was probably a reason why your doc put you on effexor besides effexor being known to be good for GAD and depression, can you infer what those reasons were? were there any other options discussed?
> >
> > Have you been taking benzo's and have they been helping?
> >
> > I'd suggest you stick it out for 2-3 weeks and then see if you're fairing better. If not, maybe a simple SSRI, like Lexapro, Celexa, or Paxil is better for you.
> >
> > good luck, keep in touch with us.
> >
> > JRB
> >
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > > In reply to your questions
> > >
> > > 1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
> > >
> > > 2 I am taking the 75 mg at dinnertime
> > >
> > > 3 I am feeling very anxious depressed
> > >
> > > Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
> > >
> > >
> > > Thanks for your reply JRB Im interested in what you have to say from my answers
> > >
> > >
> > > Regards Robert
> > > > hang in there robert.
> > > >
> > > > yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
> > > >
> > > > couple questions...
> > > >
> > > > 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
> > > >
> > > > 2) what is your current dose of effexor?
> > > > 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
> > > >
> > > > Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
> > > >
> > > >
> > > > as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
> > > >
> > > > good luck
> > > >
> > > > JRB
> > > >
> > > >
> > > >
> > > >
> > > > > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> > > > >
> > > > > Anyones thoughts would be well appreciated
> > > >
> > > >
> > >
> > >
> >
> >
>
>
Posted by Robert Fairburn on October 3, 2003, at 16:50:20
In reply to Re: Effexor XR need advice from other users, posted by jrbecker on October 3, 2003, at 10:43:27
Thanks JRB for replying to my posting Ill try and answer your questions as best as I can. AS always thanks a million
Cheers Robert
>
> first things first.
> does your doc know your off the effexor. who's helping to make these pharmacological decisions?
THe Docter said that I could stop taking the drug if it was upsetting me to much>
> Do you and your doc have a plan to get you off effexor? did you taper off? are you using benzo's for the withdrawal.
>
I was given some benzo's for the withdrawl, but basically I stopped taking them
>
> are you cross-tapering onto something else?
My docter has given me luvox (Will start taking tomorrow) if that doesn't work then I will go back on paxil which has worked in the past, I wanted to try Luvox because it seemed to just work on seratonine and not nerophineophrine or any thing else. Ive come to the conclusion (maybee wrongly) that luvox has less side effects compared to other SSRI drugs
>
> effexor withdrawal is not as horrible as many on this board might claim, however, it can be a very bad transition period - even up to a month for some, especially if you're not tapering off right and going onto something else.
>thanks for the meds rundown. you mentioned panic attacks. do you suffer from GAD (generalized anxiety) or do you have full-fledged panic attacks? Secondly how bad is the OCD normally (not on effexor and when on other ADs)?
I was diagnosed with GAD and panic attacksBefore taking effexor I didn't suffer OCD, maybee the OCD is just a reaction of me having a bad time with effexor
>
> Are you aware of the diagnostic distinction between regular (melancholic) depression and atypical depression, or mixed (if mixed, which side is more prevalent)? Which one describes your symptoms. please explain your top five symptoms in descending order. Try to keep the symptoms as objective as possible?I really do not know the difference to a 100%, im sure however that Im not melancholic because Im still motivated to do things, in fact being busy seems to help
>My five top symptoms
Before effexor
Panic attacks
GAD
Insomia
depression
Maybee a tad OCD but very littleAfter Effexor
Depression;
OCD and GAD obsessional worry about becoming OCD Ie I want be able to keep upseting thoughts out of my mind;
Insomia
Have had very little or no panic attacks since coming off effexor, in fact they have almost gone away
>
>
>
> > Ghankyou JRB for a reply to my email
> >
> > I appreciate your well documented and thought out replies. Believe me It helps to get a response from someone who is knowledgable about drugs.
> >
> > At the moment I have been off effexor for 5 days and I have been depressed. However I am not surprised by this due to the fact that effexor really effected my system. Im going to give you a list of drugs that I have taken and there results in the hope that you can see a common thread
> >
> > Peroxtine - Good results for 2.5 years slowly got ineffective finished using 30/12/2002
> >
> > Lexapro - Didn't upset me however I didn't fix panic attacks (2 months) mind due the panic attacks were not that bad, sometimes I would feel agitated during some days, however I gave it up thinking that maybee another drug would give me a miracle cure. Boy was I dumb in believing such a thing
> >
> > Prozac - I almost wanted to slash my wrists docter tried increasing the dose which made things very much worse ( 2 months)
> >
> > Imipramine - had an interesting result, got improvement in depression caused from bad result with prozac. It seemd to work (in regards to depression) at lower doses, however at higher doses it made me feel depressed, this was due to when I tried to do relaxtion exercises it would agrevate me highly.In short doses below 50mg helped a little while doses over 50 mg ie 75 or 100 mg made me easily depressed. It also increased depression after a panic attack.
> >
> > Dothiepin took this for a month, it didn't help my anxiety and any attempt to work on my anxiety would create a panic attack,( Ihad done breathing exercises when taking peroxtine and didn't get such a extreme reaction or even why I wasn't even on drugs) did get one good result which was that I got a good night sleep, didn't make me feel depressed on average, docter suggested trying another drug to work on my GAD and panic attacks. After stopping this drug I did have trouble getting to sleep
> >
> > Effexor - what a mistake worse experience I have ever had with a drug could only take 19 days before having to completly stop taking it, still feeling very much worse with a inability to stop worrying about being OCD or becoming OCD
> >
> > I have been feeling very depressed and might need to try another drug
> >
> > So what drug should I try ?? Im sort of guessing between Fluvoxamine (Luvax) or Zoloft or Citalopram ( cant be much different to lexapro)
> >
> > Or I could try taking peroxtine again
> >
> > However I am a bit worried about trying anything that raises both seratonin and neophinphrine at the same time like the tricyclics which have a tendancy to make me feel worse at high doses. I am also coming to the conclusion that I might be very dose sensitive and higher doses make me worse while smaller amounts help a little
> >
> > Ok guys what do you think
> >
> > Im especially interesed in what you have to say JRB
> >
> >
> >
> >
> >
> >
> > > Hi Robert,
> > >
> > > you might be right in that the effexor is worsening your anxiousness, and perhaps even exacerbate your depression. but it's hard to tell. even though you have high levels of noradrenaline (norepinpehrine), this doesn't mean that taking effexor (a serotonin and norephiprine reuptake inhibitor) is going to make your depression worse.
> > >
> > > this is because, currently, the research is sort of unclear on whether depressive sufferers have increased or decreased norepinephrine (NE) levels. Most studies that have drawn blood sample have shown increased norepinephrine BLOOD levels (like yourself). However, this is only a measure of peripheral NE, not NE in the BRAIN. See, increased NE in the periphery can definitely cause ~physical~
> > > symptoms of anxiety (sweating, heart palpiations, startle effect). However, it is unclear whether increased NE in the brain is helping or hindering anxiety/depression -- currently there is good evidence that NE drugs increase neurogenesis - which is thought to be the route of depression.
> > >
> > > Since this is sort of a more complicated topic, I'd suggest you read this article (it provides a good summary on the role of NE as well as how it's tied to the stress system, the HPA)...
> > >
> > > http://www.sciam.com/search/search_result.cfm
> > >
> > > Back to addressing your concerns about effexor,
> > > many people have problems beginning on effexor. you should read the Tips section on Effexor (you can find the link at the top of the psycho-babble page). Perhaps you should cut back to 37.5mg tablets and go slow. I would also advise you to take it in the morning if it is disrupting your sleep. Once again, I can assure you that the side effects will decrease, by how much, well I can't tell you since that's individually determined.
> > >
> > > couple other notes...
> > >
> > > Effexor is a great drug, and it usually works better in cases of atypical depression, not regular unipolar (melancholic) depression. Most melancholics find that an SSRI usually works best. This is a general theory, not a rule. But there was probably a reason why your doc put you on effexor besides effexor being known to be good for GAD and depression, can you infer what those reasons were? were there any other options discussed?
> > >
> > > Have you been taking benzo's and have they been helping?
> > >
> > > I'd suggest you stick it out for 2-3 weeks and then see if you're fairing better. If not, maybe a simple SSRI, like Lexapro, Celexa, or Paxil is better for you.
> > >
> > > good luck, keep in touch with us.
> > >
> > > JRB
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > > In reply to your questions
> > > >
> > > > 1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
> > > >
> > > > 2 I am taking the 75 mg at dinnertime
> > > >
> > > > 3 I am feeling very anxious depressed
> > > >
> > > > Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
> > > >
> > > >
> > > > Thanks for your reply JRB Im interested in what you have to say from my answers
> > > >
> > > >
> > > > Regards Robert
> > > > > hang in there robert.
> > > > >
> > > > > yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
> > > > >
> > > > > couple questions...
> > > > >
> > > > > 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
> > > > >
> > > > > 2) what is your current dose of effexor?
> > > > > 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
> > > > >
> > > > > Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
> > > > >
> > > > >
> > > > > as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
> > > > >
> > > > > good luck
> > > > >
> > > > > JRB
> > > > >
> > > > >
> > > > >
> > > > >
> > > > > > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> > > > > >
> > > > > > Anyones thoughts would be well appreciated
> > > > >
> > > > >
> > > >
> > > >
> > >
> > >
> >
> >
>
>
Posted by surfin323i on October 4, 2003, at 8:48:47
In reply to Re: Effexor XR need advice from other users, posted by Robert Fairburn on October 3, 2003, at 16:50:20
Hi,
I was wondering if anyone has any information regarding Efexor and preganancy.My wife is on 150mg a day and has just discovered that she is preganant.
We are concerned that the Efexor may have some effect on the baby.When she has tried to stop taking
Efexor the withdrawals have been excruciating for her.Of course she was not informed of this when she was first given the prescription.Any information would be greatly appreciated.
Kindest regards,
Raymond
Posted by jrbecker on October 5, 2003, at 0:34:12
In reply to Re: Effexor XR need advice from other users, posted by Robert Fairburn on October 3, 2003, at 16:50:20
hmm. realize that I'm just another depressive sufferer such as yourself, but these are my instinctual thoughts...
Luvox has never been a great fvorite of anybody I've known, but you're right in terms of it having the best side-effect ratio among the SSRIs. Between this choice and Paxil, I'd try a low dose of Paxil in combo with a long-acting benzo (I'll get to that). By the way, I know you've been on Lexapro, but have you tried Celexa? I had the same anxious reaction to Lexapro, but I never found this with Celexa. Celexa is a great drug, and is fairly tolerable. Thinking a low dose of 20mg might be worth a shot.
It's almost as good as paxil for the anxiety, and I always found it personally to be a better AD. It was also not as sedating, and I think most others would agree.Secondly, considering your strong anxiety component, I'm wondering what benzos you've tried and liked the best. I have found that the best strategy for me has always been to combine a lower dose of an AD with a long-acting benzo like klonopin or xanax xr. Have you tried this strategy? If not, I'd be curious to hear why you haven't found success with taking a benzo long-term.
Have you and your doc ruled out any soft cycling to your depression?
Lastly, the best thing for me beyond meds that has consistently worked for me, bar none, has been moderate-to-intense exercise. It is the workhorse of my treatment regimen. Although exercise has always been lauded as a generally healthy thing to do, it's finally getting its fair due as a preventative measure against depression/anxiety. In the past few years, there has been a tremendous amount of research that shows that exercise is linked to increased neurogenesis. Moreover, exercise as a treatment has been shown to be just as efficacious as current antidepressants, maybe more so, and that combining the two have has produced the most powerful treatment response. But of course the data doesn't have to tell me it works, I already know first hand.
let me know your feedback.
JRB
> Thanks JRB for replying to my posting Ill try and answer your questions as best as I can. AS always thanks a million
>
> Cheers Robert
> >
> > first things first.
> > does your doc know your off the effexor. who's helping to make these pharmacological decisions?
>
>
> THe Docter said that I could stop taking the drug if it was upsetting me to much
>
> >
> > Do you and your doc have a plan to get you off effexor? did you taper off? are you using benzo's for the withdrawal.
> >
> I was given some benzo's for the withdrawl, but basically I stopped taking them
> >
> > are you cross-tapering onto something else?
>
>
> My docter has given me luvox (Will start taking tomorrow) if that doesn't work then I will go back on paxil which has worked in the past, I wanted to try Luvox because it seemed to just work on seratonine and not nerophineophrine or any thing else. Ive come to the conclusion (maybee wrongly) that luvox has less side effects compared to other SSRI drugs
> >
> > effexor withdrawal is not as horrible as many on this board might claim, however, it can be a very bad transition period - even up to a month for some, especially if you're not tapering off right and going onto something else.
> >thanks for the meds rundown. you mentioned panic attacks. do you suffer from GAD (generalized anxiety) or do you have full-fledged panic attacks? Secondly how bad is the OCD normally (not on effexor and when on other ADs)?
>
>
> I was diagnosed with GAD and panic attacks
>
> Before taking effexor I didn't suffer OCD, maybee the OCD is just a reaction of me having a bad time with effexor
> >
> > Are you aware of the diagnostic distinction between regular (melancholic) depression and atypical depression, or mixed (if mixed, which side is more prevalent)? Which one describes your symptoms. please explain your top five symptoms in descending order. Try to keep the symptoms as objective as possible?
>
> I really do not know the difference to a 100%, im sure however that Im not melancholic because Im still motivated to do things, in fact being busy seems to help
> >
>
> My five top symptoms
>
> Before effexor
>
> Panic attacks
> GAD
> Insomia
> depression
> Maybee a tad OCD but very little
>
> After Effexor
>
> Depression;
> OCD and GAD obsessional worry about becoming OCD Ie I want be able to keep upseting thoughts out of my mind;
> Insomia
> Have had very little or no panic attacks since coming off effexor, in fact they have almost gone away
>
>
> >
> >
> >
> > > Ghankyou JRB for a reply to my email
> > >
> > > I appreciate your well documented and thought out replies. Believe me It helps to get a response from someone who is knowledgable about drugs.
> > >
> > > At the moment I have been off effexor for 5 days and I have been depressed. However I am not surprised by this due to the fact that effexor really effected my system. Im going to give you a list of drugs that I have taken and there results in the hope that you can see a common thread
> > >
> > > Peroxtine - Good results for 2.5 years slowly got ineffective finished using 30/12/2002
> > >
> > > Lexapro - Didn't upset me however I didn't fix panic attacks (2 months) mind due the panic attacks were not that bad, sometimes I would feel agitated during some days, however I gave it up thinking that maybee another drug would give me a miracle cure. Boy was I dumb in believing such a thing
> > >
> > > Prozac - I almost wanted to slash my wrists docter tried increasing the dose which made things very much worse ( 2 months)
> > >
> > > Imipramine - had an interesting result, got improvement in depression caused from bad result with prozac. It seemd to work (in regards to depression) at lower doses, however at higher doses it made me feel depressed, this was due to when I tried to do relaxtion exercises it would agrevate me highly.In short doses below 50mg helped a little while doses over 50 mg ie 75 or 100 mg made me easily depressed. It also increased depression after a panic attack.
> > >
> > > Dothiepin took this for a month, it didn't help my anxiety and any attempt to work on my anxiety would create a panic attack,( Ihad done breathing exercises when taking peroxtine and didn't get such a extreme reaction or even why I wasn't even on drugs) did get one good result which was that I got a good night sleep, didn't make me feel depressed on average, docter suggested trying another drug to work on my GAD and panic attacks. After stopping this drug I did have trouble getting to sleep
> > >
> > > Effexor - what a mistake worse experience I have ever had with a drug could only take 19 days before having to completly stop taking it, still feeling very much worse with a inability to stop worrying about being OCD or becoming OCD
> > >
> > > I have been feeling very depressed and might need to try another drug
> > >
> > > So what drug should I try ?? Im sort of guessing between Fluvoxamine (Luvax) or Zoloft or Citalopram ( cant be much different to lexapro)
> > >
> > > Or I could try taking peroxtine again
> > >
> > > However I am a bit worried about trying anything that raises both seratonin and neophinphrine at the same time like the tricyclics which have a tendancy to make me feel worse at high doses. I am also coming to the conclusion that I might be very dose sensitive and higher doses make me worse while smaller amounts help a little
> > >
> > > Ok guys what do you think
> > >
> > > Im especially interesed in what you have to say JRB
> > >
> > >
> > >
> > >
> > >
> > >
> > > > Hi Robert,
> > > >
> > > > you might be right in that the effexor is worsening your anxiousness, and perhaps even exacerbate your depression. but it's hard to tell. even though you have high levels of noradrenaline (norepinpehrine), this doesn't mean that taking effexor (a serotonin and norephiprine reuptake inhibitor) is going to make your depression worse.
> > > >
> > > > this is because, currently, the research is sort of unclear on whether depressive sufferers have increased or decreased norepinephrine (NE) levels. Most studies that have drawn blood sample have shown increased norepinephrine BLOOD levels (like yourself). However, this is only a measure of peripheral NE, not NE in the BRAIN. See, increased NE in the periphery can definitely cause ~physical~
> > > > symptoms of anxiety (sweating, heart palpiations, startle effect). However, it is unclear whether increased NE in the brain is helping or hindering anxiety/depression -- currently there is good evidence that NE drugs increase neurogenesis - which is thought to be the route of depression.
> > > >
> > > > Since this is sort of a more complicated topic, I'd suggest you read this article (it provides a good summary on the role of NE as well as how it's tied to the stress system, the HPA)...
> > > >
> > > > http://www.sciam.com/search/search_result.cfm
> > > >
> > > > Back to addressing your concerns about effexor,
> > > > many people have problems beginning on effexor. you should read the Tips section on Effexor (you can find the link at the top of the psycho-babble page). Perhaps you should cut back to 37.5mg tablets and go slow. I would also advise you to take it in the morning if it is disrupting your sleep. Once again, I can assure you that the side effects will decrease, by how much, well I can't tell you since that's individually determined.
> > > >
> > > > couple other notes...
> > > >
> > > > Effexor is a great drug, and it usually works better in cases of atypical depression, not regular unipolar (melancholic) depression. Most melancholics find that an SSRI usually works best. This is a general theory, not a rule. But there was probably a reason why your doc put you on effexor besides effexor being known to be good for GAD and depression, can you infer what those reasons were? were there any other options discussed?
> > > >
> > > > Have you been taking benzo's and have they been helping?
> > > >
> > > > I'd suggest you stick it out for 2-3 weeks and then see if you're fairing better. If not, maybe a simple SSRI, like Lexapro, Celexa, or Paxil is better for you.
> > > >
> > > > good luck, keep in touch with us.
> > > >
> > > > JRB
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > > In reply to your questions
> > > > >
> > > > > 1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
> > > > >
> > > > > 2 I am taking the 75 mg at dinnertime
> > > > >
> > > > > 3 I am feeling very anxious depressed
> > > > >
> > > > > Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
> > > > >
> > > > >
> > > > > Thanks for your reply JRB Im interested in what you have to say from my answers
> > > > >
> > > > >
> > > > > Regards Robert
> > > > > > hang in there robert.
> > > > > >
> > > > > > yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
> > > > > >
> > > > > > couple questions...
> > > > > >
> > > > > > 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
> > > > > >
> > > > > > 2) what is your current dose of effexor?
> > > > > > 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
> > > > > >
> > > > > > Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
> > > > > >
> > > > > >
> > > > > > as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
> > > > > >
> > > > > > good luck
> > > > > >
> > > > > > JRB
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > > > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> > > > > > >
> > > > > > > Anyones thoughts would be well appreciated
> > > > > >
> > > > > >
> > > > >
> > > > >
> > > >
> > > >
> > >
> > >
> >
> >
>
>
Posted by Louisa on October 5, 2003, at 17:35:40
In reply to Re: Effexor XR need advice from other users, posted by surfin323i on October 4, 2003, at 8:48:47
I am just now starting to try to conceive (ttc) and have been advised to come off Effexor during pregnancy (my gp -- also an obgyn -- suggested Zoloft as a better alternative, also for breastfeeding). I sympathize MIGHTILY about the Effexor withdrawal symptoms, as I am suffering very much with them! I would have your wife talk to her ob/gyn as soon as possible -- they generally have a lot of experience with this situation. And then taper! otherwise she'll really be miserable.
Best,
Louisa
> Hi,
> I was wondering if anyone has any information regarding Efexor and preganancy.My wife is on 150mg a day and has just discovered that she is preganant.
> We are concerned that the Efexor may have some effect on the baby.When she has tried to stop taking
> Efexor the withdrawals have been excruciating for her.Of course she was not informed of this when she was first given the prescription.Any information would be greatly appreciated.
> Kindest regards,
> Raymond
Posted by Robert Fairburn on October 7, 2003, at 17:41:10
In reply to Re: Effexor XR need advice from other users » Robert Fairburn, posted by jrbecker on October 5, 2003, at 0:34:12
Thanks JRB, Just because you suffer depression doesn't invalidate the knowledge you have.
In reply to your message there are several things I would like to say. If I fail on Luvox I will definitely be going back to Paxil. In regards to benzo I have mixed emotions. This is due to the belief they reduce the number of gaba receptors in the brain. However, I might be interested in taking Karva which can have the opposite effect from what I understand.
You might be of interest to know that I am receiving my results from a whole battery of blood tests. The doctor suspects that I have Leaky Gut Syndrome. However, I will not know until I get my blood results. I have one or two questions to ask you. What is your knowledge of CCK and substance P it is my understanding that these are hormones that are produced in the intestines and yet have a link to depression and anxiety. I know that patients injected with higher levels of CCK have induced panic attacks that are similar in nature to normal occuring panic attacks. Substance P as you are well aware has also been involved with depression. From what I can understand can excessive amounts of substance P in the blood stream be causing a problem. If I remember correctly merk was developing a substance P antagonist which has been dropped what I understand from clinical trials. Also cortisole releasing factor (CRF) is suspected to play an important part in depression through the HPA axis. Hence high levels of corisole are found in the blood amoung many depressed patients. Elevated levels of cortisole increase the amount of trytophan pyrrolase which is an enzyme that competes for trytrophan usage. This also reduces the amount of free trytrophan that can pass through into the blood brain barrier.
I must admit that I have only done a small amount of research in limited time but it appears to me that the intestines and liver plus adrenal glands play an extremely important facet in regards to depression. How many people do you know of or read of that have found dramatic improvements through diet and stress reduction changes in lifestyle that lead to dramatic improvements of depressive symptoms.
Regards
Robert
> hmm. realize that I'm just another depressive sufferer such as yourself, but these are my instinctual thoughts...
>
> Luvox has never been a great fvorite of anybody I've known, but you're right in terms of it having the best side-effect ratio among the SSRIs. Between this choice and Paxil, I'd try a low dose of Paxil in combo with a long-acting benzo (I'll get to that). By the way, I know you've been on Lexapro, but have you tried Celexa? I had the same anxious reaction to Lexapro, but I never found this with Celexa. Celexa is a great drug, and is fairly tolerable. Thinking a low dose of 20mg might be worth a shot.
> It's almost as good as paxil for the anxiety, and I always found it personally to be a better AD. It was also not as sedating, and I think most others would agree.
>
> Secondly, considering your strong anxiety component, I'm wondering what benzos you've tried and liked the best. I have found that the best strategy for me has always been to combine a lower dose of an AD with a long-acting benzo like klonopin or xanax xr. Have you tried this strategy? If not, I'd be curious to hear why you haven't found success with taking a benzo long-term.
>
> Have you and your doc ruled out any soft cycling to your depression?
>
> Lastly, the best thing for me beyond meds that has consistently worked for me, bar none, has been moderate-to-intense exercise. It is the workhorse of my treatment regimen. Although exercise has always been lauded as a generally healthy thing to do, it's finally getting its fair due as a preventative measure against depression/anxiety. In the past few years, there has been a tremendous amount of research that shows that exercise is linked to increased neurogenesis. Moreover, exercise as a treatment has been shown to be just as efficacious as current antidepressants, maybe more so, and that combining the two have has produced the most powerful treatment response. But of course the data doesn't have to tell me it works, I already know first hand.
>
> let me know your feedback.
>
> JRB
>
>
> > Thanks JRB for replying to my posting Ill try and answer your questions as best as I can. AS always thanks a million
> >
> > Cheers Robert
> > >
> > > first things first.
> > > does your doc know your off the effexor. who's helping to make these pharmacological decisions?
> >
> >
> > THe Docter said that I could stop taking the drug if it was upsetting me to much
> >
> > >
> > > Do you and your doc have a plan to get you off effexor? did you taper off? are you using benzo's for the withdrawal.
> > >
> > I was given some benzo's for the withdrawl, but basically I stopped taking them
> > >
> > > are you cross-tapering onto something else?
> >
> >
> > My docter has given me luvox (Will start taking tomorrow) if that doesn't work then I will go back on paxil which has worked in the past, I wanted to try Luvox because it seemed to just work on seratonine and not nerophineophrine or any thing else. Ive come to the conclusion (maybee wrongly) that luvox has less side effects compared to other SSRI drugs
> > >
> > > effexor withdrawal is not as horrible as many on this board might claim, however, it can be a very bad transition period - even up to a month for some, especially if you're not tapering off right and going onto something else.
> > >thanks for the meds rundown. you mentioned panic attacks. do you suffer from GAD (generalized anxiety) or do you have full-fledged panic attacks? Secondly how bad is the OCD normally (not on effexor and when on other ADs)?
> >
> >
> > I was diagnosed with GAD and panic attacks
> >
> > Before taking effexor I didn't suffer OCD, maybee the OCD is just a reaction of me having a bad time with effexor
> > >
> > > Are you aware of the diagnostic distinction between regular (melancholic) depression and atypical depression, or mixed (if mixed, which side is more prevalent)? Which one describes your symptoms. please explain your top five symptoms in descending order. Try to keep the symptoms as objective as possible?
> >
> > I really do not know the difference to a 100%, im sure however that Im not melancholic because Im still motivated to do things, in fact being busy seems to help
> > >
> >
> > My five top symptoms
> >
> > Before effexor
> >
> > Panic attacks
> > GAD
> > Insomia
> > depression
> > Maybee a tad OCD but very little
> >
> > After Effexor
> >
> > Depression;
> > OCD and GAD obsessional worry about becoming OCD Ie I want be able to keep upseting thoughts out of my mind;
> > Insomia
> > Have had very little or no panic attacks since coming off effexor, in fact they have almost gone away
> >
> >
> > >
> > >
> > >
> > > > Ghankyou JRB for a reply to my email
> > > >
> > > > I appreciate your well documented and thought out replies. Believe me It helps to get a response from someone who is knowledgable about drugs.
> > > >
> > > > At the moment I have been off effexor for 5 days and I have been depressed. However I am not surprised by this due to the fact that effexor really effected my system. Im going to give you a list of drugs that I have taken and there results in the hope that you can see a common thread
> > > >
> > > > Peroxtine - Good results for 2.5 years slowly got ineffective finished using 30/12/2002
> > > >
> > > > Lexapro - Didn't upset me however I didn't fix panic attacks (2 months) mind due the panic attacks were not that bad, sometimes I would feel agitated during some days, however I gave it up thinking that maybee another drug would give me a miracle cure. Boy was I dumb in believing such a thing
> > > >
> > > > Prozac - I almost wanted to slash my wrists docter tried increasing the dose which made things very much worse ( 2 months)
> > > >
> > > > Imipramine - had an interesting result, got improvement in depression caused from bad result with prozac. It seemd to work (in regards to depression) at lower doses, however at higher doses it made me feel depressed, this was due to when I tried to do relaxtion exercises it would agrevate me highly.In short doses below 50mg helped a little while doses over 50 mg ie 75 or 100 mg made me easily depressed. It also increased depression after a panic attack.
> > > >
> > > > Dothiepin took this for a month, it didn't help my anxiety and any attempt to work on my anxiety would create a panic attack,( Ihad done breathing exercises when taking peroxtine and didn't get such a extreme reaction or even why I wasn't even on drugs) did get one good result which was that I got a good night sleep, didn't make me feel depressed on average, docter suggested trying another drug to work on my GAD and panic attacks. After stopping this drug I did have trouble getting to sleep
> > > >
> > > > Effexor - what a mistake worse experience I have ever had with a drug could only take 19 days before having to completly stop taking it, still feeling very much worse with a inability to stop worrying about being OCD or becoming OCD
> > > >
> > > > I have been feeling very depressed and might need to try another drug
> > > >
> > > > So what drug should I try ?? Im sort of guessing between Fluvoxamine (Luvax) or Zoloft or Citalopram ( cant be much different to lexapro)
> > > >
> > > > Or I could try taking peroxtine again
> > > >
> > > > However I am a bit worried about trying anything that raises both seratonin and neophinphrine at the same time like the tricyclics which have a tendancy to make me feel worse at high doses. I am also coming to the conclusion that I might be very dose sensitive and higher doses make me worse while smaller amounts help a little
> > > >
> > > > Ok guys what do you think
> > > >
> > > > Im especially interesed in what you have to say JRB
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > > Hi Robert,
> > > > >
> > > > > you might be right in that the effexor is worsening your anxiousness, and perhaps even exacerbate your depression. but it's hard to tell. even though you have high levels of noradrenaline (norepinpehrine), this doesn't mean that taking effexor (a serotonin and norephiprine reuptake inhibitor) is going to make your depression worse.
> > > > >
> > > > > this is because, currently, the research is sort of unclear on whether depressive sufferers have increased or decreased norepinephrine (NE) levels. Most studies that have drawn blood sample have shown increased norepinephrine BLOOD levels (like yourself). However, this is only a measure of peripheral NE, not NE in the BRAIN. See, increased NE in the periphery can definitely cause ~physical~
> > > > > symptoms of anxiety (sweating, heart palpiations, startle effect). However, it is unclear whether increased NE in the brain is helping or hindering anxiety/depression -- currently there is good evidence that NE drugs increase neurogenesis - which is thought to be the route of depression.
> > > > >
> > > > > Since this is sort of a more complicated topic, I'd suggest you read this article (it provides a good summary on the role of NE as well as how it's tied to the stress system, the HPA)...
> > > > >
> > > > > http://www.sciam.com/search/search_result.cfm
> > > > >
> > > > > Back to addressing your concerns about effexor,
> > > > > many people have problems beginning on effexor. you should read the Tips section on Effexor (you can find the link at the top of the psycho-babble page). Perhaps you should cut back to 37.5mg tablets and go slow. I would also advise you to take it in the morning if it is disrupting your sleep. Once again, I can assure you that the side effects will decrease, by how much, well I can't tell you since that's individually determined.
> > > > >
> > > > > couple other notes...
> > > > >
> > > > > Effexor is a great drug, and it usually works better in cases of atypical depression, not regular unipolar (melancholic) depression. Most melancholics find that an SSRI usually works best. This is a general theory, not a rule. But there was probably a reason why your doc put you on effexor besides effexor being known to be good for GAD and depression, can you infer what those reasons were? were there any other options discussed?
> > > > >
> > > > > Have you been taking benzo's and have they been helping?
> > > > >
> > > > > I'd suggest you stick it out for 2-3 weeks and then see if you're fairing better. If not, maybe a simple SSRI, like Lexapro, Celexa, or Paxil is better for you.
> > > > >
> > > > > good luck, keep in touch with us.
> > > > >
> > > > > JRB
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > >
> > > > > > In reply to your questions
> > > > > >
> > > > > > 1 Before taking the med I was suffering from GAD but not OCD or depression now I feel depressed plus slightly OCD.
> > > > > >
> > > > > > 2 I am taking the 75 mg at dinnertime
> > > > > >
> > > > > > 3 I am feeling very anxious depressed
> > > > > >
> > > > > > Before taking the drug I had a test that showed that i had abnormal high levels of noradrenaline. I think what effexor is doing is that its making me so anxious that it causing the depression and OCD. For me depression fellows anxiety attacks not the other way around
> > > > > >
> > > > > >
> > > > > > Thanks for your reply JRB Im interested in what you have to say from my answers
> > > > > >
> > > > > >
> > > > > > Regards Robert
> > > > > > > hang in there robert.
> > > > > > >
> > > > > > > yes, for many, including myself, you can feel worse before you get better when taking an antidepressant.
> > > > > > >
> > > > > > > couple questions...
> > > > > > >
> > > > > > > 1) so if I'm correct, you said you only had anxiety and slight OCD tendencies but not majorly depressed?
> > > > > > >
> > > > > > > 2) what is your current dose of effexor?
> > > > > > > 3) when you say you're more depressed now, vs. before you started. how depressed are we talking here, are you speaking more to your energy or sense of anxiety/excitation (some get this on effexor). Or is the depression more of the common melancholy, emptiness, etc.?
> > > > > > >
> > > > > > > Unless, you feel you're doing substantially worse than when you started, I'd give it at least 5-6 weeks before you can fully start judging whether effexor is right. the side effects as well as the benefit of the drug will be leveling out all the way up until then.
> > > > > > >
> > > > > > >
> > > > > > > as for the benzo's your doc gave you...he might have the right idea there. see, where effexor is great for mental anxiety, it can sometime exacerbate physical anxiousness (restlessness/excitability). this is due to the noradrenergic effect of the effexor. for me, this side effect dwindled with time, and was such a minor tradeoff to the pwerful antidepressant effect I was getting from the drug. However, I did benefit from taking a low dose of a benzo as well to help with the anxiousness. Just a quick caveat, keep the dose of the benzo as low as possible, since it can worsen your current depressive symptoms (by making you feel numb). secondly, make sure you are taking the benzo dosage consistently. for instance, if you are taking a short-half-life benzo like ativan (less than 12hr half-life). make sure you are not missing your doses (but keep them small). for some, especially those sensitive to meds, missing doses of a benzo can lead to a decrease in mood. think of it in terms of early withdrawal symptoms before the drug is fully out of your system and full withdrawal occurs. for me, it's either take a benzo on a regimented schedule or not at all. missing a dose leads to a slight depressive effect.
> > > > > > >
> > > > > > > good luck
> > > > > > >
> > > > > > > JRB
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > >
> > > > > > > > I have been taking effexor for 19 days and for the last 4 days I have been starting to feel a lot worse. I was taking effexor for anxiety but know Im feeling depressed and slightly OCD I cant seem to get worrying thoughts out of my mind. The docter has told me to hang on in there and given me some Benzo's to help calm me down. Is this a common experince for some people who still contined to take the drug and things got better, or the opposite the continued to take the drug and got worse and had to stop taking the drug.
> > > > > > > >
> > > > > > > > Anyones thoughts would be well appreciated
> > > > > > >
> > > > > > >
> > > > > >
> > > > > >
> > > > >
> > > > >
> > > >
> > > >
> > >
> > >
> >
> >
>
>
Posted by dizzy on October 7, 2003, at 20:38:33
In reply to Re: Effexor XR need advice from other users, posted by surfin323i on October 4, 2003, at 8:48:47
Hey I understand what you are going through. I just went from 150mg to 37.5 because I just found out I was pregnant. Our goal was to come off completely but that was not happening. All of my doctors agreed to keep me on a low dose because it is riskier for me to go completely off. It just depends on how bad her depression is. They said when you are pregnant you may not need any meds or less meds due to hormonal changes. This time I need less, last time I was able to come off paxil until ppd. It is not healthy for the baby if the mother is not healthy mentally and physically.
This is the end of the thread.
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