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Re: Irritability/Crying a side effect of Effexor XR?

Posted by JohnL on October 2, 2000, at 3:35:57

In reply to Irritability/Crying a side effect of Effexor XR?, posted by StaceyLacy on September 28, 2000, at 2:58:03

> I recently changed from 60mg of Paxil and 15 mg of Buspar per day to 37.5 mg of Effexor XR per day. My Dr. thought Effexor XR could treat my depression/anxiety all in one pill. Since the change over 3 weeks ago, I have had nothing but irritation/anger all day long which ends in explosive, hour long crying spells. When I explained this to my Dr. last week, she increased the dosage to 75 mg per day. Today is one week later and the there has been no change. I am concerned and wondering if anyone else has experienced feelings of severe irritation, anger or crying while adjusting to this drug?

I'm so sorry about the way you're feeling. Yikes. I've been there.

It's hard to tell what's going on. It could be your brain adjusting to the absence of Paxil+Buspar. That could very well be the case. At the same time it's being forced to adjust to Effexor. There are many intricate things happening at a molecular level, and you might well be getting the double whammy from several different angles.

I wonder why it was decided to stop Paxil+Buspar? Side effects? Not working well? And how fast were they discontinued? Stopping Paxil from 60mg should take about 2 months, based on a general rule of thumb of 10% dose reduction per week. Paxil is usually one of the more difficult meds to stop and it takes time to do it right. I don't know, in your shoes I would be very tempted to drop the Effexor for now and immediately get back on the other meds and then slowly discontinue them on a schedule that is tolerable to you. Then start something else.

I can't help but wonder if both Paxil and Effexor are all wrong for you. I mean, even now, 3 weeks after stopping Paxil, you have an ocean full of serotonin floating around in your brain. Not to mention huge amounts of serotonin at 60mg. It's my general belief that the closer a med is to targeting a chemical imbalance, the lower the dose is needed to fix it. The farther away it is, the higher the dose...because most of it is wasted on a domino chain reaction kind of thing, rather than going straight to the problem. If you needed 60mg, it just makes me wonder seriously if serotonin is the chemical imbalance involved with you. I'm tempted to think it's not. Otherwise, you never would have needed 60mg in the first place. That just indicates to me we're barking up the wrong tree.

But of course, doctors are not trained to think that way generally, and so my interpretation is likely to be ridiculed by most doctors. They are trained to think that if throwing a plate full of spaghetti at the wall doesn't work, then try throwing a bucketfull instead, without even giving a second thought to whether spaghetti is the right thing to throw in the first place, or whether the wall is the place to throw it. Kind of a weird example, but you know what I mean?

I don't know where you should go from here. But in your shoes, knowing what I know now from my own trials and errors, I would personally probably restart Paxil+Buspar, get comfortable, then slowly withdraw them, and then rethink the whole approach. And when I restarted something new, I would be tempted to look at other chemistries besides serotonin. But that's a bridge to cross later. For now stability is most important as I see it. Your doctor will probably urge you to wait it out and give it time. I totally disagree. He/she should try feeling the way you do and see if they could wait it out! I think not. Just so you know, my own psychiatrist would have stopped this thing in a heartbeat. Bad reactions like yours were not tolerated at all. He would pull the plug immediately and take another course of action. No hesitation. No ego. No second thoughts.




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