Posted by SLS on May 8, 2001, at 8:18:39
In reply to Effexor: MY Conclusions, posted by kid47 on May 7, 2001, at 14:43:15
Hi Kid.
Don't worry. No sh_t coming your way. :-)> Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression.
Just a few thoughts. Some facts. No absolute advice.Some physicians would classify you as being treatment-resistant. You would indeed qualify if you have tried 7 different antidepressants, having fully explored high dosages and allowed for a clinically sufficient time period to evaluate each. You might be at a greater risk of relapse given your treatment history. If your medical history of depression is one of chronic recurrence, this risk becomes greater still. Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective. For the average person with the average depression (unipolar and not bipolar), 13 months is a reasonable amount of time to remain well on an antidepressant before stopping. In my opinion, the key phrase is "remain well". I would not count the period between initiating medication and reaching full improvement as part of this 13 months. The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months. It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
> I don't think this is a drug that should be given as a first line AD.This will be an issue of debate, as it has been the experience of many doctors that Effexor is better than any of the SSRIs. A recent study that included between 1000 and 2000 patients has recently concluded the same. Not only does Effexor get more people well, but it gets these people more well.
> I think a discontinuation strategy should be discussed with your doc before being rx'd FXR.
...or any other antidepressant, along with the possible side effects. Withdrawal phenomena and treatment-emergent side effects occur with almost ALL of the antidepressants currently available. Of course, these occurences are variable for different drugs. I don't believe that Effexor can reasonably be singled-out. Perhaps Effexor is more visible now because it is becoming more frequently chosen as the "first line" by physicians.
> I think there should be comprehensive studies on discontinuation & a protocol established for it.
I agree, both aspects of your statement are happening right now. Unfortunately, the psychiatric community has been woefully neglectful of these things.
> But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.Since 1992, Effexor (venlafaxine) has shown a tendency to be somewhat superior to the SSRIs when treating treatment-resistant depression (TRD). However, MAOIs might have a better record still.
> 13 days med free & loving it!!!
13 months - 13 days.I hope you are not superstitious. :-)
- Scott
> PS As always your mileage may vary.With the prices of gas and psychiatric care on the rise, it is probably best to move ahead with careful planning.
poster:SLS
thread:13781
URL: http://www.dr-bob.org/babble/20010507/msgs/62088.html