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Dr. Bob is Robert Hsiung, MD,
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Posted by xena on July 23, 2002, at 11:21:09
In reply to Re: Apo-fluvoxamine vs. Effexor XR, posted by jannbeau on July 23, 2002, at 11:14:06
Yes I am Canadian. And at the risk of sounding like a total moron, I am more confused than ever. Is one drug more potent than the other, if so, which one? Thanks for your patience.
Posted by jannbeau on July 23, 2002, at 13:01:39
In reply to Re: Apo-fluvoxamine vs. Effexor XR, posted by xena on July 23, 2002, at 11:21:09
> Hi, Zena--no question is moronic. Some are more complex than others, that's all!
Effexor and Luvox are not directly comparable with respect to "potency." Potency is a pharmacological term defined as the amount of any substance it takes to produce the same effect to the same degree. For instance, if it takes 10 milligrams of Paxil to increase the amount of time that one molecule of serotonin stays in the synaptic cleft by 1 second and it takes 100 mg of Prozac to do the same, then Paxil is 10 times as potent as Prozac. Effexor and Luvox are different drugs that may have different spectra of effects.
I suspect that the question you are trying to ask is "which of these drugs is more effecacious in treating depression/anxiety?" Efficacy is the ability of a drug to treat the problem for which it is prescribed. Efficacy is not synonymous with potency, and the answer to the question is probably more complex than the "potency" question and will depend, to some degree, upon your problem. Most of the time, with the CNS drugs, finding the right drug may be more trial and error than when prescribing an antibiotic, for instance. You may have to try more than one medication or a combination of meds to get the result you need.
Hope this info has helped.
jannbeau
Yes I am Canadian. And at the risk of sounding like a total moron, I am more confused than ever. Is one drug more potent than the other, if so, which one? Thanks for your patience.
Posted by sly on July 23, 2002, at 15:26:01
In reply to Re: Apo-fluvoxamine vs. Effexor XR, posted by jannbeau on July 23, 2002, at 11:14:06
calm down Jannbeau!
It's not like you invented the stuff.
And I think you're missing the point.
Apo refers to a Canadian drug company that produces generic versions of the original. Any medication in Canada that starts with apo- is generic, just take that off and you've got the chemical name. All she needs to do is look up Fluvoxamine.
The difference is SSRI vs. SNRI. Effexor also inhibits norepinephrine reuptake. It claims to be more efficacious, but we're all different. Since none of us are medical Doctor's none of us are in a position to offer recommendations on medication - and I hope Xena would consult her Dr. if she's concerned.
fyi - I also took chemistry, biochemistry, pharmacology, neurology, and psychopharmacology, but I guess I forgot to read up on them before responding to the email, I didn't realize I'd be tested on my answers. And quite frankly, I have better things to do. I was only trying to help.
ASA or acetaminophen, seven or seventeen years, whatever, how does that help Xena, you get the point don't you? If not, get a life.
When I was very depressed I used to waste hours at work researching and responding to every critical statement in an email defending my opinion and point of view, kind of like you here - again, you didn't invent the stuff - but proving someone wrong was a hollow victory, when I got better I finally realised, NOBODY CARES! only I did, and in the process I alienated my co-workers/friends.
Think about it. The tone of your email was highly defensive and took cheap shots at me. Why?
Posted by jannbeau on July 23, 2002, at 18:07:20
In reply to Re: Apo-fluvoxamine vs. Effexor XR, posted by sly on July 23, 2002, at 15:26:01
>Sorry, Sly. I didn't intend to offend you or anyone else. Why ARE you offended, anyway? I'm not offended by your response and I didn't take any more cheap shots at you than you fired off at me! "Me thinketh the fellow protesteth too much!"--
Cheers,
Jannbeaucalm down Jannbeau!
>
> It's not like you invented the stuff.
>
> And I think you're missing the point.
>
> Apo refers to a Canadian drug company that produces generic versions of the original. Any medication in Canada that starts with apo- is generic, just take that off and you've got the chemical name. All she needs to do is look up Fluvoxamine.
>
> The difference is SSRI vs. SNRI. Effexor also inhibits norepinephrine reuptake. It claims to be more efficacious, but we're all different. Since none of us are medical Doctor's none of us are in a position to offer recommendations on medication - and I hope Xena would consult her Dr. if she's concerned.
>
> fyi - I also took chemistry, biochemistry, pharmacology, neurology, and psychopharmacology, but I guess I forgot to read up on them before responding to the email, I didn't realize I'd be tested on my answers. And quite frankly, I have better things to do. I was only trying to help.
>
> ASA or acetaminophen, seven or seventeen years, whatever, how does that help Xena, you get the point don't you? If not, get a life.
>
> When I was very depressed I used to waste hours at work researching and responding to every critical statement in an email defending my opinion and point of view, kind of like you here - again, you didn't invent the stuff - but proving someone wrong was a hollow victory, when I got better I finally realised, NOBODY CARES! only I did, and in the process I alienated my co-workers/friends.
>
> Think about it. The tone of your email was highly defensive and took cheap shots at me. Why?
Posted by xena on July 23, 2002, at 23:01:43
In reply to Re: Apo-fluvoxamine vs. Effexor XR » xena, posted by jannbeau on July 23, 2002, at 13:01:39
Many thanks for all of the information. I think I understand more clearly the difference between the two drugs.
I did not mean to cause friction on this page! I hope all is well now.
X.
Posted by sly on July 24, 2002, at 8:03:04
In reply to Many thanks, posted by xena on July 23, 2002, at 23:01:43
No worries, I think we all enjoy a good discussion.
For most of us, this page is an outlet. As you can see, the writings go far and above just Effexor. Depression may be biochemical, a medical illness, but it affects more than our bodies, it takes over your mind and spirit. The damage is just as real as a broken limb, only no one can see your pain because we carry it inside.
Pages like this let us blow off a little steam and share feelings with people who understand what we're going through. No matter how loving and supportive my family and friends, I don't get the same comfort as hearing from someone else who is going through the same thing.
Take care and good luck, let us know how things are going.
shannon
Posted by jannbeau on July 24, 2002, at 10:23:14
In reply to Many thanks, posted by xena on July 23, 2002, at 23:01:43
> Xena, You caused no friction at all. Don't worry about it. I WOULD like to add one comment: I am NOT a physician, so any statements I may have made were for your information only and were not meant to be medical advice. You should (and, in the US, must, always consult your physician re any prescription medication questions that you have and/or changes to those medications. I thought that went without saying!
Cheers,
JannbeauMany thanks for all of the information. I think I understand more clearly the difference between the two drugs.
>
> I did not mean to cause friction on this page! I hope all is well now.
>
> X.
Posted by xena on July 25, 2002, at 7:39:16
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Last night I met a friend for dinner, and I had a couple of drinks. When I got home I had never been more sick in all my life. I didn't throw up, but I thought I might. I don't drink very often, maybe once every couple of months, and never to the point of intoxication. A couple of drinks has never made me feel like that. Obviously it is the Effexor. Has anyone else had the same experience? Why wouldn't my doctor tell me explicitly not to drink while on this medication? Also, if this is a long term medication (in my case, I am guessing it will be), does that mean I can never have an alcoholic drink with a friend until I am off?
Posted by sly on July 25, 2002, at 7:56:11
In reply to Feeling terrible., posted by xena on July 25, 2002, at 7:39:16
Actually Effexor has not been shown to have additive effects when mixed with Alcohol. The sickness you felt may not have been the medication, it could have been anything you ate, or what you drank.
You said you don't drink regularly, if you were sitting all night and consumed 2 or more alcoholic drinks, with little or no food, that could make you ill.
My neighbour is a counsellor who also took Effexor. One night she went to a bar with her Doctor, he ordered a drink and she ordered pop. When he asked her why she wasn't drinking she said, "are you kidding, I"m on medication, you know I can't drink", to which her medical Doctor replied, "if everyone on anti-depressants didn't drink the bars would be empty"!
I'm not saying go ahead and drink. I started out slow, one drink at a time to see how I felt. For me, I actually get less of a high from the alcohol than before, with no ill side effects.
Posted by xena on July 25, 2002, at 8:28:25
In reply to Re: Feeling terrible., posted by sly on July 25, 2002, at 7:56:11
I did eat a full meal before I consumed any alcohol, and the 2 drinks I had were over a period of 5 1/2 hours. Not to mention I had about 4 glasses of water. I wanted to pace myself as I was unsure of the effects myself. I not only felt sick to my stomach, I started to have hot and cold spells. ie. Sweating profusely, and then shaking like a leaf. Normally, I do not sweat at all, though I have noticed from previous posts that some do experience this as a side effect.
> Actually Effexor has not been shown to have additive effects when mixed with Alcohol. The sickness you felt may not have been the medication, it could have been anything you ate, or what you drank.
>
> You said you don't drink regularly, if you were sitting all night and consumed 2 or more alcoholic drinks, with little or no food, that could make you ill.
>
> My neighbour is a counsellor who also took Effexor. One night she went to a bar with her Doctor, he ordered a drink and she ordered pop. When he asked her why she wasn't drinking she said, "are you kidding, I"m on medication, you know I can't drink", to which her medical Doctor replied, "if everyone on anti-depressants didn't drink the bars would be empty"!
>
> I'm not saying go ahead and drink. I started out slow, one drink at a time to see how I felt. For me, I actually get less of a high from the alcohol than before, with no ill side effects.
Posted by sly on July 25, 2002, at 12:00:36
In reply to Re: Feeling terrible., posted by xena on July 25, 2002, at 8:28:25
I've had the hot and cold spells, but not consecutively. For the first month I was always cold but it went away. All of a sudden about 3 weeks ago I've been sweating more than usual, mostly at night in my sleep, I wake up soaked. But I rarely drink so I know it's nothing to do with mixing Effexor with alcohol.
What time of day do you take the meds? My doctor suggests taking them before bed so some of the side effects occur while you're sleeping. For me, taking them at night makes me sleepy during the day, I want to maximize the energizing effects so now I take them early afternoon.
Posted by xena on July 25, 2002, at 14:48:53
In reply to Re: Feeling terrible., posted by sly on July 25, 2002, at 12:00:36
I take my pill around 1pm everyday. I don't usually get the hot and cold spells until night time, around 10pm or so. It has happened everyday since my first dose. I also get a terrible headache around 6 or 7pm, which has also happened everyday since my first dose. However, I was aware of that side effect, I just take an advil, and I am fine.
I appreciate your insight, and patience with my questions. :)
Posted by jannbeau on July 25, 2002, at 14:56:05
In reply to Re: Feeling terrible., posted by xena on July 25, 2002, at 14:48:53
>Xena, do you take ANY other medications? If so, which ones?
Cheers,
jannbeauI take my pill around 1pm everyday. I don't usually get the hot and cold spells until night time, around 10pm or so. It has happened everyday since my first dose. I also get a terrible headache around 6 or 7pm, which has also happened everyday since my first dose. However, I was aware of that side effect, I just take an advil, and I am fine.
>
> I appreciate your insight, and patience with my questions. :)
Posted by sly on July 25, 2002, at 16:14:21
In reply to Re: Feeling terrible., posted by xena on July 25, 2002, at 14:48:53
I've had a lot of side effects since I started, but none of them seemed to last too long. In fact, recently (with the exception of the sweating) all of them have disappeared, even my appetite is back and my sex drive is returning. Halleleujah for that, I can have an orgasm again! I think that was one of the major side effects holding me back and keeping me from feeling "normal".
Unless it really bothers you, don't give up easily. Most of the side effects do diminish or disappear with time.
Posted by Gabbi on July 25, 2002, at 19:58:46
In reply to Feeling terrible., posted by xena on July 25, 2002, at 7:39:16
Many of my medications have given me that horrible "I drank a gallon of cheap wine feeling" by themselves especially while starting, or reducing them.
This isn't a mystical aromatherapy cure all. But its helped me sleep on many a sick, toss and turn headachy sweaty night.
Pure Peppermint oil, not extract or flavoring.
Put it on the back of your neck or you can mix a few drops in any light lotion and apply it like any cream. And if you are feeling queasy as well put a couple of drops in a teaspoon of honey and swallow. Just don't get it from your fingers into your eyes, or you will curse me forever. Oh its cheap too.
Posted by LynnPerley on July 25, 2002, at 22:34:47
In reply to Feeling terrible., posted by xena on July 25, 2002, at 7:39:16
Xena, this is probably due to the short time you have taken the meds. I noticed when I first started AD meds (generic prozac) my tolerance for alcohol was MUCH less. I didn't even want to drink alcohol because it made me feel so weird. This feeling gradually went away. I can drink as much as I could before I started meds and the only difference is a one in attitude.
Remember that alcohol is itself a depressant, so logically it seems that one should not drink alcohol while on AD meds. However the social situation you described seems perfectly accaptable.
If you got any prescription info from your pharmacist when you filled your scrip or if any came with your sample pack you will see that the manufacturer officially recommends avoiding alcohol while taking Effexor, but there is not an explicit warning as there will be for other meds such as narcotic type painkillers, sedatives, etc.
I hope this helps. If I were you I would wait a few weeks and try again, making sure that you drink at least one glass of water for every alcoholic drink. If you are still having sweating events you may be dehydrated, and the alcohol will only increase your dehydration unless you drink plenty of water.
Posted by xena on July 26, 2002, at 0:18:08
In reply to Re: Feeling terrible. » xena, posted by LynnPerley on July 25, 2002, at 22:34:47
I am not taking any other meds, except for the advil, as I mentioned above to get rid of my headaches. I do have seasonal allergies, but have not taken any antihistamines since I have started on Effexor. Would there be a problem if I did? Once in a while my allergies hit me pretty bad.
I don't plan on giving up on Effexor yet, because I do notice a change in myself, even though I have only been taking it since Monday. The side effects are not serious enough to deter me. I used to wonder if life was really worth all of this hassle, I kind of felt dead inside. Now, even though I don't sleep very well, I find it easier to get up in the morning, and I enjoy going outside. I don't lock myself up in front of the tv or in my room and wallow away. I don't sit around and beat up on myself, and tell myself how insignificant, stupid, and how much I hate myself anymore. (I don't know how silly this sounds) And it feels really good.
I will definitely try the Peppermint Oil for my queasy stomach, and sleepness nights! I really appreciate that tip, and I will let you know how it works out for me.
Was it not difficult for any of you to explain to friends why you were unable to have a drink or two while out for dinner, or any other social events, without telling them you are on AD's? At this point, I really don't feel comfortable having to explain that I can not drink because of the medication I am on, as that would lead up to more questions about why I am taking them etc. etc.
Posted by LynnPerley on July 26, 2002, at 5:16:55
In reply to Re: Feeling terrible. » jannbeau, sly, Gabbi Lynn, posted by xena on July 26, 2002, at 0:18:08
xena, unless you are at a restaurant one-on-one with someone to the point they notice the server bringing them drink after drink while you sip on one, most likely nobody will notice. This was one of my concerns beforehand but it turned out to be a non-issue. Why not sip on one and if someone asks, say something innocent like "It just doesn't taste good tonight"? That ought to do the trick. Only other advice I can offer is suggest activities where alcohol is not available, or avoid these kind of friends in situations where alcohol is expected to be consumed for the next week or so. If you do not feel comfortable telling your friends you are on meds, don't tell them.
Posted by sly on July 26, 2002, at 8:15:11
In reply to Re: Feeling terrible. » jannbeau, sly, Gabbi Lynn, posted by xena on July 26, 2002, at 0:18:08
You don't sound silly at all, I know exactly what you're going through. Those feelings will go away, trust me, I woke up every day thinking the best thing that could happen to me today is that I will die. I drove by a fatal car accident one day on my way to work and actually thought to myself, "wow, those people are so lucky, they're dead and they didn't even have to commit suicide, I wish that could happen to me".
I told a friend that at dinner and he looked at me like I was crazy, he told me if I really believed that I needed help. I really didn't understand how wrong that sounded.
Four months later, thanks in large part to Effexor and therapy, I know that dead, empty, invisible feeling is not normal and I don't have to feel like that anymore.
Most of my friends don't know I'm on AD's, but you'll be very surprised how supportive and understanding some of them will be. And how many of them are or were on them themselves! For those that don't, I just say, I don't feel like drinking tonight, it upsets my stomach, or I'm broke, I have other things I need to spend my money on, I don't want the empty calories, I have to get up early tomorrow... You can also order a virgin drink, I offer to go up to the bar and get them, or at home I'll make them myself and leave out the alcohol in mine, no one will know there's no rum in your daiquiri or coke.
Posted by jannbeau on July 26, 2002, at 10:32:50
In reply to Re: Feeling terrible. » jannbeau, sly, Gabbi Lynn, posted by xena on July 26, 2002, at 0:18:08
> Xena, why do you feel that you owe friends an explanation for not having a drink? I thought that in this day and time, the right to refuse an alcoholic drink was implicit in social etiquette. It's nobody's business why you have decided not to indulge! If you have to tell them anything, how about something like "I'm trying to clean up my nutritional act and alcohol contains no known nutrients, just empty calories?" Just an idea! An old standby is to order a drink and nurse it through the evening.
With regards to the antihistamines: I have noticed that it depends on what antihistamine I take. For instance, I cannot take "sedating" antihistamines like Benadryl or other OTC antihistamines, because they seem to exacerbate the sedation I get with Effexor-I don't wake up really until about four pm if I take a Benadryl at bedtime. However, I don't have any problem with Claritin or Allegra, both of which are nonsedating prescription antihistamines. That's just my personal experience. Others might have other experiences or advice.
Cheers,
jannbeau
I am not taking any other meds, except for the advil, as I mentioned above to get rid of my headaches. I do have seasonal allergies, but have not taken any antihistamines since I have started on Effexor. Would there be a problem if I did? Once in a while my allergies hit me pretty bad.
>
> I don't plan on giving up on Effexor yet, because I do notice a change in myself, even though I have only been taking it since Monday. The side effects are not serious enough to deter me. I used to wonder if life was really worth all of this hassle, I kind of felt dead inside. Now, even though I don't sleep very well, I find it easier to get up in the morning, and I enjoy going outside. I don't lock myself up in front of the tv or in my room and wallow away. I don't sit around and beat up on myself, and tell myself how insignificant, stupid, and how much I hate myself anymore. (I don't know how silly this sounds) And it feels really good.
>
> I will definitely try the Peppermint Oil for my queasy stomach, and sleepness nights! I really appreciate that tip, and I will let you know how it works out for me.
>
> Was it not difficult for any of you to explain to friends why you were unable to have a drink or two while out for dinner, or any other social events, without telling them you are on AD's? At this point, I really don't feel comfortable having to explain that I can not drink because of the medication I am on, as that would lead up to more questions about why I am taking them etc. etc.
>
>
Posted by jannbeau on July 26, 2002, at 10:49:01
In reply to Re: Feeling terrible., posted by sly on July 26, 2002, at 8:15:11
> Great Response, Sly!!
jannbeau
You don't sound silly at all, I know exactly what you're going through. Those feelings will go away, trust me, I woke up every day thinking the best thing that could happen to me today is that I will die. I drove by a fatal car accident one day on my way to work and actually thought to myself, "wow, those people are so lucky, they're dead and they didn't even have to commit suicide, I wish that could happen to me".
>
> I told a friend that at dinner and he looked at me like I was crazy, he told me if I really believed that I needed help. I really didn't understand how wrong that sounded.
>
> Four months later, thanks in large part to Effexor and therapy, I know that dead, empty, invisible feeling is not normal and I don't have to feel like that anymore.
>
> Most of my friends don't know I'm on AD's, but you'll be very surprised how supportive and understanding some of them will be. And how many of them are or were on them themselves! For those that don't, I just say, I don't feel like drinking tonight, it upsets my stomach, or I'm broke, I have other things I need to spend my money on, I don't want the empty calories, I have to get up early tomorrow... You can also order a virgin drink, I offer to go up to the bar and get them, or at home I'll make them myself and leave out the alcohol in mine, no one will know there's no rum in your daiquiri or coke.
>
Posted by LynnPerley on July 26, 2002, at 14:44:20
In reply to Re: Feeling terrible. » xena, posted by jannbeau on July 26, 2002, at 10:32:50
I've had no problem with Allegra when taking Effexor XR. I mainly use a cortizone nasal spray now, and just add the Allegra-D when it's realy bad.
Posted by jannbeau on July 26, 2002, at 15:05:01
In reply to Antihistamines Effexor » jannbeau, posted by LynnPerley on July 26, 2002, at 14:44:20
>
Lynne, Xena: Same here. I use Flonase, 2 sprays at night and usually don't need the antihistamines.I've had no problem with Allegra when taking Effexor XR. I mainly use a cortizone nasal spray now, and just add the Allegra-D when it's realy bad.
Posted by Gabbi on July 26, 2002, at 18:03:06
In reply to Re: Feeling terrible. » jannbeau, sly, Gabbi Lynn, posted by xena on July 26, 2002, at 0:18:08
Please do let me know how it works. I have been so glad for it, especially on nights when I know I'm supposed to get up early. Its such an awful feeling. It just cools you down, and is amazing for an upset stomach.
No I never really had a problem with explaining, I would just say Oh I don't feel like it, or I'm on antibiotics. But I've never been under much pressure socially. (probably because I never go out)
I read a recent book on Depression and I've also heard all the negative comments about it. The author of this book went through several medications but what worked for him was Effexor, he did mention though that the side effects showed up for him weeks before the benefits did.
I tried it, but wasn't in a stable enough situation to risk possible not having it work and then going through the withdrawl. So I can't judge. But most medications, for me in the beginning made me feel I was either pregnant or had food poisoning. Even if I didn't drink. I would definately stick it out for at least 6 weeks, unless its absolutely intolerable.
Posted by Starwatcher on July 26, 2002, at 18:29:18
In reply to Re: Feeling terrible. » xena, posted by Gabbi on July 26, 2002, at 18:03:06
> Please do let me know how it works. I have been so glad for it, especially on nights when I know I'm supposed to get up early. Its such an awful feeling. It just cools you down, and is amazing for an upset stomach.
>
> No I never really had a problem with explaining, I would just say Oh I don't feel like it, or I'm on antibiotics. But I've never been under much pressure socially. (probably because I never go out)
>
> I read a recent book on Depression and I've also heard all the negative comments about it. The author of this book went through several medications but what worked for him was Effexor, he did mention though that the side effects showed up for him weeks before the benefits did.
>
> I tried it, but wasn't in a stable enough situation to risk possible not having it work and then going through the withdrawl. So I can't judge. But most medications, for me in the beginning made me feel I was either pregnant or had food poisoning. Even if I didn't drink. I would definately stick it out for at least 6 weeks, unless its absolutely intolerable.Thanks for the info. on the peppermint oil - sounds like a wonderful remedy! I still get queasy sometimes in the morning if I take my blood pressure pill on an empty stomach, and sometimes have stomach problems at night. Maybe this will help!
The 37.5 mg. dose I take of Effexor still seems to be making me feel a little loaded when I first wake up in the morning - even after several months of taking it - but that's okay! I'm sleeping fairly well through the night most of the time now, although sometimes I want to sleep a lot on the weekends when I don't have to do anything. It only takes a little while for the cobwebs to clear out of my brain, and it's keeping the fibromyalgia pain under control, which is why I'm taking it.
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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