![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 6179 to 6203 of 10407. Go back in thread:
Posted by ZAPPA on January 23, 2004, at 0:26:59
In reply to Just started, posted by Caligula on January 20, 2004, at 23:46:26
> I just started the 37.5mg XR this morning. I hadn't slept for a couple days because I was out of trazadone. Now, with 40mg of celexa, .5mg of xanax, and 50mg of trazadone on top of the Effexor, I can't sleep at all. I am not tired. I have heartburn. My jaw is really tight. I think my vision is less blurry. My head feels (painlessly) like it's going to explode. So, um, usual start-up fun, really. I'll post back in a couple weeks when I have a better idea.
It really helps to keep a daily diary of how you feel or if you feel "wierd" or different (good or bad) in any way. Never discount how you feel, and always talk to your pdoc about any changes. I say this in hindsight. I did not realize that some of the things that I was experiencing was directly related to the meds that I was taking.
Good Luck....ZAPPA
Posted by ZAPPA on January 23, 2004, at 1:02:48
In reply to discontinuing Effexor, posted by Katies1 on January 21, 2004, at 13:16:02
> Well, I have been on Effexor for about 4 years. I have been on 37.5 for the last 2. Lately I decided to take myself off of it. I just want to be free of medication and don't want to get pregnant on it. I am a registered nurse so I read up on it and decided to get off this stuff. I have been on it for anxiety. I started taking it everyother day for about 2 months and the every two or three days. I am on day 6 of nothing. Feeling a little weird, nauseated in the morning, anxious, mainly a really odd feeling. My husband is a doc (not a psychiatrist) so he has been a great support. I guess I am really scared of not being on it anymore. I have been dreading the discontinuation symptoms for a long time. I just had to do it. I would recommend having a doc monitor you during the withdrawal. I don't have one right now so I am just watching myself. I biggest fear is the risk of seizures when stopping. I hope the is on really high doses. Anyways, I just needed to get this out. I hope someone who has been through this can give me some encouragement. I know God will get me through. Thanks.
Dear Katies1,
In my darkest hours I felt that God had lost me. I felt so alone, even with my family surrounding me with love and compassion. More often than not their support made me feel worse because I could not explain why I could not be the wife, mother, sister or daughter that I felt they wanted me to be. Would I have felt this way if I was suffering from an illness that manifested itself more apparently such as, God forbid, cancer, etc. I really don't think so. I just knew that I had to fight this illness any way that I could. My resolve was reinforced by the support from my family. So I did fight and I am still fighting. I have hit a few snares but my husband says that I am like a -diamond in the rough- the more it is rubbed, the brighter it shines. As for God loosing me, no way. It is his light that now shines through me!
Hang in there....I will keep a good thought for you! ZAPPA
Posted by PoohBear on January 23, 2004, at 10:29:58
In reply to Re: discontinuing Effexor, posted by ZAPPA on January 23, 2004, at 1:02:48
> In my darkest hours I felt that God had lost me. I felt so alone, even with my family surrounding me with love and compassion. More often than not their support made me feel worse because I could not explain why I could not be the wife, mother, sister or daughter that I felt they wanted me to be. Would I have felt this way if I was suffering from an illness that manifested itself more apparently such as, God forbid, cancer, etc. I really don't think so. I just knew that I had to fight this illness any way that I could. My resolve was reinforced by the support from my family. So I did fight and I am still fighting. I have hit a few snares but my husband says that I am like a -diamond in the rough- the more it is rubbed, the brighter it shines. As for God loosing me, no way. It is his light that now shines through me!
> Hang in there....I will keep a good thought for you! ZAPPAZAPPA:
Interesting that you should post this, as I faced some of the same issues this week. I wonder the same thing, because my wife DOES have cancer: she was diagnosed with ovarian cancer the same week that I started treatment for depression. (She's on chemo and doing okay...).
The point is this:
We had an argument the other day because I picked up ANOTHER prescription, and because of our deductible, had to pay nearly full price, even with insurance. She went off on why did I need another prescription, how many more was I going to need, etc. My answer was AS MANY AS IT TAKES TO GET IT RIGHT.
I'm in this for the long haul. I WANT TO BE WELL. What she doesn't understand is that i have a disease that can be just as DEADLY as her cancer. The only reason it hasn't resulted in death so far is my faith, though this doesn't work for everyone.
I'm not minimizing the seriousness of her illness, but I want her to give mine the same consideration, not the same short shift is gets from most of society because mental illness is "out of sight, out of mind".
I hope to be able to explain in-depth what my PDoc and I are trying to achieve tonight when we have some time without the teens around.
Funny, my 17 year-old daughter understands perfectly, but my 51 year-old wife doesn't get it...
Best Wishes,
TR
Posted by Lokisdream on January 24, 2004, at 14:49:51
In reply to Re: How long would these withdrawal symtoms last?, posted by readingboy on January 14, 2004, at 23:35:36
>
> Wow. It's good to find a group to discuss these issues with. I couldn't imagine going what I went through without finding these posts.
>
> I've had a difficult time with my psychiatrist and decided to stop seeing him and find another. Previously, he prescribed Effexor XR and I've gradually gone to 150 mg. dosage, which did wonders for my depression and pain through my break up and divorce (a couple years ago). I stopped going to my psychiatrist recently, thinking that I'd find another soon enough. It hasn't happened and my prescription ran out yesterday morning.
>
> Holy Mother of God! -- brain-flashes, dizziness, a slight nausea, and my skin began to feel electrified. I wasn't warned about these being side effects (not that I remember several years after being prescribed it), but knew it was Effexor withdrawal. It came on struck increasingly over a few hours. I didn't notice at first, the main is the dizziness and brain flashes, which happened when I'd move. When it really began to hit, I had to excuse myself from work. There wasn't any way I could be in public feeling like this.
>
> I went home, found the phone number, asked my former psychiatrist for help telling him what I was experiencing, got a refill, and several hours later I'm recovered from the symptoms. It really scared me. I couldn't last a day of normal life with the intensity of the effects when they hit full force. I don't understand how I made it to the pharmacy and back (I walked since I couldn't trust myself driving).
>
> I'm so glad to see others are working their way off with success. Really, finding this board helped immensely. I think with my divorce passed and things in my life beginning to look better, I'm probably ready to try life without Effexor XR. I will find another psychiatrist and ask to be taken off this medicine. To be fair, Effexor helped lift my depression and allowed me to live my life at a time when I was worried I couldn't. But now that things have improved, I don't want to stay on this drug forever, but the withdrawal symptoms are startlingly bad for me. If there was no way to get off but go through days of that, I would be taking Effexor for the rest of my life.
>
> I now see that lowering the dosage gradually (it wasn't clear about the dosages and length of times though) along with taking mini-dosages of Prozac as needed is helping some work their way off it. I will definitely suggest this to my new psychiatrist if he or she is unaware of the process.
>
> Thank you all for posting. And thanks Dr. Bob for putting this site up. You all have made a frightening episode much less scary in posting and explaining a lot of things.
>
> -- readingboy
>
>
> Ye Gods! So many people with such similar problems with the same stuff. I have 2 brothers-1 is a GP and the other is a counselor. A family has to have a black sheep so here I am. I am an epileptic taking Dilantin and Neurontin with mild tinnitus and slightly bad knees. I cracked when I found out my wife of less than 6 mos. was sleeping around and left me. Bro.#2 hooked me up with a nut who's answer for everything seemed to be take another Effexor. The tinnitus got almost unbearable but I didn't know what was causing it. My depression was still present but I just can't feel it-or much else-and I have open wounds that wouldn't heal because I couldn't feel them. I told Bro#1 that I didn't think it was doing any good and he said 'you don't know what you've got till it's gone.' Understatement. So I kick it and almost immediately start having seizures,every nerve ending felt scraped raw,at times have had trouble remembering my name,and ringing so loud can't hear much,needless to say, sleeping is out of the question. But, I can feel the pain, and life is nothing but different kinds of pain. It's our choice, hopefully. I have no ultimate answer. Just a warning-be very careful, esp if you have a seizure disorder or any form of tinnitus. It could be very unhealthy for your dr. LOKISDREAMp.s. There may be an upside to this-I've dropped 35+ pounds in around 3 months(gets kinda fuzzy back around Oct.) from forgetting to eat-I didn't feel hungry.
Posted by vilkas on January 25, 2004, at 0:22:56
In reply to Be VERY careful with Effexor Re: » readingboy, posted by Lokisdream on January 24, 2004, at 14:49:51
Hi all.
I just thought I'd throw in my experiences with effexor xr. Have just started being treated for depression. by just started, I mean probably 3 or 4 months. Anyway, I was on effexor xr for probably close to 3 months, and dose was ramped up to 375mg.
I couldn't say I saw too many positive effects. Intensity of suicidal thoughts *did* decrease, but at the same time my motivation and concentration was worse than ever. On a positive note, I was having plenty of weird dreams, which I always enjoy. But I just found that I really wasn't getting any better on these pills, and decided with my pdoc to try fluoxetine hcl (aka prozac). After reading about other's withdrawal experiences, I was interested to see what would happen. So, on day 1 of withdrawal, I cut back to 225mg, day 2 150, days 3+4 75mg, days 5+6 Nothing, then started on 20mg of fluoxetine on day 7. I know that I wasn't going completely off the drugs, but I will say that I really didn't have any bad times during the switch. Maybe it's because effexor really didn't do anything for me to begin with. I have had some strange auditory hallucinations, late at night, but that's OK.
One thing I will say, though, coming off the effexor, i feel much more motivated, and less sleepy, and have much less brain fog. When I was on effexor, I just felt like a zombie. I was breathing and sometimes eating, and that was about it. But, as we know, one drug is not going to benefit 100% of the population...
we'll see what the fluoxetine does.take care,
vilkas
Posted by KimRN73 on January 25, 2004, at 0:52:19
In reply to Effexor and, posted by vilkas on January 25, 2004, at 0:22:56
Hi all
Well i went to my doctor the other day to talk about getting off of Effexor. I currently take 75mg twice a day. She told me to stop taking it and she is starting me on Zoloft 50mg daily. I asked about weaning off , she said i shouldnt have to due to Zoloft being a similar medication so therefore I should not have any withdrawel problems but if i did, i could take 37.5mg of Effexor for a week or two in addition to the Zoloft. Has anyone tried taking Zoloft when getting off Effexor?!?!? Im nervous to try this, but I have to...sick of the dizziness, and "out of it" feelings. Write back !
Kim
Posted by EFFEXED on January 25, 2004, at 8:55:12
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I JUST STARTED EFFEXOR 2 WEEKS ON IT SO FAR ALL IS WELL JUST THIS LOCKED JAW FEELING MY TEETH ARE KILLING ME IS THIS NORMAL THIS IS MY FIRST AD I AM 24 JUST FOUND OUT I AM DEPRESSED FOR FIRST TIME ALL THIS STUFF I HAVE BEEN READING IS SCARY I AM ON 75 EFFEXOR NOW WAS ON 37 FOR 2 WEEKS THAT WENT WELL AFTER THE DRY MOUTH , SHAKES LOSS OF APPATITE WENT AWAY THIS IS DAY 2 OF 75 AND THAY MAKE ME A LITTLE MOODY A BIT SHARP WITH EVERY ONE HOPEFULLY THIS TO WILL PASS SORRY TO GO ON AND ON JUST DONT HAVE ANY ONE TO RELATE TO AT THIS TIME
THANKS FOR HEARING ME OUT
EFFEXED
Posted by ZAPPA on January 25, 2004, at 11:35:06
In reply to Re: Effexor and, posted by KimRN73 on January 25, 2004, at 0:52:19
> Hi all
>
> Well i went to my doctor the other day to talk about getting off of Effexor. I currently take 75mg twice a day. She told me to stop taking it and she is starting me on Zoloft 50mg daily. I asked about weaning off , she said i shouldnt have to due to Zoloft being a similar medication so therefore I should not have any withdrawel problems but if i did, i could take 37.5mg of Effexor for a week or two in addition to the Zoloft. Has anyone tried taking Zoloft when getting off Effexor?!?!? Im nervous to try this, but I have to...sick of the dizziness, and "out of it" feelings. Write back !
> Kim>Hi Kim,
I tried quitting Effexor "cold turkey". Bad idea. My pdoc put me on Lexapro, 10mg per day(he says it is similar to Zoloft but Lexapro is covered under my insurance). So far it is working like a charm! I feel great for the first time in a very long time. At this point the only side effect is dry mouth, so I keep a water bottle with me all the time. I hope this is helpful.
Good luck....ZAPPA
Posted by KimRN73 on January 25, 2004, at 11:40:34
In reply to Re: Effexor and, posted by ZAPPA on January 25, 2004, at 11:35:06
> > Hi all
> >
> > Well i went to my doctor the other day to talk about getting off of Effexor. I currently take 75mg twice a day. She told me to stop taking it and she is starting me on Zoloft 50mg daily. I asked about weaning off , she said i shouldnt have to due to Zoloft being a similar medication so therefore I should not have any withdrawel problems but if i did, i could take 37.5mg of Effexor for a week or two in addition to the Zoloft. Has anyone tried taking Zoloft when getting off Effexor?!?!? Im nervous to try this, but I have to...sick of the dizziness, and "out of it" feelings. Write back !
> > Kim
>
> >Hi Kim,
>
> I tried quitting Effexor "cold turkey". Bad idea. My pdoc put me on Lexapro, 10mg per day(he says it is similar to Zoloft but Lexapro is covered under my insurance). So far it is working like a charm! I feel great for the first time in a very long time. At this point the only side effect is dry mouth, so I keep a water bottle with me all the time. I hope this is helpful.
> Good luck....ZAPPA
>ZAPPA..... So you totally stopped the Effexor, and then replaced it with Lexapro and it was ok???
If that is so, that makes me a LOT less nervous about doing this !!! Let me know? Kim
Posted by kattay on January 25, 2004, at 11:56:34
In reply to Re: Anyone had success on Effexor XR?, posted by EFFEXED on January 25, 2004, at 8:55:12
> I JUST STARTED EFFEXOR 2 WEEKS ON IT SO FAR ALL IS WELL JUST THIS LOCKED JAW FEELING MY TEETH ARE KILLING ME IS THIS NORMAL THIS IS MY FIRST AD I AM 24 JUST FOUND OUT I AM DEPRESSED FOR FIRST TIME ALL THIS STUFF I HAVE BEEN READING IS SCARY I AM ON 75 EFFEXOR NOW WAS ON 37 FOR 2 WEEKS THAT WENT WELL AFTER THE DRY MOUTH , SHAKES LOSS OF APPATITE WENT AWAY THIS IS DAY 2 OF 75 AND THAY MAKE ME A LITTLE MOODY A BIT SHARP WITH EVERY ONE HOPEFULLY THIS TO WILL PASS SORRY TO GO ON AND ON JUST DONT HAVE ANY ONE TO RELATE TO AT THIS TIME
>
> THANKS FOR HEARING ME OUT
> EFFEXEDIs the lock jaw feeling as if you are clenching your teeth all of the time and it's sore? I started having this almost constant headache and it seems to stem from my jaw line just below my ear. And my jaw is always achy as if i'm clenching my teeth alot. other then that, i seem to have very little side affects. i'm tired and get sore sometimes but i can't complaign much.
Posted by katies1 on January 25, 2004, at 12:05:31
In reply to Re: Anyone had success on Effexor XR?, posted by kattay on January 25, 2004, at 11:56:34
Hey everyone
I have been off Effexor for 1 week and two days. I am doing fine now. It was difficult at first but now I am fine. I just wanted everyone to know that it can be done. I never used Prozac and Lexapro, or anything. Of course, I have been titrating down for a long time - about a year. My max dosage was 150mg, but that was 3 years ago. I went down to 75 for about a year and then 37.5. It works well if you go to taking it every other day then every 2 days and so on. This may not work for everyone though. Fortunately, I am not going to be on any meds now. Had a rough time in nursing school and finished that a while back and just never stopped the meds. It is scary to know you will be without someting you have been so dependant on for so long. But for me the freedom of not being on it is wonderful. I wish all of you the best of luck and just know it will get better. God Bless.
Posted by katies1 on January 25, 2004, at 12:07:59
In reply to Re: Anyone had success on Effexor XR?, posted by kattay on January 25, 2004, at 11:56:34
About the jaw pain:
My husband is an oral surgeon and he made me a splint when I was having that problem. I was clinching my teeth while sleeping. It wouldn't hurt to see your dentist to get an eval and then maybe you can get some relief. Advil and Naprosyn worked well for me in regards to pain. Good luck.
Posted by Stryker88 on January 25, 2004, at 13:48:02
In reply to Re: Anyone had success on Effexor XR?, posted by katies1 on January 25, 2004, at 12:07:59
Hello everyone I have had success on Effexor 150mg. I have been taking it over a one year period. One thing I have learned is that your diet can have a huge impact on the way you feel, and sometimes things you eat and drink can cause you to feel terrible and depressed. The fact is that you need to identify foods in your diet that effect you instead of just eating whatever. Example: For a while I was wondering why I felt so dehydrated throughout the day Answer: I was drinking way to much coffee and not enough water. I started taking Multi-Vitamins about a year ago because I discovered that I was not getting enough of them in my diet. Foods we eat can have just as much impact as Effexor.
Posted by LOKIsDREAM on January 25, 2004, at 15:42:25
In reply to Re: Anyone had success on Effexor XR?, posted by EFFEXED on January 25, 2004, at 8:55:12
Please don't be offended, but some of what you're feeling sounds like jitters brought on by what you've read. Just give it a little time to let your body get adjusted. You've got a great place to talk it out here. If you'd rather, and I'm not too obnoxious, you can usually find me at yahoo or sbcglobal.net, by the same name. peace
Posted by LOKIsDREAM on January 25, 2004, at 16:22:41
In reply to Re: Anyone had success on Effexor XR?, posted by katies1 on January 25, 2004, at 12:05:31
> Hey everyone
> I have been off Effexor for 1 week and two days. I am doing fine now. It was difficult at first but now I am fine. I just wanted everyone to know that it can be done. I never used Prozac and Lexapro, or anything. Of course, I have been titrating down for a long time - about a year. My max dosage was 150mg, but that was 3 years ago. I went down to 75 for about a year and then 37.5. It works well if you go to taking it every other day then every 2 days and so on. This may not work for everyone though. Fortunately, I am not going to be on any meds now. Had a rough time in nursing school and finished that a while back and just never stopped the meds. It is scary to know you will be without someting you have been so dependant on for so long. But for me the freedom of not being on it is wonderful. I wish all of you the best of luck and just know it will get better. God Bless.I'm with you on all of that! Only I'm finding that if I don't take a Remeron(although only half my pdoc's prescribed dose of 60mg a night) I'll be wired 24 a day like I'm doing pot after pot of espresso with a hit of something else in it. For now I gotta take it so I can sleep, at least until I can kick my addiction to having a wife and kids.
Posted by terrics on January 25, 2004, at 16:41:45
In reply to Re: Effexor and, posted by KimRN73 on January 25, 2004, at 0:52:19
I hope this helps. I was on zoloft 200mgs for a number of yrs. Then it stopped workinf so the shrink put me on effesor. He gave me a schedule. As I was lowering the zoloft I was increasing the effexor. So I was on both at once with no side effects. [He was the best shrink I ever had.] terrics
Posted by Tiger's Dad on January 25, 2004, at 19:39:15
In reply to Be VERY careful with Effexor Re: » readingboy, posted by Lokisdream on January 24, 2004, at 14:49:51
> p.s. There may be an upside to this-I've dropped 35+ pounds in around 3 months(gets kinda fuzzy back around Oct.) from forgetting to eat-I didn't feel hungry.
I've lost 40. Only another 100 to go :( At least it was nice to have something go unexpectedly right for once in my life.
Now if I could just find the right combo of drugs. I went from 300mg Effexor to my current 187mg Effexor, 450mg Wellbutrin, 150mg Lithium. Since we added the Lithium I haven't had any of the depressive swings I usually have. Hope it keeps up.
Posted by ZAPPA on January 25, 2004, at 20:50:33
In reply to Re: Effexor and, posted by KimRN73 on January 25, 2004, at 11:40:34
> > > Hi all
> > >
> > > Well i went to my doctor the other day to talk about getting off of Effexor. I currently take 75mg twice a day. She told me to stop taking it and she is starting me on Zoloft 50mg daily. I asked about weaning off , she said i shouldnt have to due to Zoloft being a similar medication so therefore I should not have any withdrawel problems but if i did, i could take 37.5mg of Effexor for a week or two in addition to the Zoloft. Has anyone tried taking Zoloft when getting off Effexor?!?!? Im nervous to try this, but I have to...sick of the dizziness, and "out of it" feelings. Write back !
> > > Kim
> >
> > >Hi Kim,
> >
> > I tried quitting Effexor "cold turkey". Bad idea. My pdoc put me on Lexapro, 10mg per day(he says it is similar to Zoloft but Lexapro is covered under my insurance). So far it is working like a charm! I feel great for the first time in a very long time. At this point the only side effect is dry mouth, so I keep a water bottle with me all the time. I hope this is helpful.
> > Good luck....ZAPPA
> >
>
> ZAPPA..... So you totally stopped the Effexor, and then replaced it with Lexapro and it was ok???
> If that is so, that makes me a LOT less nervous about doing this !!! Let me know? Kim
>>Kim,
I did stop taking the Effexor "cold turkey" for about 5 days, but the "brain zaps" were out of control. I started the Lexapro and the zaps did stop immediately. It has been 6 days now and I still feel great. No side effects other then dry mouth. I do have more energy which could be from the Lexapro but I think it is because I feel so good. I am ME again.
Again, good luck.....ZAPPA
Posted by blueeye on January 26, 2004, at 22:45:11
In reply to Re: Anyone had success on Effexor XR?, posted by LOKIsDREAM on January 25, 2004, at 16:22:41
hey all
I have been taking Effexor XR for 5 years and it has worked excellently. I have bi-polar, panic disorder and am epileptic, so it rules out the whole prozac/zoloft fam, as that sent me into a hypo-mania I will never forget. Yes, coming off Effexor is slightly hellish (I have forgotten to take it a few times), but in terms of having no side effects after a little while and it being a good option for depression, it gets two thumbs up from me. I also take trileptil and topomax for the seizures/bi-polar, and have begun abilify cuz I was having break through mania. Just remember that the meds take time.;-)
Posted by meds4life on January 27, 2004, at 14:33:45
In reply to Re: Anyone had success on Effexor XR?, posted by blueeye on January 26, 2004, at 22:45:11
Hi! I have been on effexor xr for 4 months now due to deep recurring depressions and anxiety. I was hospitalized for a brief period. I realize now that I will be on medication for life to prevent a relapse. I don't like the idea, but realize that my life depends on it. I take 150 mg. of effexor xr. I started on effexor,klonopin, and ambien (for sleep) I feel great now. I have no anxiety or depression. I also discontinued klonopin and ambien without any problems. My concern is the weight gain. I have only gained 10 pounds, however when on paxil for my last depression I gained 40 pounds. My psychiatrist has talked about adding synthroid or something else to offset the weight gain side effect for me. Does anyone have any comments? Other than the weight gain, effexor has been highly effective!
Posted by zinya on January 27, 2004, at 14:49:36
In reply to Re: Anyone had success on Effexor XR?, posted by meds4life on January 27, 2004, at 14:33:45
Greetings, all!
I've been completely offline lately, which has been -- thank goodness -- a *good* sign. I've had a recovery of energy which -- get this -- was triggered by an antibiotic i had to take for a dreadful flu back at NY Eve time... There's a whole theory now about this which i THINK i wrote about here a couple of weeks ago -- about yin and yang -- and made me realize that maybe, given my own 15 yr history of being "restored" each time i had to take an antibiotic and suddenly having an energy level i'd been craving for months if not years ... that i once again posed this query and my chiropractic/guru who knows both eastern and western medicine too knew to tell me that antibiotics are a 'yang' phenom ... and i already know i have an almost exclusively 'yin' body -- super low body temps, low b.p., cold hands and feet, and more ... anyway, i'm now adding ginseng to my daily repertoire since the end of the antibiotic (bactrim) since ginseng is a 'yang' phenom too (i'm using the real thing, not packaged 'tea' packets, to brew into a daily drink)
anyway, meanwhile, i've returned to an active "life" (LIFE!!! imagine!!! it feels like a dream!) and am almost never even able now to keep up with some of the e-mailing and posting i wish i could also still do,... and never forgetting what a lifesaver this place was in its hour of need for me...
anyway, here's an article that appeared Sunday a.m. and , as an example, i was going to post it right then ... and it's only taken me 48 hrs to do so ... but for a change, that isn't becuz i was too depressed to follow thru but rather cuz i was too active! ... [but not manic either, just active -- minor miracle here ... and from current point of view, for me at least, the A-D route was a digression which for me wound up being more of a "ruling out" cuz at this point i don't think effexor honestly made any positive contribution ... BUT, nothing ventured, nothing gained...
wishing you ALL well...
warmly,
zinyaTruth: a Bitter Pill for Drug Makers
Greg Critser
January 25, 2004
LA TimesGreg Critser is the author of the forthcoming "One Nation Under Pills" and "Fat Land: How Americans Became the Fattest People in the World," recently out in paperback.
Next month, an advisory committee of the Food and Drug Administration will meet to discuss what might arguably be the most tendentious issue in modern psycho-pharmacology: the use of antidepressants to treat childhood and teen depression and the drugs' possible role in teen suicide. This comes on the heels of Britain having banned the prescribing of Paxil for children under 18 and advising against most other commonly prescribed antidepressants for that age group.
But the FDA should really be debating bigger issues, including the role these drugs have come to play in society, and the ways the drug companies have distorted the truth about their products.
The current crop of antidepressants, mostly selective serotonin reuptake inhibitors, or SSRIs, have become, in a sense, cultural products as well as medical products. We have embraced them as a society, yet we are intensely conflicted about them. They are not just pills but stories we tell ourselves about how we should feel and how life should be lived — pills as movies if you will. This may well be the reason we have such mixed feelings about antidepressants: We simply don't know how to assess them objectively, independent from the tales we have told ourselves.
One reason for that is the speed with which these drugs were launched out of the corporate womb and into the patient population. In the old days, before medicines were marketed directly to consumers, prescription drugs took years to gain a foothold and hence become profitable. Doctors stuck to the tried and true and were slow to embrace new drugs. But after Congress passed a law in the 1980s making generic drugs easier to get, brand-name companies had to become entrepreneurial; they realized they could no longer afford long waits for profitability.
This change led directly to a whole new marketing strategy at the big pharmaceutical companies: Rather than marketing to the relatively small pool of potential prescribers with psychiatric training, they cast a wider net: focusing on building demand among general practitioners — and later, more directly, among patients themselves. To help general practitioners unfamiliar with antidepressants explain the drugs to their patients, the manufacturers created easily understood stories, maintaining that SSRIs, such as Prozac (made by Lilly), Paxil (GlaxoSmithKline) and Zoloft (Pfizer), were not like the previous generations of psych meds. They were not uppers or downers or tranquilizers that turned patients into zombies but more sophisticated compounds that simply reestablished our "natural" neurotransmitter balance. It was a powerful message to a generation of patients inclined toward the natural.
The balance story is not exactly a lie, but it's not exactly the truth, either. When pushed, in a lawsuit against his company, Alan Metz, vice president for clinical development at Glaxo, admitted in court papers, "It's not possible really to measure total serotonin." He added that "we do not know with absolute certainty about how any of the antidepressants work." If the drug companies can't really measure what normal serotonin levels are, and they don't know really how the drugs work, then how can we say they restore balance?
A more accurate version of the message would be this: Varying levels of various neurotransmitters, including serotonin, are associated with varying levels of depression. But that doesn't make as good a story, and so the industry has aggressively and successfully promoted the notion of neuro-balance. SmithKline, before its merger with Glaxo, explained Paxil's effects with animations of a pool table, on which balls ricocheted madly until they were put back in order by Paxil. Pfizer, the largest pharmaceutical company in the world, sponsors "Brain: The World Inside Your Head," a traveling show for science museums in which the company tells children that depression may be caused by, you guessed it, "an imbalance in neurotransmitters."
So does this mean that the big pharmaceutical companies are evil, as the Church of Scientology and other conspiracy buffs have suggested? Of course not. It simply means that Pfizer, Glaxo, Lilly and the rest are doing what they are supposed to do: make money. If they have gained in recent years far too much cultural power, it is because we have given it to them.
Are the drugs evil? Again, not at all. They are, at least in the short run, quite valuable, if monitored closely. Even the foremost critic of SSRI overuse, the British specialist David Healy, still prescribes antidepressants other than Paxil to patients.
The chief myth is that SSRIs — being restorers of "natural" balance — are safer than previous generations of psychiatric meds and, therefore, OK for family doctors to prescribe. They are not necessarily safer, and they should be prescribed only by people trained in their use who will closely monitor patients.
Closely monitor means weekly follow-ups for the first three months — something almost impossible in the modern managed-care environment where general practitioners average about eight minutes per patient to diagnose and prescribe. Follow-up appointments are tough to get. Yet nearly every study that has found SSRIs safe and effective looked at patients who received intense follow-up care. In the real world, most people who are prescribed SSRIs today are on their own.
This does not mean that only psychiatrists should prescribe them, but it does mean that any general practitioner who does so needs to have had substantial training in their use and a commitment to providing the necessary follow-up. That would not only make the process safer all around, it would free the general practitioner from simply endorsing a patient's self-diagnosis and request for treatment, which often happens. Better training would also provide doctors with the tools to resist the animated messages of the drug companies about these powerful psychiatric drugs. It also might make them consider providing a more accurate message to their patients, something like this: These drugs will stimulate some parts of your brain and tranquilize others. But you must report to me regularly, which is the only way I can make sure that the side effects don't turn into something harmful.
Those side effects can be major. Consider Paxil, approved in the early 1990s. Its biggest drawback is that going off the drug suddenly can cause serious withdrawal symptoms (or, as the company's legal staff insists on calling it, "discontinuation syndrome"), including suicidal despair. This was clear as early as 1996, when both the company and the FDA knew that the withdrawal syndrome — flulike symptoms, depression, anxiety and other fun experiences like "brain zaps" (a feeling sort of like an electrical charge in the head) — was, statistically speaking, Paxil's leading problem. Yet the company refused to put withdrawal syndrome on the drug's precautions label until 2001.
I once asked Jan Leschly, until 2000 the head of SmithKline, Paxil's maker, why that was so. We were sitting in a conference room of a large New York communications agency. Leschly, a charming onetime tennis pro from Denmark, was not surprised at the question. He said all the right things — that the company would never purposely endanger patients, that it would be bad for business as well as morally wrong, and that "we may press [advertising regulations] but we would never, never go beyond it." But why, I asked, when withdrawal syndrome was clearly the leading adverse event reported to both the company and the FDA, did he not put that warning under the precautions section of the label, where general practitioners might comprehend its gravity? Why, in fact, did the company spend millions to justify not doing so? Leschly then made it clear he had had enough of me. "Some people will never have enough information," he said, sticking out his hand for a conclusive handshake. "That's it. I've got an attorney sitting down there waiting to see me. I've got to go."
The public is still waiting for an answer.
Posted by flyingdreams on January 27, 2004, at 17:37:49
In reply to Re: Anyone had success on Effexor XR?, posted by meds4life on January 27, 2004, at 14:33:45
There is information on the weight gain issue at:
http://www.prozactruth.com/weight.htm
The fact is you can run 5 miles a day for a month straight and not lose a lb. I'm proof of that. This is because these drugs lower our metabolism, this is why we gain weight. Shame of the drug companies for denying it! All they want is $$$.
Never heard of synthroid, read up on the side effects and withdrawals from actual people who have been on that drug first! I'd ask about natural ways to fix it first.
Posted by flyingdreams on January 27, 2004, at 17:56:31
In reply to fwd new article about anti-depressants, posted by zinya on January 27, 2004, at 14:49:36
THANK YOU for posting this article! It says everything!
If everyone would post this article as often as they can in other groups and to friends and family, PLEASE get the word out there! Save some people from the pain I'm in now getting off these drugs!
Posted by EFFEXED on January 27, 2004, at 19:40:15
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
LIKE I SAID BEFORE I TOOK THE 37XR FOR 2 WEEKS NOW I AM ON THE 75XR WAS MOODY FOR THE FIRST 2 DAYS BUT NOW DAY 4 IS HERE AND TODAY IS THE BEST I HAVE FELT IN YEARS THIS STUFF IS GREAT I REALLY WAS ABLE TO GET UP THIS MORNING GO TO SCHOOL ON TIME AND AT THE END OF THE DAY I DID NOT FEEL LIKE I WAS GOING TO PASS OUT ON THE WAY TO PICK UP MY KIDS FROM SCHOOL MY DAUGHTER EVEN ASKED WHY I COULD NOT PLAY WITH HER LIKE THIS EVERY DAY I FEEL GREAT THANKS TO THE EFFEXOR
PS.I KNOW THIS IS ONLY DAY 4
HOPE IT LASTS.THANK YOU.( EFFEXED )
Posted by omegon on January 27, 2004, at 20:59:37
In reply to Re: Anyone had success on Effexor XR?, posted by flyingdreams on January 27, 2004, at 17:37:49
> [efexor, prozac, SSRI's in general]
> http://www.prozactruth.com/weight.htm
>
> The fact is you can run 5 miles a day for a month straight and not lose a lb. I'm proof of that. This is because these drugs lower our metabolism, this is why we gain weight.Some people gain. Others lose it. Prozac has destroyed my appetite completely in the last few weeks.
Before anyone gets any ideas about weight loss, this is not necessarily a good thing, especially as the main reason for the change is that I feel too sick to eat most of the time. I am well underweight for my height already: male, 23, 178cm, under 60kg before I started it.
(Other SSRIs I've tried didn't make me gain weight either - though they certainly destroyed any fitness I had, due to the absolute apathy and inertia they produced.)
> Shame of the drug companies for denying it! All they want is $$$.
Well, yes. That's why they are called companies, and why they have managed to develop the few drugs they have at costs of hundreds of $million each. It's what they do and it's why their staff work for them. A non-profit company might have an outside chance of discovering a useful drug, but getting it through the (necessary) regulatory systems, and then actually marketing it enough so that it reaches patients? no chance.
The current systems work for the most part - it's just that they need a bit of (necessarily forcible) adjustment of the profit<->people balance, to sort out the side-effects that profitability doesn't notice, like making the people you're "helping" feel suicidal when you stop "helping" them.
Despite this, I see lots of posts on here slating "the drug companies" for releasing drugs that help some people but not others / not giving the side effects and withdrawal symptoms enough emphasis / not giving out free medicine to everyone / making any money at all. (For the record, I am a victim [perhaps only partially an unwitting victim] of paxil, effexor, and (increasingly) prozac - see earlier posts - so I'm not entirely biased towards those drug companies.) Again, who would develop these drugs in the absence of vast profits, especially given the current culture of litigation? The regulatory process (which is entirely necessary for new drugs) is inevitably very expensive to get through.
Obviously if you look at the whole system, and the devastating damage that these drugs can inflict on an individual human level when they are not used carefully enough, it it looks shaky under any moral scrutiny. Unfortunately, big companies don't work like that, for much the same reason as why one country can go to war against another and sanction the killing of people they've never seen: self-interest, tribe instinct. People in those companies will settle for helping some people, some of the time, and getting paid. The people who are hurt are someone else's problem.
If anyone is to blame, I think it is precisely those various governmental regulatory systems (much the same in any country, from what I've read): surely their primary purpose is to rationalise (humanise?) and keep this kind of thing in check while maintaining the advantages of opening the drug development sector up as a commercial market? Those agencies should be placing far more emphasis than they are effectively managing to do on sparing patients/victims the adverse effects of these drugs, which in many cases could be easily avoided or at least greatly reduced. Clearly the human cost of this is vast, and should be enough for those supposedly human-focussed governmental thingums to sort things out.
Of course, this is rarely enough unless the mainstream press happen to jump on the bandwagon. Taking the cynical point of view, the economic cost is huge as well, inevitably greater than the drug company profits! And it's likely that, even if you don't offset the economic losses directly against those profits, the latter will get zapped eventually when the aforementioned litigation gets going and produces multi-billion class-action lawsuits. They need to encourage cautious dosage changes, warn about withdrawal symptoms, potential for mood changes if misdiagnosed, and so on into hell for the patient. This information is widely available, seems to be well supported by studies as well as anecdotal evidence (admittedly I have not formally researched this, and my viewpoint may be biased) and is readily found if you research on the web, whether focussed on research or on patient experiences. Yet despite this, it is emphatically NOT getting to many of the doctors who prescribe these drugs, until their better-informed patients go through it and report back to them!
So what can we do?
Well, since most of us "victims" only have access to the doctors who put us through this, and to peers who might have to go through this later, the most useful thing is just to tell those people.
And of course if it might help you feel better, or satisfy your moral sense to some extent without actually having to engage in any conflict with those who might disagree, you could do worse than to post a long, unnecessarily detailed rant to an internet board where most people won't even read it.
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Dr. Bob is Robert Hsiung, MD,
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