![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 4501 to 4525 of 10407. Go back in thread:
Posted by Susy on July 12, 2003, at 0:03:01
In reply to Re: your response to my attacks, posted by mercedes on July 11, 2003, at 17:52:41
Hi Mercedes, I was so happy that you could make it driving to meet your grandaughter that then I felt so bad when you describe your attack.I have been taking Xanax for more than 2 years now, since my panic attacks instead of improving are getting worse. =(
Right now I am taking this alprazolam made in Pakistan, 0.25 I am taking a half of tablet per day, one quarter in the morning, around 10 the other quarter in the afternoon around 4, sometimes I wake up in the middle of the night let's say at 3 or 4 a.m. and I take another quarter. I do have a lot of paxil's the last Dr. gave me, but I am affraid to take them again, even when the Dr. told me that I can take Xanax and Paxil along, I still don't dare to do it.
I had a terrible experience with Paxil, although I did notice 2 good things, in the middle of 1,000 bad things when I took Paxil (just 3 times)
and it was that I didn't smoke that much those days as I usually do, and I didn't go to the bathroom to pee that much either.
Those were the only two good symptons I noticed with Paxil. But then, I wasn't able to sleep, neither to eat, I felt not able to control my own thoughts and I was more nervous than usual, and like If I was stoned, very bad.
Please keep on telling us how you are feeling I will pray for you Mercedes.
Posted by Bridget on July 12, 2003, at 14:19:18
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I started on 75mg today going from 37.5 and went to the gym with my husband. I felt so good. I SO FAR have not had anything major not even sweating too much. I just am not hungry. I have to force myself to eat. I hope this is all the effects or it may start in a few days...
I guess so far I am a lucky one...:0)
Posted by zinya on July 12, 2003, at 15:32:51
In reply to Re: Anyone had success on Effexor XR? » zinya, posted by mercedes on July 11, 2003, at 18:17:22
Well, i identify with the frustration of writing a full response and then discovering it fell into the cybermuda triangle...
If/When you have the energy to try again, i look forward to it but i know from experience it can take a while to psych up to restate what one has already said.
Tonight's my last night at 75. Given that I now only have 150 mg tablets, I am planning to move up from 75 next to 100 then 125, then 150, as those are relatively easy divisions of capsules (although i've been spoiled by a whole week of being able to just pop one capsule. Now back to my little dishes and dividing 300 into 3 nights' worth, etc).
I'm impressed that you went in one leap from 150 to 300. Does your non-mention of side effects mean it was a relatively easy increase? Is it your experience that the higher you go, the more your body is already used to Effexor and makes the transition easier, even when it means doubling from 150 to 300??
Boy, i sure am feeling the heat/sweat potential. I did finally do some errands yesterday at banks, etc. that i'd felt zero energy to do for a while, so it's a good sign that i did those things but i found myself everywhere I went thinking and a couple of times asking "Is it just me or is your A/C not working very well?" :))) The clerks I asked were having no problem, so guess who was having the sweats and heat-rising feelings even in a/c-ed banks and stores... On Thursday I had a return of unusual dizziness but i realized it was cuz i did something that morning that probably provoked it. Basically, i'm down to the sweating as the one lingering side effect. And wishing I had started this process some other season than summer! :)
good wishes,
zinya
Posted by zinya on July 12, 2003, at 16:00:12
In reply to Re: Anyone had success on Effexor XR? » sierra1, posted by CherC68 on July 11, 2003, at 21:29:08
hi Cher,
gosh, when i read of what you've gone through and is still unresolved for you in this horrible saga of cysts and hormones, I can't imagine how I would be reacting. I assume you mean the patch you were put on was Estraderm, so you've already tried that? Gosh, is there any chance you could find a specialist to see? I would try to insist on seeing some more expert person who might have some better idea about all these lingering cysts, etc. It seems sooo possible that what you are dealing with that led you to Effexor is related to either this unresolved cyst situation or the lack of HRT or some such.Did you try the all natural estrogen that is sold wihtout prescription in little boxes - I think it's called Estroven or something like that?
and to both Cher and Sierra and anyone,
The major alarm so far with new HRT tests is all focused on the role of progesterone for those still with uteruses (and especially those starting HRT after age 60). While the jury's still out on estrogen alone as to other cancer risks, it seems like one is wise to proceed cautiously but to not yet assume that estrogen alone will be proven to have those same risks either.
Also, a friend just sent me this reference, which seems very interesting - I've read some of it but not the whole article yet - It's an article on "'Natural' Isomolecular Hormone Replacement: An Evidence-Based Medicine Approach." at this website:
http://www.islandpharmacy.com/natural%20hormones.html
She excerpted some paragraphs I've read and it discusses all the different forms of estrogen and one in particular (which isn't contained in premarin at all) which can impact frequency of urination, something both my friend and I have had troubles with for some time.
Which just adds to the sense of how incredibly interrelated everything is in our bodies. The first clue to me in recent years if a doctor is someone I will trust is whether he/she recognizes all these interactions. When I still hear a doctor say things like "Oh, no, estrogen only affects x in your body" I know he/she has WAY too limited an understanding of things. Our hormones affect virtually every system in us - and such things as hair growth, sweating, skin, carpal tunnel syndrome, now to learn urinary frequency, etc. The connections just keep getting more and more extensive.
(Sometimes i think we need to have been born about 20 or more years later - maybe they'll finally know this stuff. Although i dare say it's also required a 'baby boom generation' to get to this stage in life for enough more people to start seriously researching it.)
In case you or anyone missed it, this is a relevant portion of a post I sent to Bridget above about hormones:
Too many doctors (imo) prescribe Premarin as if it were the only option. Especially for long-term use, which presumably will be your case too, I think a much healthier route is Estraderm patches - It's a more natural form of estrogen - estradiol -- and there are other newer even more natural forms now getting developed which i'm just learning about which use more of estriol .. Using a patch is more efficient (transdermal) and it also protects the liver from having another daily drug to break down which, over time, can lead to liver function problems. I switched to using Estraderm in 1988 and have been very pleased overall, but again, as with ADs, each body is different and responds differently to doses and products.
But your latest post seems to raise this as a second thing that makes me curious (although you don't have to answer these Qs if you would rather not and i'll understand) ... There's a book I've recommended to women here before which I'll re-recommend to you re women's hormones if you haven't heard of it. I discovered her (a gynecologist somewhere in New England as i recall) on PBS when she did special programs. Her name is Christiane Northrup and the book is "Women's Bodies, Women's Wisdom".
my 3 cents' worth,
zinya
Posted by worrier on July 12, 2003, at 22:14:16
In reply to Had terrible attack. Any 1 have these symtoms?, posted by mercedes on July 11, 2003, at 3:26:16
> I had a terrible panic, anxioty, siezure, mild stroke, whatever?.. yesterday. My attacks have mostly been diagnosed by my pdoc as PTSD and I suffer from depression also. These attacks started almost 7 years ago. Has anyone ever had this? I've read some people here refer to "brain freeze". Anyway, this is what happens to me.
>
> Yesterday, was fine in the a.m., had my coffee & cig. and decided to work in my garden early, before it got hot. This was around 8:30 a.m. It was going to be 105!
>
> Anyway, I grabbed my coffee cup and ZAP! My vision get's stuck. I feel it mostly in my left eye and I see two of everything. I can't get myself out of it. I sat down, looked around for about 5 minutes with that dble vision, sorta one up higher than the other. Anyway, after about 20 min. or so, I cld. my brother and left a message. I can't see the keypad on the phone but I've learned the keys by touch. He didn't call me back so I fell asleep or passed out, don't know. My sis-n-law cld me around noon, asked if I was ok, and I just remember telling her "I fell asleep" about 3 times. my speach was slurred or slow, and I didn't make sense she told me later. My bro. cld me around 3 p.m. I still was talking nonsense, told him I didn't need anything, just needed to sleep. I was talking to him but do not remember anything else I said. He would ask me something and I babbled off and didn't remember what he'd ask me. During this time, I was unsteady while walking and my head hurt real bad, left side.
>
> A month ago I had up to six of these one week and the next week 7. Then, I won't have one for a month or so. Remember, I'm the one that finally drove by myself in 6 years. I don't drive when I have these "attacks". I take Xanex for these symtoms and Effexor for my depression. Oh, I cld my primary care phys. so she could see what happens to me and she wouldn't see me, sd I had to see my pdoc. I cried, felt like I'll never ever be rid of these attacks and felt rejected by my primary doc. which made me depressed.
>
> Anyone ever have something like this? HELP !
>
> Mercedes>I have severe panic attacks too, but have never really had the symptoms you described. However, they sound alot like what happens to my brother-in-law when he has really bad migraines. He often loses the vision in one eye, has occasionally lost the use of his arm on the same side, his speech is effected..can't name familar objects, etc. Maybe you are having these types of migraines in addition to the anxiety/panic. I'd ask your doc to refer you to a neurologist. Just a thought. Worrier.
Posted by Greg Stone on July 12, 2003, at 23:51:27
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
> Hi there,
>
> Anyone care to comment on the use of Effexor? Anyone
> "happy" with it? I have tried Prozac (too much anxiety),
> Serzone (too sedating). I am currently on Buspar for anxiety.
>
> Been reading many different reports... Effexor seems
> to have a lot of success...
>
> please share your thoughts on this.I have been on Effexor XR for almost 5 years. It has been great for me. I am in the process of getting of it at the time and even though the withdrawl symptons are a bit hairy, I think I can handle it. Among other things being on this medication (150mg)fueled by desire to return for my MBA which I just received with high honors. To me it has been a wonder drug.
Posted by mercedes on July 13, 2003, at 2:04:01
In reply to Re: Had terrible attack. Any 1 have these symtoms?, posted by worrier on July 12, 2003, at 22:14:16
Dear Worrier,
You are the second person that has mentioned "migranes". This never occurred to me because I hardly ever have headaches. My head hurts alot after my attacks, but not before. If I have ever had a headache, the strongest thing I take is Tylenol because I fear mixing over the counter drugs with my prescibed drugs.I'll mention it to my pdoc and then pursue it with my neurologist. Does your brother-n-law take daily medication for these migranes? My son used to get migranes at the age of 6 & 7. He was very sensitive to bright light or sun. Now that I think about it, I had worked in my yard outside in the sun, the day before.
Thanks for your input,
Mercedes
Posted by mercedes on July 13, 2003, at 2:32:48
In reply to Re: Anyone had success on Effexor XR? » mercedes, posted by zinya on July 12, 2003, at 15:32:51
Hi Z,
I was mistaken. I went from 150 to 225 then 300. I really don't remember bad side effects other than the sweating, not sleeping at night. It was at 225 that I started taking Effexor XR before noon and had more energy. When I went to 300 mgs. I don't remember the side effects getting worse, I just remember that I was smiling more and was finally feeling happy (more so than not). Although I still have the anxioty but I take xanex for that. Mercedes
***********************************
I'm impressed that you went in one leap from 150 to 300. Does your non-mention of side effects mean it was a relatively easy increase? Is it your experience that the higher you go, the more your body is already used to Effexor and makes the transition easier, even when it means doubling from 150 to 300??
Posted by mercedes on July 13, 2003, at 3:04:08
In reply to Re: your response to my attacks, posted by Susy on July 12, 2003, at 0:03:01
Hi Susy, thanks for your note. I also take alprazolam but take much more than you. This past March/April, when I was having 6 attacks a week, my pdoc increased my alp. to 1 full mg. three times a day. Prevously, I was on .5, three times a day.
The way you describe your panic attacks, sounds like you need to take more mgs. I don't know if the dr only prescibed that low dose or if it is because of the cost, or from having to get it from another country. It just sounds to me like you are taking next to nothing, but I'm not your pdoc. Sometimes I won't take the last tablet if I'm already sleepy or not feeling anxiety. However, the next morning I feel some tingling on my lips or like needles poking out of my skin. As soon as I take my dose, the symtoms go away. I also took paxil at one time along with the xanex. However I was drinking alot at that time, very depressed, that I didn't give the antidepressants a chance. Alcohol is a depresant in itself so I was making myself worse by drinking but at that time, it was all I could do to survive. I haven't been drinking hardly, since I've been on Effexor.
Keep writing,
Mercedes
*****************************
> Hi Mercedes, I was so happy that you could make it driving to meet your grandaughter that then I felt so bad when you describe your attack.I have been taking Xanax for more than 2 years now, since my panic attacks instead of improving are getting worse. =(
> Right now I am taking this alprazolam made in Pakistan, 0.25 I am taking a half of tablet per day, one quarter in the morning, around 10 the other quarter in the afternoon around 4, sometimes I wake up in the middle of the night let's say at 3 or 4 a.m. and I take another quarter. I do have a lot of paxil's the last Dr. gave me, but I am affraid to take them again, even when the Dr. told me that I can take Xanax and Paxil along, I still don't dare to do it.
> I had a terrible experience with Paxil, although I did notice 2 good things, in the middle of 1,000 bad things when I took Paxil (just 3 times)
> and it was that I didn't smoke that much those days as I usually do, and I didn't go to the bathroom to pee that much either.
> Those were the only two good symptons I noticed with Paxil. But then, I wasn't able to sleep, neither to eat, I felt not able to control my own thoughts and I was more nervous than usual, and like If I was stoned, very bad.
> Please keep on telling us how you are feeling I will pray for you Mercedes.
>
Posted by mercedes on July 13, 2003, at 4:01:15
In reply to Re: Has anyone experienced nightmares on Effexor XR? » Susy, posted by CherC68 on July 11, 2003, at 16:39:27
Cher, I cannot beleive your doctors won't prescribe xanex or the generic known as alprazolam. Are these pdocs or GP's? Maybe it's the State you live in. I live in CA and have been on alp for nearly 7 years. I have been lectured about it being habit forming by some pdocs but they still prescribe it for me. I don't abuse it either.
Now for the hard part, I haven't had the courage to say that my PTSD, anxiety, depression and agraphobia are the results of being raped nearly 7 years ago. I admire your courage. I already was stressed at work, raising my out of control teenage son, and being a caregiver for my 82 yr old mom. And then that happened. I couldn't talk to my family about it. I just kept living like a robot. Got up, went to work, came home, faked a smile for my mom, cried myself to sleep, woke up crying, drank every night straight for a month, but managed to go to work everyday till I finally passed out at work. It was then that I sought psyc help, about two months after the attack. I wanted to kill myself, but I had my mom to care for. I told myself back then that I would kill myself after she passed on. I was given many types of AD's but I preferred to drink so I only took them for a little while and tell the dr. they were not working for me.
My mom passed on 3 yrs ago. I thank God for the 5 years I was able to take care of her. I kept my secret from her and my family and most importantly....I'M STILL HERE! ALIVE! I'm so glad I didn't kill myself. Effexor has worked for me but I also sacrificed the alcohol to make it work.
Anyway, back to you. I want to thank you for your many responses to my notes. It really feels like I have so many freinds yet have not met any of you. I just wonder how a doc can think you would get well with a 10 pill prescription after such a traumatic event. Can I ask how long ago it happened? I wish you luck in trying to get the anxiety med you really need. Keep in touch.
Mercedes, WHEW! SIGH!
***************************
I was given xanax when I was younger - just one prescription of 10 after I was raped and every now and then my mom gets a prescription and will give me two of hers to hold for when I get my "I think I'm dying panic attacks" NO doctor I have been to recently will prescribe xanax - As a matter of fact, I've taken maybe 20 in my entire life and I'm almost 40. Why are Dr's so afraid of giving out this drug (addictive or not)when it is the one pill that seems to help when I have a bad anxiety attack. Zoloft and Effexor is addictive too in its own way, all the AD's are if you ask my opinion.
Posted by pasdenom on July 13, 2003, at 9:44:37
In reply to Re: Effexor - Exercise - Better Experience, posted by livingghost on June 17, 2002, at 19:51:23
Hey, has anyone started smoking after taking effexor xr? I had quit for 15 years but am now smoking again. I have not been able to quit? Does anyone think that effexor increases impulsivity? I have bipolar II and effexor put me into mod-hi hypomania. Bought a beautiful new comfortable living room set that I couldn't afford. I am now on three meds: effexor, lamictal, and lexapro. each time a med is added I keep thinking this one will help me quit smoking. no such luck. this is my first message ever on this board. am I nuts? am I alone in this? I do experience strange side-effects to drugs, often the opposite of the listed side-effects. Please respond to this any other weirdos like me.
Posted by PhilChemicalEngineer on July 13, 2003, at 13:20:50
In reply to Re: Anyone had success on Effexor XR?, posted by Bridget on July 11, 2003, at 18:18:38
I just came out of a two-week major depression. First time in nine years. I have been on remeron at 60 mg/day and just went from 5 days on 37.5 Effexor to 75 mg/day. The depression lifted the first day on Effexor but I was getting a lot of support from my wife, a good friend and a psychiatrist we've been seeing for a year and a half.
I know it's supposed to take longer for Effexor to have an effect, but when I started Prozac three years ago, the first thing I noticed was great anxiety relief 3-4 days after I started it.
When I stopped Prozac cold turkey on my own, in about a month I couldn't sleep and had severe leg-thigh discomfort when trying to sleep. First Serzone, then Paxil, now remeron with neurontin for a couple months. Seems to work well except for the onset of depression, which might have to do with our couples therapy.
Anyone going through similar drugs?
Let me know
Phil
Posted by zinya on July 13, 2003, at 15:55:51
In reply to Effexor Remeron, seeking feedback, posted by PhilChemicalEngineer on July 13, 2003, at 13:20:50
Phil,
I am going to chime in on just one thing you mention here, not from personal experience but because of something I just saw/read. (i'm on Effexor for over a month, just had my last night at 75 mg last night) and doing okay by going super slow to avoid side effects being too harsh. I know nothing about remeron.) But your mention of neurontin rang a bell. I dont' usually watch Dateline but I did see the following piece the other night and just discovered the transcrip on the web.. I thought at the time that for all of us there is some sobering info here in general that it behooves us to realize can be influencing our doctors' prescribing practices, but this instance happens to focus on neurontin in particular so could be of extra interest to you...
I send this a bit guardedly cuz i certainly dont' want to be fostering alarmism, but I also don't want to fail to relay something that might make you want to ask some clarifying questions of your doctor about why you were given neurontin, just to make sure you are comfortable with the reasoning.
Drug giant accused of false claims
Whistleblower alleges illegal encouragement of off-label useScientist David Franklin says he became part of a broad mission at pharmaceutical company Warner-Lambert to deceive, even entice doctors to prescribe drugs to patients whether it was scientifically justified or not.
NBC NEWS
July 11, 2003 — The questions began with the confession of an insider at one of the nation’s largest pharmaceutical firms. He says his former company deliberately distorted information about one of its drugs, possibly putting lives at risk, and costing patients and taxpayers millions of dollars. “Dateline” went looking for some answers and has the results of a year-long investigation into what may be one of the biggest medical deceptions in history. NBC’s John Hockenberry reports.
DAVID FRANKLIN: “I was trained to deceive, to lie to doctors.”
John Hockenberry: “So these doctors were completely misled?”
Franklin: “Absolutely.”
Who would train and then pay someone to mislead doctors? Scientist David Franklin says pharmaceutical company Warner-Lambert paid him to do that back in 1996.
Franklin: “It was my responsibility to leverage the trust that physicians had with pharmaceutical companies to corrupt the relationship between the physician and the patient.”
John Hockenberry: “Your job was to find trust, and exploit it, to produce more sales for Warner-Lambert.”
Franklin: “Absolutely.”
Since he was a little boy growing up in Rhode Island, Franklin says, he wanted to be a scientist. But he wanted to use that science to help people, doing medical research to cure disease. So Franklin got his Ph.D. in biology at the University of Rhode Island and from there became a researcher at the prestigious Dana Farber Cancer Institute. After more than three years as a researcher, Franklin wanted to get out of the lab. He found a job at Parke-Davis, a division of Warner-Lambert. He would be a medical liaison, using his scientific expertise to explain the scientific merits of drugs to doctors.
Franklin: “The medical liaison was supposed to be fair and balanced, where the physician could trust what the medical liaison was telling them.”
Hockenberry: “So, doctors wouldn’t necessarily see you as a company guy, as much as they would see you as a scientist. As as a medical doctor, like them in a way.”
Franklin: “Exactly. A person whose primary responsibility is to care of the patients, making sure that the doctor, to enable the doctor to practice the best possible medicine that science would allow at this point in time.”
Hockenberry: “So, a doctor needs more drugs for their practice. They call the salesman. But if they have questions about the medical use of that drug, they call you.”
Franklin: “Exactly.”
But almost immediately, Franklin says, he became little more than a salesman. The job he thought would be about caring for people turned out to be little more than caring for the company’s bottom line. With his Ph.D. and the title of doctor, Franklin says he became part of a broad mission to deceive, even entice doctors to prescribe drugs to patients whether it was scientifically justified or not.
Franklin: “It was a matter of leveraging, corrupting, if you would, perverting the science, to greatly increase sales and profitability.”
This corporate whistleblower, telling his story to “Dateline” in his first broadcast interview, has rocked the pharmaceutical industry to its core. Pieced together with confidential documents and taped voicemails, you’ll see a portrait of sales over science.
But mostly this is the story of how David Franklin helped one little drug become a star: Gabapentin, one of the drugs Franklin was responsible for, which goes by the brand name Neurontin. Neurontin is a useful and generally safe drug. The Food and Drug Administration approved it in 1993, but for only one use — to help control epileptic seizures and only if taken in conjunction with another drug.
But Franklin says he soon learned that Warner-Lambert had plans for Neurontin, the little epilepsy drug, a plan to go directly to doctors and get them to prescribe Neurontin for all kinds of uses the FDA hadn’t approved, called “off-label” uses.
Hockenberry: “Warner-Lambert basically told you, ‘The FDA says, scientifically, Neurontin treats epilepsy. But we can convince doctors. And here’s how you’ll do it, to use Neurontin for a dozen other things.”
Franklin: “Absolutely. This was holding their hands and pushing them into to using Neurontin off-label.”
And according to Franklin, the list of off-label uses was long, everything from attention deficit disorder to alcohol and drug withdrawal.
Now, off-label uses are nothing new. Doctors have been observing surprising new uses for drugs throughout history. Some of their discoveries become medical breakthroughs. One of the best-known examples is aspirin, once thought only good for pain, was found by doctors to increase blood circulation and prevent heart attacks.
Hockenberry: “So it’s legal for doctors to say, ‘You know what? I think this drug that is approved for your ear might be good for your throat.’”
Franklin: “Not only is it legal, but it’s good medical practice.”
But what is not legal is for a drug company to promote such unapproved, off-label uses or to exaggerate or report unproven breakthroughs to doctors as a way to get them to prescribe their drugs. Assistant U.S. Attorney Jim Sheehan, one of the country’s leading prosecutors of health care fraud, says such regulation exists because off-label use can be unsafe.
Sheehan: “Every prescription drug is an inherently dangerous product with the potential to kill people as well as cure them. That’s why we have very strict regulation, that’s why we have rules about what marketing and promotion they can do. That’s why we have rules about what they can produce and how they produce it.”
Franklin says the rules went out the window from the moment he arrived on the job. For instance, he was told not simply to wait for doctors to ask him for his scientific opinions, but to instead target doctors and convince them to prescribe Neurontin, even though he knew that there was no FDA approval for its off-label uses.
Franklin says he was actually “cold calling” doctors, showing up like a salesman unannounced, and he found one thing about him opened a lot of doors.
Franklin: “If I were to show up at a doctor’s office and say, ‘Dr. Franklin is here to speak to Dr. Smith,’ Dr. Smith is much more likely to respond, as opposed to his receptionist calling him in his office, and saying, ‘The Warner-Lambert sales rep is here to talk to you.’”
Franklin didn’t say that he wasn’t a medical doctor. Simply having the title of doctor, the Ph.D. he was so proud of, was all that mattered, Franklin says, and Dr. Franklin, it turns out, wore lots of hats, depending on whom he was visiting.
Hockenberry: “So, you could have had a Ph.D. in economics or metallurgy, and it would have been just as fine?”
Franklin: “As long as it granted me the title of Dr. Franklin.”
Hockenberry: “What were you told to tell doctors about your background?”
Franklin: “We actually trained the sales representatives to introduce me as an expert in cardiovascular medicine.”
Hockenberry: “Were you?”
Franklin: “Absolutely not. My Ph.D. was in microbiology. At 9 in the morning I was an expert in cardiovascular medicine. At 10 when we walked across the street to a neurologist office, I was an expert in neurology.”
And once inside, Franklin would make his pitch to the doctor. As I played the doctor’s part — he showed me what he would say about Neurontin.
Franklin: “We’re really being inundated with information from across the country with physicians that are seeing a profound improvement in patients with bipolar disease ... so we would suggest that you titrate the patient up to 4,800 milligrams — you will see marked improvement in their symptoms.”
Hockenberry: “So your suggestion to me is triple the dose and I might see some positive results.”
Franklin: “Absolutely. It’s not a matter of might. You will see an improvement.”
He’s a scientist who couldn’t sound more certain. But is there any scientific validity to what he is saying about, for instance, bipolar disorder?
Franklin: “None at all. And in fact, much of it is a fabrication. It is simply untrue.”
Hockenberry: “Was there any data that really supported the claims you were making?”
Franklin: “Not at all.”
At best the claims were based on promising anecdotal and untested preliminary information that Franklin says was, promoted to doctors vigorously, directly and illegally.
Franklin: “Not only is it illegal, it’s downright immoral. It doesn’t just hurt the medical community, it has the potential of hurting patients.”
But as you’ll see, there was nothing potential about the money to be made through these tactics. The billions to come were real ... as real as the patients whose stories are just beginning to emerge. Was their health compromised in a scientifically invalid campaign to raise sales of Neurontin?
A PATIENT’S PERSPECTIVE
By the late spring of 1996, Franklin understood fully what he was doing in supplying misleading information to doctors about the drug Neurontin. What he didn’t know, he says, was the effect on real patients. It’s a knot in his stomach that’s still there today.
Franklin: “There hasn’t been a day in six years that I haven’t thought about this and wrestled with my involvement in it.”
Long after David Franklin began to have his first reservations about his job, 54-year-old Regina Adams got her own education about off-label uses of Neurontin.
Adams: “My whole life was turned upside down, and I almost lost my life because of it.”
Adams has bipolar disorder.
Hockenberry: “When were you first diagnosed with a condition that might require ongoing use of pharmaceutical drugs?”
Adams: “About 11 years ago.”
Hockenberry: “And the symptoms you were exhibiting were?”
Adams: “Mania, mostly mania. Because I had just lost touch with reality.”
Bipolar disorder occurs when the brain constantly cycles between mania and depression. Those who suffer from it can experience uncontrollable highs and lows.
Before she found a reliable treatment the disease played havoc with Adams’ life. She divorced and was in and out of hospitals. Doctors finally found a therapy that seemed to work, a drug called Depakote, FDA-approved for bipolar disorder.
Adams: “That worked really well, worked for my head. But the side effect was weight gain.”
Hockenberry: “Weight gain?”
Adams: “I gained 100 pounds.”
Adams wanted the benefits of Depakote without all the weight, so she asked her doctor for a different drug. The doctor recommended Neurontin. At first Adams felt better and lost weight, but soon after things started to come apart.
Adams: “I became more and more out of control. My whole personality — I’m very a sweet, nice person. And I got hostile.”
Hockenberry: “Had you ever behaved like this before?”
Adams: “No. No. My ex-boyfriend said he had never seen me, when I was manic, act like this.”
Adams went back to her doctor for help.
Adams: “She just kept increasing the Neurontin. I didn’t want to go any higher. I didn’t want to get harmed from it.”
Hockenberry: “And your doctor’s response was, Increase the dosage.’”
Adams: “Mm-hm.”
Was there a risk? Adams’ dosage was tripled. Neurontin is known to have few if any side effects, one of its big selling points. But Neurontin was now Adams’ only treatment for bipolar disorder, which was very risky because Neurontin, it turns out, does essentially nothing for bipolar disorder — and that’s a scientific fact.
Dr. Gary Sachs: “Neurontin’s a drug that has been studied under double-blind conditions twice. And in neither case did it prove to have any efficacy at all.”
Hockenberry: “In neither case?”
Sachs: “In neither case.”
Dr. Gary Sachs runs the Bipolar Treatment Center at Massachusetts General Hospital.
Hockenberry: “So, based on the science, someone with bipolar who’s only taking Neurontin is essentially untreated.”
Sachs: “I think that’s a fair assumption.”
And for a bipolar patient like Adams, being untreated can be life-threatening. On Neurontin, Adams’ manic behavior became uncontrollable. She says she tried to kill herself. She ended up in the hospital.
Hockenberry: “If your doctor gives you something, your assumption is that it works, and that somebody’s shown that it works, right?”
Adams: “Right.”
Hockenberry: “In the case of Neurontin, was any of that true?”
Adams: “Not for me.”
We tried to talk to Adams’ doctor at Meridian Behavioral Healthcare in Gainesville, Fla. — and Adams said she had no problem allowing us see her medical records. But the company refused our request, issuing only a statement from her doctor acknowledging that Adams was treated with Neurontin but that the drug was discontinued when she “experienced a manic episode.”
Adams is back on her old medication and doing fine.
Hockenberry: “What do you have to say to the drug company that might have been very interested in doctors’ prescribing their medication?”
Adams: “I think that they’re greedy, and they just are after money. And they don’t really care about the person who takes the medicine, obviously.”
David Franklin says he was surprised how easy it was for him to get doctors to switch to Neurontin or to raise dosages.
Hockenberry: “And would they do it?”
Franklin: “It’s remarkable the high percentage of physicians that would do this.”
Hockenberry: “How did you feel?”
Franklin: “I would leave a physician’s office in pain. There was no other way of describing it. This is — I was in — a combination of embarrassed by what I had just done, felt responsibility to the patient, to the doctor and the patient, that I had just misled this individual. And that some third party that wasn’t even in the room, some patient, may actually be impacted by it.”
Parke-Davis’ own internal documents obtained by “Dateline” show the company couldn’t have been more excited about: “new indications for Neurontin,” especially for people like Adams with bipolar disorder: “Bipolar disorders offer the greatest expected return on investment ... as much as $55 million.”
Even though the 1995 memo later states “there is no pre-clinical evidence of efficacy in bipolar disorders.” In other words, no real scientific evidence that it would work. Franklin says the company’s enthusiasm about off-label prescriptions translated into real pressure on the job — pressure, he says, to sell.
Franklin: “I was pressured to fill the gap that the sales team, the actual sales representatives weren’t filling. That the sales representatives weren’t as effective as medical liaisons. And that we had to, I think the quote was, to take the ball and run with it.”
And Franklin let “Dateline” experience this sales pressure just as he did, through this recorded voicemail from his boss.
“You know there’s a Neurontin push that’s supposed to be on.... So what we need to do is focus on Neurontin, when we get out there - we want to kick some ass on Neurontin - we want to sell Neurontin on pain all right? And monotherapy...I don’t know if you guys are embarrassed, but I’m embarrassed with where we are with Neurontin.”
Franklin saved this voicemail because he could barely believe what his boss was saying: sell Neurontin expressly for uses not approved by the FDA. Franklin was frightened. What he was being asked to do, he believed, was illegal. So he began to tape more conversations and messages from company officials. Here’s a quote from a senior Warner-Lambert executive on a conference call:
“I want you out there every day selling Neurontin... holding their hand, whispering in their ear — Neurontin for pain, Neurontin for monotherapy, Neurontin for bipolar, Neurontin for everything.... I don’t want to see a single patient coming off Neurontin before they’ve been up to at least 4,800 milligrams a day.”
And then he said this:
“I don’t want to hear that safety crap either.... It’s a great drug”
We showed Assistant U.S. Attorney Jim Sheehan that colorful quote.
Sheehan: “It would seem to me that’s a pretty clear advocacy for off-label use by the company. And therefore a violation of the FDA’s rules.”
Hockenberry: “You know, I don’t know if I’d use the word advocacy. I might use, like, threat.”
Sheehan: “When I look at this, Neurontin not for pain, not an on-label use, Neurontin for bipolar, not approved, no application for that either. Neurontin for everything, well, that’s pretty obvious.”
And company sales people got to make this pitch right in the inner sanctum of doctors’ offices. Franklin would tell doctors they could get paid to let company sales reps go over patient medical records and to actually be there in the examining room while patients were being treated.
Franklin: “If you are willing to allow a sales representative to spend a day with you as you see patients, we’ll compensate you for that. We’ll pay you for it.”
This is a voicemail Franklin recorded, in which a salesman boasts about his success after a day spent with a doctor and his patients:
“The doctor would review the chart of each patient with me in a one-on-one fashion. Then we would go meet the patient, the patient would be examined. I saw the actual prescription generated in front of me... that was certainly nice. I certainly felt that me being there, I had some influence on that medical decision.”
Medical decisions that were very good business. From its introduction in 1993, Neurontin the little epilepsy drug, has rocketed to the top of the sales charts. Today it’s a more than $2 billion drug, outselling even blockbuster Viagra, and more than three-quarters of Neurontin’s sales, by the parent company’s own estimate, are from off-label uses.
But Franklin was having serious doubts about the safety of off-label use, about his job and about what kind of legal trouble he might be in. He would not make it through his first year at Parke-Davis. In the summer of 1996, he decided he’d had enough.
GOING PUBLIC
By the early summer of 1996, after four months working as a medical liaison for Warner-Lambert, David Franklin began to realize it was time to get out. He believed what he was doing was wrong and feared what would happen if he stayed.
Franklin: “I knew that in the period of time that I had been there, my own personal behavior was illegal, that I had done things that were simply illegal.”
His biggest worry was that he was aiding and abetting a medical fraud. The scientist who reluctantly became a salesman now wondered if he had what it took to blow the whistle on a drug company worth billions.
Franklin: ”“Either I needed to own up to this now and put it behind me, or at some point in the future, this could come back, and I’d find myself on the wrong side of this investigation. I did believe, when I left, that they were so aggressively ramping this up, that at some point, someone would expose what was going on there. And therefore, I would find myself in the equally, or even more difficult, position of trying to explain why I ignored an obvious illegal and immoral activity within the company.”
So on July 29, he drove to a co-worker’s home, dropped off his office keys and company car and turned his back on Parke-Davis for good. Next stop? Greene and Hoffman attorneys at law.
Franklin: “I showed up to their office saying, I’ve— I’m in trouble. And I need some help out of this.”
Franklin filed a lawsuit against Warner-Lambert and its Parke-Davis division charging the company with violations of the U.S. False Claims Act. He says he was not motivated by the fact that he stands to be in line for a percentage of the damages if the company loses or if it settles out of court.
Tom Greene: “We had no idea the extent of the Neurontin prescriptions, how successful this program had been.”
Tom Greene is David Franklin’s attorney. He has spent the last seven years amassing Warner-Lambert and Parke-Davis documents going back to 1994. He shared many of them with “Dateline” — they fill more than 160 boxes, memos and reports that prove, Greene says, that David Franklin was merely a cog in a grand marketing strategy to deliberately and illegally encourage off-label use.
Greene: “There are countless documents that support what he says and go far beyond his story and bring the level of knowledge of this illegal marketing program to the highest levels of the company.”
For example, one memo shows that plans for marketing Neurontin for at least one off-label use were sent to top executives, including Anthony Wild, the president of Parke-Davis’ pharmaceutical division, and Lodewijk de Vink, president of parent company Warner-Lambert. Neither responded to our request for comment.
Other Parke-Davis documents, like one from 1997, show that there were teams inside the company not merely pushing the envelope on acceptable marketing practices but deliberately advocating going around the expensive FDA approval process, because the patent life of the drug was so short.
The “recommendation” is that Parke-Davis “not file” an application with the FDA but instead take the message straight to the doctors.
It was a full-court press. While sales reps and medical liaisons like David Franklin supplied company information in doctors’ offices, documents show company messages being planted aggressively in the scientific literature. Doctors simply trying to stay educated about new drugs would find themselves inundated with research, paid for by the company and made to look like independent scientific papers.
Greene: “They wanted to disseminate knowledge of these off-label uses throughout the medical literature. They hired outside companies to write articles about off-label uses so that the message about off-label use of Neurontin could be planted in the medical literature around the country, and indeed around the world.”
Here’s one example of how what Parke-Davis called its “publication strategy” worked: A company called Medical Education Systems of Philadelphia (MES) was hired by Parke-Davis to put together a series of articles on off-label uses of Neurontin. MES would contact doctors hand-picked by Parke-Davis to author the articles. But in some cases, it appears that articles were essentially ghostwritten by MES, and the doctor’s name added later. As one MES status report notes: “MES draft completed — we just need an author.”
And what did the doctors get for becoming authors of papers they sometimes didn’t write? Fees of up to one thousand dollars a pop.
Sheehan: “You are attempting to create a false impression, and you are making false representations, and you’re doing it for money. I just don’t see how that approach can be supported or can be viewed as appropriate.”
Hockenberry: “You know, it’s always been my impression that the finding of an author precedes the actual writing of the paper.”
Sheehan: “One would hope that’s what would happen.”
Papers were just the beginning. Franklin says there was lots of money to go around.
Hockenberry: “Did you pay doctors?”
Franklin: “I personally did not pay physicians. What my responsibility was, was to let physicians know that there was money available to them.”
In fact the documents show there were all kinds of ingenious ways for doctors to get paid for an education in the use of Neurontin. For instance, “honoraria” are fees paid to doctors to hear information or a presentation about Neurontin. Parke-Davis records show that these scientific presentations occurred in some unscientific places: “Bus to Yankee Stadium,” “World Yacht Cruise” and “Braves Stadium.”
Doctors were also recruited for teleconferences, seminars and trips to places like Jupiter Beach, Fla., perhaps better known for golf than for research.
Paying physicians like this, giving them drug company money to listen to information about the products they prescribe, may be legal and common practice in the industry, but to critics like Dr. Arnold Relman, professor emeritus at Harvard and former editor of the New England Journal of Medicine, it’s a conflict of interest — especially in the case of Neurontin.
Relman: “What you have is an unproven drug being widely used for difficult problems by doctors who are given a powerful economic incentive to do it, spurred on by a company that’s wildly aggressive in its marketing.”
After seven years of legal motions and countermotions, Franklin’s lawsuit is now being scrutinized by the U.S. government and all 50 states to see if government medical programs like Medicaid may have been defrauded into spending millions on improper off-label prescriptions.
And in fact, in recently filed court papers, the Justice Department said that Franklin’s case “has presented evidence of an illegal off-label marketing scheme that is rife with false statements and fraudulent conduct all of which had one intended purpose and result — increasing sales ...”
Three years ago, Pfizer bought Warner-Lambert and Parke-Davis, so now the biggest drug company in the world is the defendant in one of the highest-profile cases in the history of the industry. Pfizer officials would not speak on camera but did provide this statement: “...the events to which you referred are alleged to have occurred well before — in some cases years before — Pfizer acquired Warner-Lambert. Pfizer completed the acquisition of Warner-Lambert in June 2000. It is long-standing policy that Pfizer has not and does not promote its products outside their FDA-approved labeling.... We are unable to comment further because of the pending litigation...”
But it’s litigation that will mean little to Regina Adams, who says she will always believe that her experience with bipolar disorder and the drug Neurontin almost ruined her life.
Adams: “Now that I look back, and that I know what I know now, I wouldn’t have ever taken the drug. I want everybody to know that’s taking this drug the truth about it.”
Last year the FDA approved the use of Neurontin in the treatment of post herpetic neuralgia, severe nerve pain, in addition to epilepsy. It is still widely prescribed for pain and a variety of other unapproved uses, some of which have been studied and endorsed by scientists and approved for use in other countries.
And as for whistleblower Franklin, he may have escaped legal liability for what he did during his four months with Parke-Davis, but he hasn’t escaped his own conscience. He admits he should have known from the start that he was heading down the wrong path.
Franklin: “Actually interviewing for this position, I was asked about giving examples of where I had to bend the rules in the past and how I handled that and how comfortable was I working in gray areas.”
This case could end up clarifying some of those gray areas and end up costing defendant Pfizer millions of dollars. And there’s one more thing. Because his lawsuit is filed under the federal False Claims Act, as a whistleblower Franklin stands to get a piece of any monetary damages, up to 30 percent, which could add up to millions. So the four-month job in sales that caused so much agony for this scientist, ironically, might in the end have set him up for life.
Hockenberry: “But even after you get a settlement, if you do, or a judgment if you do, or the case just completely goes away if it does, there are patients out there who took drugs based on decisions doctors made relying on your judgment.”
Franklin: “Right.”
Hockenberry: “They could be hurt because of that.”
Franklin: “They may have been hurt. And that’s something that I wrestle with.”
Hockenberry: “What’s to wrestle with? If they’re hurting, it’s because of you.”
Franklin: “It’s because of me. There hasn’t been a day in six years that I haven’t thought about this and wrestled with my involvement in it and the guilt I feel associated with it, and the sense that I need to correct it.”
Posted by zinya on July 13, 2003, at 16:07:53
In reply to Re: your resp. to Suzy re: xanex, everyone » CherC68, posted by mercedes on July 13, 2003, at 4:01:15
my gosh. I am so saddened by what both of you have shared as the most dreadful of experiences. Somehow, Cher, and i can't figure out how, when i responded to your last post here, I didn't even see the post of yours which Mercedes has responded to here with mutual sharing. I had two different of those murky kind of sickening but not-so-clear-cut date rape kinds of situations in my life, but I dare say that hasn't given me the full sense of what you have both been through. There are no words, but I want you both to know how much I was impacted by your sharings, how much my heart goes out to each of you, how much i hope you each have or still will find ways to exorcise the inevitable demons such an experience plants in our psyches... And if talking more here or by e-mail "in the comfort of strangers" (echoes of Blanche BuBois), I am a ready and supportive ear.
with my warm caring and hugs to you both,
zinya
Posted by Susy on July 13, 2003, at 18:09:43
In reply to Re: your response to my attacks » Susy, posted by mercedes on July 13, 2003, at 3:04:08
> Hi Susy, thanks for your note. I also take alprazolam but take much more than you. This past March/April, when I was having 6 attacks a week, my pdoc increased my alp. to 1 full mg. three times a day. Prevously, I was on .5, three times a day.
>
> The way you describe your panic attacks, sounds like you need to take more mgs. I don't know if the dr only prescibed that low dose or if it is because of the cost, or from having to get it from another country. It just sounds to me like you are taking next to nothing, but I'm not your pdoc. Sometimes I won't take the last tablet if I'm already sleepy or not feeling anxiety. However, the next morning I feel some tingling on my lips or like needles poking out of my skin. As soon as I take my dose, the symtoms go away. I also took paxil at one time along with the xanex. However I was drinking alot at that time, very depressed, that I didn't give the antidepressants a chance. Alcohol is a depresant in itself so I was making myself worse by drinking but at that time, it was all I could do to survive. I haven't been drinking hardly, since I've been on Effexor.
> Keep writing,
> Mercedes
>
> *****************************
> > Hi Mercedes,I feel better because you sound a lot better today, so you mean that you are still taking Xanax 3 times a day and also Effexor?
Is that working ok for you? I mean dealing with the side effects, the fatigue, etc....
Well, I do suffer Panic Attacks since 14 years old now, after I had my second son; but the Drs didn't know what it was,they said first it was low blood presure, and then an imbalance in my hormones.....thank God I didn't suffer that time a lot of panic attacks, maybe 1 or 2 per year and I was able to control them breathing or going out or drinking a cognac.....but this last three years, the attacks came back with vengeance, the first time my son even call the ambulance because we all thought I was having a heart attack.
This Dr. was the one who gave me Xanax for the first time, and I took them as needed.
When my medicine was over I went to other Dr. who make me a series of analisis to determine that it really was panic and anxiety what I suffer. Even an electrocardiogram, blood, xrays, etc....
But when he gave me the prescription he told me "this is the only time I am going to give you Xanax, next time go to a Mental Health Clinic"
When I didn't have more, I went to this place were they give you free clinic attention, and the Dr gave me PaxilCR 25 mg. That was horrible for me so I went back and again she told me that she couldn't give me any more medicine, to go to a Mental Health Clinic, now, I went to this County hopital and wait there for more than 7 hours and at the end, they told me I had to have an emergency to get medical attention. =( I have gone to a lot of different places, even to Mental Health Clinics but they said they don't deal with anxiety and panic attacks, just esquizofrenia,bipolar disorder and other issues.
That is why, I have to take as less as I can because it is very expensive buying Xanax from
the internet and the quality is not the same.
But it is better to take it everyday, even taking it I do suffer a lot of anxiety and attacks, I am praying to collect more strength so I can at least go back to work again.
Well sorry I made it too long, please don't forget to tell me how are you feeling now.
Bye Mercedes =)))
>
>
Posted by Susy on July 13, 2003, at 18:28:40
In reply to Re: your resp. to Suzy re: xanex, everyone » CherC68, posted by mercedes on July 13, 2003, at 4:01:15
> Cher, I cannot beleive your doctors won't prescribe xanex or the generic known as alprazolam. Are these pdocs or GP's? Maybe it's the State you live in. I live in CA and have been on alp for nearly 7 years. I have been lectured about it being habit forming by some pdocs but they still prescribe it for me. I don't abuse it either.
Mercedes, I forgot to tell you, I am from Spain but I do live also in California, in Los Angeles;
I will really appreciate if you give me some clues about where can I go to get some Mental Health help. Thanks, Susy
>
>
Posted by zinya on July 13, 2003, at 18:31:53
In reply to Re: your response to my attacks » Susy, posted by mercedes on July 13, 2003, at 3:04:08
hi again mercedes,
You mentioned that you hadn't been "hardly" drinking since going on Effexor. Like you, i too decided I just had to quit entirely when I started Effexor, and actually had already quit completely a couple of months before that, hoping that eliminating alcohol by itself would have helped my depression even without starting Effexor but when it hadn't, i finally decided to take the chance on Effexor's side effects and started taking it.
But i do occasionally think it would be nice. Anyone who's reported here about trying to have a drink while on Effexor said it set them back for 2-3 days afterwards and they regretted it.
Are there any precautions you take when you do have a drink now to keep from having side effects?
hope you're (all) having a good Sunday. I just came in from doing some trimming on the deck, standing in the shade the whole time (it is a hot day here but i was in a cool breeze and in the shade) and yet i was soon dripping with sweat the whole time, the one bugaboo it seems of Effexor, and had to come in and take a shower just from a little trimming in the shade! I've never been a sweat-er my whole life. Granted, this isn't a debilitating side effect but still the one really persistent and annoying one. Oh well... :))
zinya
Posted by mercedes on July 13, 2003, at 20:47:21
In reply to Re: drinking on Effexor » mercedes, posted by zinya on July 13, 2003, at 18:31:53
Hi Zinya,
Yes, I take precautions. I usually hold my drink with two hands so I won't spill it in case I get dizzy.....just kidding..,:)First I want to say that I do not encourage drinking on any kind of AD's. And this comes from someone who drank everyday after being raped nearly 7 years ago. I eased up once starting therapy.
But to answer your question Z, I too, had the bad affects 2-3 day setback when I was taking the effexor in the evening so I stopped drinking all together.
I think that since taking my effexor mid-morning with food, and making sure I eat something (which I force myself to do because I have no appetite, sometimes I just have bread & cheese) before I drink and I don't get bad effects. I do NOT however take my last dose of xanex before drinking or after. I usually have the best sleep, like a full 8 hours, then I just start my meds. as usual the next morning.
The other thing I do is set a goal, ie., I have to pull weeds, or mop my kitchen floor or vacume, things I don't like to do. Then I give myself permission to occasionally go to Kareoke or drink at a birthday party or something like that. The first time I tried this I had my drink at home, cuz I wasn't sure how my body or mind would react.
No bad effects.Congratulations on doing some trimming on the deck. I'm so happy to hear that you are getting some work done. I know it takes alot to come up with the energy to do something like that. Just remember to pat yourself on the back when you do that. And here's my pat on the back to you. Pat...pat. You've been more productive than me today. The weather where you are sounds like the weather here where I am. I live in a small town near Fresno, CA. hot but a bit breezy.
Wishing good things for you...and keep on writing.
Mercedes
***********************************
> hi again mercedes,
>
> You mentioned that you hadn't been "hardly" drinking since going on Effexor. Like you, i too decided I just had to quit entirely when I started Effexor, and actually had already quit completely a couple of months before that, hoping that eliminating alcohol by itself would have helped my depression even without starting Effexor but when it hadn't, i finally decided to take the chance on Effexor's side effects and started taking it.
>
> But i do occasionally think it would be nice. Anyone who's reported here about trying to have a drink while on Effexor said it set them back for 2-3 days afterwards and they regretted it.
>
> Are there any precautions you take when you do have a drink now to keep from having side effects?
>
> hope you're (all) having a good Sunday. I just came in from doing some trimming on the deck, standing in the shade the whole time (it is a hot day here but i was in a cool breeze and in the shade) and yet i was soon dripping with sweat the whole time, the one bugaboo it seems of Effexor, and had to come in and take a shower just from a little trimming in the shade! I've never been a sweat-er my whole life. Granted, this isn't a debilitating side effect but still the one really persistent and annoying one. Oh well... :))
>
> zinya
Posted by mercedes on July 13, 2003, at 21:58:32
In reply to Re: your resp. to Suzy re: xanex, everyone, posted by Susy on July 13, 2003, at 18:28:40
Suzy, you don't mention if you have health insurance. I am assuming you don't since you have to pay for your medication.
I too, lived in L.A. county (Azusa) up until last Sept. when I sold my house and bought one near Fresno, CA. I am not working now because my company was sold but I pay for my own medical insurance....a whopping $286.00 a month! But I need it. I too hope to work soon.
However, when I was working, my primary care physician referred me to a psyciatrist and he prescribed the alp (xanex) for me. Normally reg. med dr's don't want to prescibe because it is a psyciatric drug, a "controlled substance".
So first question, do you have insurance? Do you have Medical? If you don't have insurance, you need to make an appt. with a psychiatrist near your home that has "income average" or "pay scale" plan. (My pdoc charges my ins. $75.00 a visit plus I have to pay a co-pay of $15.00. Be sure to describe all your symtoms. I know of one pdoc in Covina but don't know if you want to go that far (about 25 miles from L.A.
Le bamos a preguntar a Zinya to help here cause she is very good about looking up things on internet.
Te deseo salud y me dises tocante la segurancia.
Entre todos te bamos a ayudar.
Mercedes
*******************************
Mercedes, I forgot to tell you, I am from Spain but I do live also in California, in Los Angeles;
I will really appreciate if you give me some clues about where can I go to get some Mental Health help. Thanks, Susy
Posted by CherC68 on July 13, 2003, at 22:09:22
In reply to Re: personal support to CherC68 and » mercedes, posted by zinya on July 13, 2003, at 16:07:53
Posted by mercedes on July 13, 2003, at 22:25:23
In reply to Re: Effexor and smoking, posted by pasdenom on July 13, 2003, at 9:44:37
Hi and welcome to p-babblers. I just found this site about a month and a half ago while researching effexor. I find it very very helpful. Kinda different strokes for different folks re: medications.
I cannot share your concern because I was a smoker before meds., and still a smoker. The one thing I've noticed is that I smoke more now but I think it's because of not working. However it doesn't bother me if I'm in a store for hours to not have a cig. I went on a buying spree last year b-4 Christmas at Costco. I was very depressed, crying all the way to the store...bought over $700 dollars (two visits) of stuff I didn't need. Luckly I returned most of it when I came to my senses. I was prepared to tell the clerk that the reason for my returns was that "I shop when I'm depressed" but she didn't ask. I didn't go crazy and buy a new living room set but I thought about it. Oh, I bought a car back in '96 cause I was depressed. Gosh, what memories come back when someone shares their experiences. Keep in touch.
Mercedes*********************************
> Hey, has anyone started smoking after taking effexor xr? I had quit for 15 years but am now smoking again. I have not been able to quit? Does anyone think that effexor increases impulsivity? I have bipolar II and effexor put me into mod-hi hypomania. Bought a beautiful new comfortable living room set that I couldn't afford. I am now on three meds: effexor, lamictal, and lexapro. each time a med is added I keep thinking this one will help me quit smoking. no such luck. this is my first message ever on this board. am I nuts? am I alone in this? I do experience strange side-effects to drugs, often the opposite of the listed side-effects. Please respond to this any other weirdos like me.
Posted by PhilChemicalEngineer on July 13, 2003, at 22:38:49
In reply to Re: neurontin and pharmacy-peddling » PhilChemicalEngineer, posted by zinya on July 13, 2003, at 15:55:51
zenya, thanks for the info on neurontin. It triggered me to start looking hard for additional info. phil
Posted by mercedes on July 13, 2003, at 22:51:05
In reply to Re: personal support to CherC68 and (nm), posted by CherC68 on July 13, 2003, at 22:09:22
Cher, looks like you forgot to confirm post. I've done it too. My email, if you care to write me is [email protected]
Posting here is fine too because I'd never have known about your expierence if it weren't for this site and maybe there are more people out there that will share their most fearful thoughts with others. Like I said before, I didn't have the courage to say why I suffer, until I read your's. I'm much better now but have been through it all, anger, tears, wanting to beat someone up, suicidal thoughts, thoughts of getting a contract on the perpetrater, depression, lack of concentration, not feeling any feelings, and on and on and on.
Hope to hear from you soon.
Mercedes
Posted by mercedes on July 13, 2003, at 22:51:52
In reply to Re: personal support to CherC68 and (nm), posted by CherC68 on July 13, 2003, at 22:09:22
Cher, looks like you forgot to confirm post. I've done it too. My email, if you care to write me is [email protected]
Posting here is fine too because I'd never have known about your expierence if it weren't for this site and maybe there are more people out there that will share their most fearful thoughts with others. Like I said before, I didn't have the courage to say why I suffer, until I read your's. I'm much better now but have been through it all, anger, tears, wanting to beat someone up, suicidal thoughts, thoughts of getting a contract on the perpetrater, depression, lack of concentration, not feeling any feelings, and on and on and on.
Hope to hear from you soon.
Mercedes
Posted by zinya on July 14, 2003, at 0:28:04
In reply to Re: Effexor and smoking, posted by pasdenom on July 13, 2003, at 9:44:37
Salut pasdenom,
Are you French? (if you don't mind my asking)
I can't address your smoking Q (I quit smoking 19 years ago) but i'm writing out of curiosity. I am probably way out in left field but is the person that prescribed Effexor or Lexapro for you the same person diagnosing you as bipolar ? I'm not sure what distinguishes bipolar II but I had two different doctors over the past 15 years think i was dealing with bipolar instead of depression per se, and I tried both lithium and depakote at different times, to no avail. But from the little I know, I'm surprised that either Effexor or Lexapro are prescribed for bipolar. Maybe somebody here knows better than me, but given your concern about impulsivity, it would seem to add to wondering if these are really right for you.
Impulsive over-purchasing is frequently a manic sign, and it seems like it could be getting aggravated by something that (at least to my understanding) is more for depression per se than for bipolar. I hesitate to say this cuz it's probably just my lack of knowledge of other diagnoses Effexor or Lexapro can treat. But I would definitely mention this 'impulsivity' to your doctor.
I am curious if you've ever been put on something like Lithium -- or is Bipolar II a lot different from regular bipolar??I've never heard of lamictal.
I do share your experience at having drug reactions that go against the norm. And one thing to know about these ADs -- seems like all of them -- that we discover here over and over again is how each individual reacts differently, with different side effects. Same drug makes one sleep all the time, the next one becomes an insomniac, etc etc...
You're not nuts. Or else, as i actually prefer to think, we're all nuts, all weird, by which i mean all of us, everyone... So welcome! and wishing you comfort.
zinya
> Hey, has anyone started smoking after taking effexor xr? I had quit for 15 years but am now smoking again. I have not been able to quit? Does anyone think that effexor increases impulsivity? I have bipolar II and effexor put me into mod-hi hypomania. Bought a beautiful new comfortable living room set that I couldn't afford. I am now on three meds: effexor, lamictal, and lexapro. each time a med is added I keep thinking this one will help me quit smoking. no such luck. this is my first message ever on this board. am I nuts? am I alone in this? I do experience strange side-effects to drugs, often the opposite of the listed side-effects. Please respond to this any other weirdos like me.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.