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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by clipper40 on February 8, 2008, at 8:30:00
I have a friend on Effexor 150 mg. and nortriptyline 75 mg. She was told that she had to go off of them cold turkey because she's having a medical procedure done in a few days. She's trying to find out if there's something else she can take now to avoid the horrible withdrawal symptoms.
Is the reason she has to go off of those meds because of the norepinephrine or would she have to go off of SSRIs as well? I'm wondering if she could take a little Prozac, Zoloft or even 5-HTP so that she won't have to suffer so much through this procedure. I know that Prozac can increase the concentrations of other drugs in the body so that might not work either.
If you have any good advice on this subject, I'd really appreciate it. I'd hate for this friend to have to go through withdrawal hell in addition to the frightening procedure she has to face.
Thanks in advance for your help.
Posted by Racer on February 9, 2008, at 13:22:04
In reply to Question for Larry Hoover or other geniuses, posted by clipper40 on February 8, 2008, at 8:30:00
There's not enough information to answer that question, really. A lot depends on what sort of a procedure is involved, and why (and how long) she has to be off those medications for it.
Some doctors are more cautious than others, and want patients off ALL medications which aren't necessary to sustain life. (ie: they'd let a diabetic stay on insulin, but not on statins) Others only want someone off those medications which would clearly interact with things like anesthesia, etc. Part of the answer for your friend would depend on how cautious the doctor in question was being; on why she had to stop the medications. Considering Effexor's known discontinuation issues, I'm guessing this isn't a psychiatrist recommending she stop it?
Actually, I'm very surprised that her doctor hasn't taken that very topic into account. It's hard for me to understand a doctor not taking steps to mitigate the discontinuation problems of stopping Effexor for any reason -- unless that doctor really is ignorant of that issue.
The best answer I can give based on the information at hand is that your friend should talk to her doctor, and ask why she needs to stop those medications, and for assistance in mitigating the discontinuation effects.
I'm very sorry I couldn't be more helpful.
Posted by Phillipa on February 9, 2008, at 17:19:20
In reply to There's not enough information to answer » clipper40, posted by Racer on February 9, 2008, at 13:22:04
Agree with above as I am having surgery and no meds need to be discontinued including a benzo. Surgeons sometimes don't know that classification of meds. Or anesthesia. I think pdocs stay out of sort of stuff. Not sure though. Phillipa
Posted by clipper40 on February 10, 2008, at 0:30:23
In reply to There's not enough information to answer » clipper40, posted by Racer on February 9, 2008, at 13:22:04
Hi,
I appreciate your response. Sorry for not providing enough information. My friend is having a cervical (neck) myelogram and it's the doctor performing the procedure who wants her off of her medications for about 4 days prior to the procedure. The procedure is coming up soon so she will not have time for a slow taper. She's terrified at the thought of having to go through this procedure while also going through a horrible withdrawal.
She's going to see her psychiatrist soon and wants to have some information available to ask for help. I had told her to see if she could get a low dose of an SSRI from her psychiatrist - providing that she could get the physician performing the procedure to ok this - as I know that a low dose SSRI could help immensely in staving off the worst of the Effexor withdrawal. But I wanted to see if anyone else had any other ideas, especially if her physician performing the procedure wouldn't allow even a low dose of an SSRI.
Posted by Racer on February 10, 2008, at 9:38:57
In reply to Re: There's not enough information to answer, posted by clipper40 on February 10, 2008, at 0:30:23
Since neither of those drugs will be out of her system in four days, I'd recommend your friend ask her psychiatrist to talk to this doctor about whether she really has to stop them. It's possible he's worried about an interaction with the dye, but I'd think that would be just as likely if she's off them for four days as if she's taken them all along.
The only other reason I can think of to stop the Effexor is that it can affect blood pressure, but this still sounds like an excess of caution to me. If that's true, then I doubt he'll be amenable to Prozac, either.
Truly, I'd recommend that she discuss this with her psychiatrist. If the doctor performing the procedure is set that she has to stop these medications, one 20mg dose of Prozac might be enough to ease her through the period she has to be off the medications.
Honestly, I wonder if the doctor doing the procedure *knows* that Effexor has such a withdrawal problem? It could be simple ignorance of that one fact on his part. I think he's the only one who can really answer why she has to be off meds, and if your friend finds it hard to talk to him, maybe her psychiatrist can discuss it with him.
Hope that helps.
Posted by clipper40 on February 10, 2008, at 10:52:09
In reply to Re: There's not enough information to answer » clipper40, posted by Racer on February 10, 2008, at 9:38:57
She will be meeting with her psychiatrist about this shortly so hopefully he can help in some way either by prescription and/or by talking to her other doctor. Thanks again for your help.
Posted by Phillipa on February 10, 2008, at 19:30:41
In reply to Re: There's not enough information to answer » Racer, posted by clipper40 on February 10, 2008, at 10:52:09
I've had mylograms and no one ever said to stop any meds. Yes the meeting and hopefully they will consult will solve the problem. Good luck to your friend. Phillipa
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