Posted by Cam W. on February 25, 2000, at 18:25:35
In reply to Re: Cindy Anticipatory Anxiety, depression, OCD, posted by Cindy W on February 25, 2000, at 9:36:57
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> > > Cam, the Effexor-XR seems to help with anxiety, but lately I feel more depressed, even at 300 mg/day, and it hasn't completely knocked out the OCD rituals. Have you heard of Effexor-XR being helpful for OCD (the results I've read were mixed)? Thanks!--CIndy W
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> > Cindy - While theoretically Effexor should work for OCD (OCD thought to involve serotonin pathways) I haven't seen it used with much success. How long have you been taking Effexor and how long have you been more depressed? Feeling down sometimes is normal, even while taking antidepressants. You could have the Effexor dose raised again for both the depression and for the OCD. OCD seems to respond better to higher doses of SSRIs (eg 60mg of Prozac or Paxil) and take longer to work, than for depression. It can take an SSRI 26 weeks to show improvement in OCD, so the wait can be frustrating. Also, if you have the Effexor dose raised it still may work better. Unlike SSRIs Effexor's dose-response curve is linear and doesn't plateau like the SSRIs. This means that increasing the dose of Effexor may show increased antidepressant effect, whereas with an SSRI (after a certain point) raising the dose does not increase efficacy. When you increase the Effexor dose (especially around the 300mg/day dose) it is like adding Desipramine to Paxil (adding an NSRI to an SSRI) as the norepinephrine reuptake blockade of Effexor begins to show. Maybe give the Effexor another week and see if this increased depression isn't just "the blues" and then ask your doctor about a dose increase or, if you feel warranted, a med change. Don't give up on an antidepressant too soon. Hope this helps - Cam W.
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> Cam, thanks for the suggestions! I've been taking Effexor-XR for about 8 weeks now (now on 300 mg/day). Will see my pdoc next Thurs. Am. Don't know whether to ask for l) more Effexor-XR, say, 375 or 400 mg/day, 2) augmentation (e.g., Anafranil, gabapentin, risperdal), or 3) switch to Celexa, Paxil, or Anafranil. I think the Effexor-XR is helping but will see how it goes next week. --Cindy WCindy - I like your idea of augmentation. I'll bet a little Anafranil or even Serzone might bump serotonin enough, or Lamictal (careful of rash) for mood stabilization (has antidepressant properties). Good luck - Cam W.
poster:Cam W.
thread:23336
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