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Dr. Bob is Robert Hsiung, MD,
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Posted by gare on May 23, 2002, at 7:32:48
In reply to Re: Switching from Effexor to Remeron » Butterfly, posted by PamelaLynn on May 22, 2002, at 21:55:18
I have read so many posts about people not liking Effexor XR/Regular within the first month or so and then desperately trying to find the next best fix.
I also have read that many people who have stuck it out for about two-four months while the Effexor XR adjusts in their system - despite the side effects of sleep disturbance, euphoric feelings, delayed ejaculation (at least you can get it up right?), dry mouth, among other things -but now are reporting benefits that seemed weren't going to come.
Also, it is interesting to note how many postings about regular docs prescribing these psychotropic medications versus a good psychiatrist + psychotherapist team to get you through.
I am wondering what is really up with switcharoo of meds:
(1) Are many of us too impatient to hang in there - being aware that as the saying goes, things have to get worse before they get rosey?
(2) Are many of us being misdiagnosed by the primary care physician (not psychiatrist) that these drugs have been misappropriately prescribed and therefore we are not achieving the results we seek that we have to switch off to something else blaming the drug Effexor for not working as it should.
This post is not intended to get anyone upset about their therapies or modalities, but as another post mentioned, you wouldn't see your OBGYN for mental health issues or let alone fill a prescription of Effexor XR from your dentist.
Yes, sometimes psychiatric docs aren't the most chatty but they are their to pinpoint your symptoms and discuss with you the options of treatment. The psychotherapist helps you with the feelings, experiences, and issues that brought you to initiate mental health therapy with a psychotropic drug.
Not only do I think that by increasing your dosage because you are not getting your issues resolved overnite is not such a wise idea, I also believe that jumping around on different medications can have implications, whether positive or negative, to your natural brain's chemistry.
As my psychiatrist said ' what is the point of putting you on a drug if it messes up your other things in life that are going well.'
I am baffled that many posts also have written how they take this and that and that and that too to combat side effects. That in itself is not a good sign.
If you start taking one thing only to end up taking five other things, I would seek a second opinion.
Posted by gare on May 23, 2002, at 7:40:26
In reply to Re: Effexor - Exercise - Better Experience, posted by johnlund on May 22, 2002, at 22:50:36
I don't believe it has an effect in the metabolism mechanism of the liver; however, you may want to get a copy of the pharmacological insert (see your pharmacist) and look under hepatic/liver abnormalities.
I would also recommend that you get a regular yearly physical that would include a blood chemistry panel that would provide you feedback on your liver functions (there are about three or four) and cholestrol.
I think there is a tendency for it to affect blood pressure.
The only thing I can think of is that if you were to decide to terminate taking Effexor/Effexor XR, then you will have to ween yourself a bit longer to avoid withdrawal symptoms and allow your brain chemistry to compensate for what Effexor/Effexor XR had been doing.
Other than that, a yearly phsyical will be great yearly and regular visits with your psychiatrist.
Posted by Allen F. on May 25, 2002, at 3:29:06
In reply to Hmm... watch out and about a good psychiatrist, posted by azurebay on May 22, 2002, at 18:17:50
The problem is that there are not enough PDoc's out there, and a "good" one is hard to find. I am also of the opionin that insurance companies, or some other organization, would rather a person take a pill than have to pay for therapy that can be very expensive.
Posted by katekite on May 25, 2002, at 10:14:57
In reply to Re: Hmm... watch out and about a good psychiatrist, posted by Allen F. on May 25, 2002, at 3:29:06
I should have been more cautious with pdocs.
A good pdoc will be completely sure of the diagnosis before prescribing anything. They will go slowly and add one medication at a time (unless someone is hospitalized and still a danger). They will be aware of withdrawal and not treat it as a new problem, but link it to the stopped medication. They will recommend exercise and therapy, strongly and repeatedly. They will look things up and will feel that all questions are important and need answers. They will not medicate things you don't ask them to medicate. They will follow-up. They will test for medical things when appropriate, and not just the first year. They will believe what you say and trust that you know what you need. They will reassess the diagnosis if the first couple of meds don't help.
Everyone preaches that trust is a good thing. I agree, if you've been properly diagnosed, it can be. But if your diagnosis is unclear, tentative etc, don't trust in the seemingly magic power of a doctor to make you 'feel better'. How can they make you feel better if they aren't sure what you have?
Don't take drugs without a well proven diagnosis unless you're suicidal or risking harming others. Don't agree to a diagnosis because you want a diagnosis, agree to a diagnosis because it fits completely what you are. Try not to let wanting to please anyone or depression or anything else interfere with rationally assessing a diagnosis to see if it fits you.
I'm allergic to trazodone or something in the coating, and nearly died about 6 years ago from taking my first pill of it. Since then I've taken lots of things with no problems. I'm all for drugs to treat serious problems. But pharmaceutical companies are advertising down our throats to treat everything we can...it does influence us. The positive experiences of people around us influence us. Seeing people achieving what we would like to influences us. Seeing people on this board trying drug after drug with no problems makes us think that everyone can. Not all of us will come away the same as we were before. A few will get lupus or myasthenia or Steven Johnson's and never be physically OK again.
Please be careful and take only what you absolutely feel you need to.
kate
Posted by supergirl on May 26, 2002, at 1:32:26
In reply to if I'd known then what I know now...., posted by katekite on May 25, 2002, at 10:14:57
Very good advice, Kate. Well said.
supergirl
Posted by Allen F. on May 26, 2002, at 16:33:37
In reply to if I'd known then what I know now...., posted by katekite on May 25, 2002, at 10:14:57
Very well said!
In todays world, with drugs advertised freely, even on television, it is easy to say you fit the problem and the drug will help you.
Ten to twenty minuites is a short time to diagnos, prescribe, and answer questions. Yet this is the common time frame of most doctor visits. And Doctors see many many people in a day, week, month, which makes it hard for them to fully remember your case and have adequate follow-up without your participation. Its your body and mind, you have to be in control of your care, which means you have to proactively ask questions, learn about the diagnosis and what your options are for treatment.
I wish I had taked a more active role years ago in my treatment versus just doing what the doctor suggested without really questioning it.
Allen
Posted by kpo2002 on May 26, 2002, at 17:30:08
In reply to if I'd known then what I know now...., posted by katekite on May 25, 2002, at 10:14:57
Yes, katekite, you have brought up a very good point. There is a new disease out there, and it goes by the name of Multiple Chemical Sensitivity, and we are the first generation of people who have been bombarded with chemicals since the day that we were born. Once you get it you have it for life. I discovered it with Ultram. I was allergic to it but forced to take it for pain relief. Two years after discontinuation I still have the allergies.
Posted by katekite on May 26, 2002, at 20:45:08
In reply to Re: if I'd known then what I know now...., posted by kpo2002 on May 26, 2002, at 17:30:08
how long were you on it before it became a problem?
I was misdiagnosed BP II. I took neurontin for about 5 weeks before developing paresthesia (a burning sensation in my legs). Since I hadn't just started the drug, no one recommended stopping it -- in fact, they recommended taking additional ones (depakote, lamictal, gabatril). It made it worse. 6 weeks later, legs still burning, I got fed up and stopped everything. 24 hrs later the problem was gone. However, now every time I take any kind of sedating drug the problem returns.
No one can say yes or no whether it was the drug. It may simply have been an underlying problem that was un-masked, like MS. I will always wonder.
And, it turns out, I have ADD only (and a history of major depression). My depression and anxiety are most likely related to the frustration of living with ADD undiagnosed for 30 years. Adderall or ritalin make my life completely different, much more normal. Had I been properly evaluated it could have been found 10 years ago, 6 years ago, 4 years ago, 2 years ago, 1 year ago (the times I switched psychiatrists). All of them missed it because none of them actually evaluated me, they only asked what I thought was wrong -- and I said I felt frustrated, depressed, scared of social situations..... As soon as I presented a problem they medicated it. Rather than trying to find a cause for any of it.
So misdiagnosis can lead to serious consequences.
Only since the words MS, lupus and myasthenia came to me as possibilities, have I looked at the risks of these drugs. I always had assumed risks would be allergy (you either die or are fine, you just don't take it again) or problems that would stop when the drug was stopped (lethargy, nausea, etc). But risks can involve sensitivites that cross over to other medications or to your own organs.... or as in multiple chemical sensitivities to anything containing methyl groups or whatever it is for each individual person who develops a sensitivity.
So hopefully someone will read this thread who was leaning towards just swallowing the pills although they aren't quite sure of their diagnosis: maybe they really should do that complete psychological workup someone once recommended.
kate
Posted by JonW on May 27, 2002, at 7:53:36
In reply to if I'd known then what I know now...., posted by katekite on May 25, 2002, at 10:14:57
> Don't take drugs without a well proven diagnosis unless you're suicidal or risking harming others. Don't agree to a diagnosis because you want a diagnosis, agree to a diagnosis because it fits completely what you are. Try not to let wanting to please anyone or depression or anything else interfere with rationally assessing a diagnosis to see if it fits you.
Hi kate,
I agree and couldn't have said it better myself! I know that when I do research on the internet the symptoms I report to my doctor are sometimes colored by that. I go out of my way to try to be objective as possible, and remind my doctors that I've been looking up things on my own again. I think we all want to be diagnosed so badly because it means we're that much closer to a cure ("so that's why I'm still not better..."), or at the very least it makes us feel like we belong.
Jon
Posted by zach on May 27, 2002, at 11:49:20
In reply to Re: 4 Wks off Effexor-/joint pain » Janie, posted by Lynn V on March 17, 2001, at 22:51:46
Wow! Well... I've been on Effexor XR for nearly one year. It has helped significantly decrease the level as well as the frequency of my depressive episodes. I am concerned (very much so) about the joing pains. From the beginning I have noticed a tightening of the jaw muscles. I had to get a mouth guard for when I sleep. I also wake up most mornings with sore muscles in my forearms, which I presume is from clenching my hands. I did not have either of these problems before one year ago. Recently, I was diagnosed with tendonitis of the wrists as well as arthritis of the knees. I take aspirin, and it helps but does not cure. I am 27 years old, and a professional musician. I also am a competing martial arts practitioner. If I knew for certain that there was a corrolation between joint pain and Effexor XR I would have to rethink my decision to take it. I started Effexor as a response to the sexual side-effects of Celexa. By the way, I also have been diagnosed with prostatitis. It has also crossed my mind that Bactrim could be causing or agrivating joint pains. I can't help wondering what the relationship between the medications and the physical ailments is. I did bloodwork to test for Reiter's syndrome. My HLAB-27 was positive. Remember, I am only 27, and in excellent shape. I stretch daily before and usually after I excercise. If anyone has any information for me please email me at zachburd@yahoo.com. This is my personal spam-free email address. Please respect this, and keep me off all lists. Thank you. -Zach
Posted by katekite on May 27, 2002, at 11:49:26
In reply to Re: if I'd known then what I know now.... » katekite, posted by JonW on May 27, 2002, at 7:53:36
Hi Jon,
I wanted to have a diagnosis. I wanted to understand why depression didn't explain how hard life was and had always been. Post diagnosis there was infinite support available on the net. I told my parents and they stopped asking, finally, when was I going to get a job. They started asking if I was happy. All of that seemed so right at the time even though, for me, it was the wrong diagnosis.
I probably would still be on mood stabilizers if not for having to switch psychiatrists because the one I liked (because he was nice and friendly and sweet and returned my calls immediately) stopped private practice. The new one said he didn't know if he liked my diagnosis. By this point I was physically ill and he couldn't diagnose anything with someone physically ill. Eventually went off mood stabilizers and felt more normal. Stayed off everything for 3 months. Realized I had been actually worse on mood stabilizers than with nothing. Then started the hunt for the right diagnosis.
This time did lots of tests with me OFF meds. Correct diagnosis eventually resulted.
Advice: if you don't really understand your diagnoses do three things. One, think back to what you were like as a kid, then research what all these disorders look like in kids (include everything, aspergers and autism and learning disabilities, bipolar and personality disorders, separation anxiety, ODD, etc). What was your personality most like?
Secondly, talk it over with a doc, and aim to reduce your meds to the minimum that allows you to function and not be depressed or otherwise irrational, then take the MMPI and any other suitable tests to make sure nothing is being missed. Have a good friend evaluate you on a bunch of internet quizzes: we see ourselves differently than others.
Thirdly, get more than a normal medical workup: thyroid and regular bloodwork is the minimum, but early Cushing's, early Addison's, CFS, migraines (which don't even have to be headaches), etc could all contribute to mental problems. Why not find out? Do it all at least once in your life. Get an EEG. Get an MRI. If you can convince a doctor to do it it is most likely a good test for you. Don't get false hopes up, just decide to rule out everything physical.
Don't do what I did: don't get a diagnosis because you need one. Get a diagnosis (or two) that explains you completely.
kate
Posted by supergirl on May 27, 2002, at 13:51:48
In reply to Re: 4 Wks off Effexor-/joint pain, posted by zach on May 27, 2002, at 11:49:20
Since being on Effexor, I have been diagnosed with carpel tunnel and tendenitis in each wrist. I also have experience joint, back, pelvic, and muscle pain. My body sometimes feels like it has aged 40 years. I am only 22 and I sometimes can't do normal things because of the pain or stiffness. The only physical problem I had before I started taking effexor was arthritis in my knee. It seems that no matter how good of shape I'm in, I still hurt, even just to sit and stand. I recently had my back x-rayed and it was fine, and I've had bloodwork done that was normal. Is this related to Effexor? Where does this pain come from?
supergirl
Posted by Beauty on May 27, 2002, at 14:34:41
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Hi all, I just started taking Effexor XR 37.5 in the a.m. with food, with a sample my Dr. gave me. I've been taking Wellbutrin 150sr once a day for about 6 mos, and prior to that had been prescribed Elavil for several months for spastic colon. Have gained A LOT of weight in the last year on those regimes. Dr. made no mention of withdrawel side effects from Effexor, and I segued from Wellbutrin overnight. This is day 2, with no noticeable side affects other than the usual hard-to-go-to-sleep issue, which the Dr. had previously prescibed low dosage (and I split into 1/4s, so basically 12.5mg - almost placebo) trazadone, which did help a lot, but knocked me out so much, even at that low dosage, that I had a hard time swimming to the surface of consciousness in the morning, after taking it at night before bed. I finally discontinued the trazadone, but took it last night to get to sleep. Should I continue the Effexor, or call my MD and ask him about the potential side effects of withdrawel? I'm hoping this depression will resolve itself over time combined with therapy, but the weight gain isn't helping matters at all! Any suggestions? Thanks!
Posted by kpo2002 on May 27, 2002, at 20:14:29
In reply to wanting to have a diagnosis, posted by katekite on May 27, 2002, at 11:49:26
Some good advice here, better than you would get at most doctors. I agree that you have to research yourself very well to get a diagnosis, but in reality you probably have characteristics in more than one disorder so you wouldn't know what meds to take and in the end you are trying one thing after another. Looking into your past is so very helpful because what appears to be the symptoms may actually be a functional crutch to get you through life and may actually be masking the real problem. I was bulimic for 20 years because I could not get my parent's love and affection. Once I quit trying to get what was the impossible and told them off to no end (especially my father) I was able to get stabilized and off meds. They say depression is anger turned inwards. It took me 20 years to get up the guts and courage to tell my parents to fuck off! (whole new set of problems now, but at least I'm not a slave to the refrigerator and the toilet anymore) I found it most helpful to read books on personality (like 10 chapters, one devoted each to a different theory) and especially Existential Phenomenology. I have a degree in Psychology from Duquesne University in Pittsburgh, Pennsylvania and they have a different course of study. The personality class was at Chatham. When no one could fix me I fixed myself. So here we are fixing ourselves...
Posted by sid on May 27, 2002, at 21:26:55
In reply to New to Effexor XR - Do I want to continue?, posted by Beauty on May 27, 2002, at 14:34:41
It's too early to say I think. What if that's THE drug that permits you to finally heal? Give it a chance.
For withdrawal: Benadryl has been mentioned, as well as good old Prozac. You should talk to your doctor about it, to reassure yourself, but you should probably not switch drug in fear of what may or may not happen (not everybody suffers these effects) when you taper off. Just my opinion.
I've been on Effexor XR myseld, at 75mg per day, for 6 months today (Yippiii !), and I feel very good. I had not since I was 13, that's 21 years ago. I had dysthymia all this time, without knowing it, and I later developped a major depression. That's when I learned I had been dysthymic for years. Therapy has been good for me, mostly CBT, and acupuncture as well. I did fear the side effects of coming off of Effexor XR at the beginning, but now I think that I'll cross that bridge when I get to it. For now, the drug has made me remember what it's like to be alive, that's already darn good.- sid
Posted by supergirl on May 28, 2002, at 0:32:39
In reply to Re: New to Effexor XR - Do I want to continue? » Beauty, posted by sid on May 27, 2002, at 21:26:55
I am now taking prozac to get off of Effexor after being stuck on 75 mg. It seems to be helping. Scientifically it makes sense, too, it also is an SSRI. Effexor has a very short half life, which means it gets out of your system faster, which means if you have been on it long enough, you could go through withdrawal. Prozac has a half life a lot longer than Effexor, so it stays in your body longer, and therefore not usually as dificult to get off of. That is one of the things the makers of Effexor suggest to avoid withdrawal symptoms.
Posted by Allen F. on May 28, 2002, at 0:41:20
In reply to Re: New to Effexor XR - Do I want to continue?, posted by supergirl on May 28, 2002, at 0:32:39
What is the half-life of Effexor and Prozac? How much Prozac are you talking? Do you find it makes you nervous, sleepless, or affects you in other ways?
Thanks.
Posted by supergirl on May 28, 2002, at 3:09:42
In reply to Re: New to Effexor XR - Do I want to continue?, posted by Allen F. on May 28, 2002, at 0:41:20
I am only on 10 mg of Prozac, but I can up it or stop if I need to. I have noticed that I am a lot more energetic, sometimes too much, and it gives me a headache. The worst things that I'm experiencing from Prozac is forgetfullness and it sometimes feels that... and this is hard to explain without it seeming that its a hallucination, but I will sometimes swear that there is someone standing or sitting in a particular spot even though there is no one there.
I am not sure exactly what the half-lives are, I haven't come across the numbers.
supergirl
> What is the half-life of Effexor and Prozac? How much Prozac are you talking? Do you find it makes you nervous, sleepless, or affects you in other ways?
>
> Thanks.
Posted by sly on May 28, 2002, at 8:13:43
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I've been on Effexor for 5 weeks now and I'm happy to say the fog is starting to lift a little, yesterday I had my first good day in a long time. However, I am finding my lack of energy troubling.
I started taking Effexor at 6pm but it made my insomnia worse than ever! I switched to 2pm and my sleeping is definitely improving, I can actually fall asleep now and when I wake up in the middle of the night I can fall back asleep again no problem, this is a huge improvement for me. The problem is, I get tired much earlier, anytime around 4-5 pm I start feeling sleepy, by 8pm I'm completely exhausted and can't wait to crawl into bed. I'm afraid to move my meds up any earlier for fear I'll fall asleep at my desk (I'm having enough problems at work).
Does anyone have any suggestions?
Posted by kickink on May 28, 2002, at 13:49:06
In reply to Re: New to Effexor XR - Do I want to continue?, posted by supergirl on May 28, 2002, at 0:32:39
> I am now taking prozac to get off of Effexor after being stuck on 75 mg. It seems to be helping. Scientifically it makes sense, too, it also is an SSRI. Effexor has a very short half life, which means it gets out of your system faster, which means if you have been on it long enough, you could go through withdrawal. Prozac has a half life a lot longer than Effexor, so it stays in your body longer, and therefore not usually as dificult to get off of. That is one of the things the makers of Effexor suggest to avoid withdrawal symptoms.
I also am on Prozac now. I HAD to take it due to the HoRRENDOUS withdrawal, head buzzing, zings, severe mood swings, just to name a few. I WARN everyone to stay AWAY from Effexor unless it is your last resort. Once you get on, ity's hard to get off.
Posted by DJT on May 28, 2002, at 15:32:36
In reply to Re: Please help! » gare, posted by Sherrie on May 14, 2002, at 20:55:03
Hi all
Just started taking effexor XR, 37.5 mg once a day. Doc says 37.5 for three days, 75 for the next three, and, uh, 112.5 after that and then we'll see.
I'm on day three. So far the side effects are heavy drowsiness, feeling overly cold or hot, difficulty ejaculating (but not becoming erect), a little nausea (but I already have irritable bowel syndrome), anything painful seems intensified, unrestful sleep, some panic, dry mouth, and absolutely no appetite. In the last week, I've lost five pounds, which is kind of scary because I'm only 130 right now.
My psychiatrist says 90% of people who take effexor have no lasting side effects, and websites I have read (check medscape.com - it's really good) say only 19% of people stop taking it because of side effects. So why is it that there are so many negative comments on this board? Is it because many of you are more difficult cases than average?
I only ask this because almost everything else I have read was positive and made me feel less anxious about taking effexor. Then I get to this board and most people seem to not like it much.
I have to say typing this up makes me feel better somehow... like sharing, I guess!
Posted by renelso1 on May 28, 2002, at 16:04:52
In reply to just started, posted by DJT on May 28, 2002, at 15:32:36
I know, this board does seem negative, but mostly it is the withdrawal, not the actual side effects. I've been on effexor for 5 weeks now (150mg) and i don't know that i have any side effects remaining except maybe constipation (which is great for me anyhow since i have IBS). the first week was horrid. i felt like i had the flu and everything hurt. after that things gradually improved. After you have been on it for a few weeks i would recommend adjusting the time of day you take it - that seemed to really help with my sleep. don't give up! and remember, everyone is different. and also, people aren't as urged to write if things are going well. it's a lot easier to jump online and complain cos that's when people are thinking about it. i don't know. anyhow, good luck!!
rox.
Posted by JANNBEAU on May 28, 2002, at 16:25:09
In reply to Re: New to Effexor XR - Do I want to continue?, posted by Allen F. on May 28, 2002, at 0:41:20
> What is the half-life of Effexor and Prozac?
>
> Thanks.Allen, found the following, along with other info at:
http://www.socialaudit.org.uk/330withd.htm
This is a UK site, so references NHS, etc.
Generic Name Brand Name Half-lifeFluvoxamine: Faverin/Luvox) 17-22 hours
Fluoxetine Prozac 4-16 days
Sertraline Zoloft 22-36 hours
Paroxetine Paxil 21 hours, variable
Venlafaxine Effexor 5-11 hours
Citalopram Cipramil 1.5 days
Nefazodone Serzone Up to 24 hoursHope this is helpful to you.
Jannbeau
Posted by DJT on May 28, 2002, at 16:29:01
In reply to Re: just started, posted by renelso1 on May 28, 2002, at 16:04:52
Rox... any improvement in your IBS with the effexor other than less constipation? My stomach/intestines are all "bubbly" - do you take anything for the IBS, even over the counter?
Posted by kpo 2002 on May 28, 2002, at 21:33:04
In reply to Re: Effexor XR cold turkey, posted by ZeKingPrawn on January 5, 2002, at 17:33:57
I cold turkeyed off effexor xr with no withdrawal symptoms whatsoever, however I was on a very low dose, 37.5, and I had only been on it for 7 weeks.
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