![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 424 to 448 of 735. Go back in thread:
Posted by Dave001 on September 24, 2004, at 17:56:41
In reply to Re: please be civil » Dave001 » Bubblehead, posted by Dr. Bob on September 22, 2004, at 16:35:20
<snip>
> > You are just the type of person I do not want working for these pharmacy companies. All you see is the growth for the drugs and not the damage of the people being used as guinea pigs.
> >
> > Bubblehead
>
> Please don't jump to conclusions about others or post anything that could lead them to feel accused or put down.I apologize for not redirecting this post to administration, but I am concerned that other members of this thread will not see it if I were to do so.
I want to make it clear that I would prefer that people not feel like they're walking on egg shells when posting to me, so if there is any way for you to "exempt" those whom you feel are being uncivilized toward me from suspension, it would be nice. I would hate for anyone to get suspended on account of giving it to me straight what is their mind. I am not offended by comments like the above at all, although critism that challenges one's ideas is more productive and thought-provoking.
Dave
Posted by kananee on September 24, 2004, at 21:00:51
In reply to Re: Effexor -tapering Q, posted by Dave001 on September 24, 2004, at 17:33:48
Hmmmmm.....I wanted to ask the same question. Why one might think Dave has a connection with Wyeth seems reasonable given the content and tone of his first two posts. I guess I'm also wondering -- given Dave's point of view and the amazing statement that he had no withdrawal symptoms -- why he would post on a board that's all about Effexor's horrible withdrawal symptoms
> > I'm curious, Dave. Do you work for Wyeth?
>
> Heavens no. Why do you ask?
>
> Dave
>
> <snip>
Posted by Dave001 on September 25, 2004, at 17:40:23
In reply to Re: Effexor -tapering Q » Dave001, posted by kananee on September 24, 2004, at 21:00:51
> Hmmmmm.....I wanted to ask the same question. Why one might think Dave has a connection with Wyeth seems reasonable given the content and tone of his first two posts. I guess I'm also wondering -- given Dave's point of view and the amazing statement that he had no withdrawal symptoms -- why he would post on a board that's all about Effexor's horrible withdrawal symptoms
1.) Look at my posting history.
2.) There is no correlation between Wyeth stock prices and Effexor posts at dr-bob.org.
3.) It would be the world's most inefficient marketing strategy.
4.) Law of the vocal minority, and absent majority dictates that those whom experience unusually bad side-effects or withdrawal from Effexor are most likely to complain about unusually bad side-effects or withdrawal from Effexor than those who did not experience adverse effects -- at least not to nearly the same magnitude. This isn't a new phenomenon; just look at the number of anti [insert drug name/class] web sites. You have your "Prozac survivors," your anti-benzo, anti-stimulant, anti-Effexor, and anti-GHB groups; the list goes on an on... Extrapolating statistics from only one cohort does not produce objective results.
Posted by dbh on September 25, 2004, at 19:22:11
In reply to Re: Effexor -tapering Q » kananee, posted by Dave001 on September 25, 2004, at 17:40:23
In item #4 you imply that the majority of those who stop taking Effexor do NOT experience side-effects. I hope this is true, and that I am among the majority who don't. I hope to start weaning myself off 75mg per day Effexor XR this next week, after consulting with my family physician.
Posted by Jiggitykid on September 25, 2004, at 19:25:52
In reply to Re: Effexor -tapering Q, posted by dbh on September 25, 2004, at 19:22:11
I hope you are one who doesn't. Please post and let us know.
> In item #4 you imply that the majority of those who stop taking Effexor do NOT experience side-effects. I hope this is true, and that I am among the majority who don't. I hope to start weaning myself off 75mg per day Effexor XR this next week, after consulting with my family physician.
Posted by Jiggitykid on September 25, 2004, at 19:42:16
In reply to Re: Effexor -tapering Q » kananee, posted by Dave001 on September 25, 2004, at 17:40:23
No one has brought up stock prices. It was mentioned, first by me, because you seem so ready to defend the drug. Also, how do you know that those who experience this awful withdrawal are indeed, a minority? Do you have proof of that? Do you have proof that the majority of people who take it have no problems? Or perhaps, could it be that most folks think they have a month-long flu or are having heart or neurological problems, like so many of us were told by physicians, until we came here and connected the dots? What makes people who have struggled or are struggling through this so angry and hurt (and unless you have been there, you CANNOT know or even begin to sympathize) is the patronizing tone of the posts, whether intended or not. Perhaps you truly are here to show both sides of the issue, but the feeling those of us who have been to hell and back get is that you are saying, "Hush now, your experience isn't all that important, so shut up."
Odds are you are a very nice person and are not intending to express this, but this is exactly how it is coming across. Your posts make it sound as if those of us who are trying to 1)heal, 2)share experiences and 3) help others through this horrible withdrawal are nothing but big babies who won't take responsibility for our lives. Sir, that is so far from the truth. Needing treatment for depression can be a touchy subject because of the social stigma of any kind of mental illness, but to have someone come in and imply that we are hot-headed, immature whiners who blame others for our problems is nothing short of spitting in our faces. Can you see why your posts stir up so much anger?
Because of my personal experience and my desire that no one else suffer the way I did, of course I'd like to see the drug at the bottom of the ocean. But practically, I do realize that for some, and in my mind a MINORITY, it does work, and taking it off the market isn't the right idea. What I want, and what the petition says, is for the drug company to reveal the information about the addictive properties of the drug and the withdrawal that it can/does cause. Funny how asking for a corporation to TAKE RESPONSIBILITY for something that it does/produces seems to illicit a response that we are not taking responsibility for our lives.
Would we be here, sharing information and supporting each other, if we weren't responsible? Would we be trying to encourage others to get well and sharing how we are healing if we weren't responsible? You know nothing about our lives, and to imply what your original post in response to the class-action post did (which was more than imply, you stated) is insulting. You requested immunity for those who answered your questions about your post; I can only hope that applies to me. You asked for the truth - you have it.
> > Hmmmmm.....I wanted to ask the same question. Why one might think Dave has a connection with Wyeth seems reasonable given the content and tone of his first two posts. I guess I'm also wondering -- given Dave's point of view and the amazing statement that he had no withdrawal symptoms -- why he would post on a board that's all about Effexor's horrible withdrawal symptoms
>
> 1.) Look at my posting history.
> 2.) There is no correlation between Wyeth stock prices and Effexor posts at dr-bob.org.
> 3.) It would be the world's most inefficient marketing strategy.
> 4.) Law of the vocal minority, and absent majority dictates that those whom experience unusually bad side-effects or withdrawal from Effexor are most likely to complain about unusually bad side-effects or withdrawal from Effexor than those who did not experience adverse effects -- at least not to nearly the same magnitude. This isn't a new phenomenon; just look at the number of anti [insert drug name/class] web sites. You have your "Prozac survivors," your anti-benzo, anti-stimulant, anti-Effexor, and anti-GHB groups; the list goes on an on... Extrapolating statistics from only one cohort does not produce objective results.
Posted by kananee on September 25, 2004, at 22:06:33
In reply to Re: Effexor -tapering Q » Dave001, posted by Jiggitykid on September 25, 2004, at 19:42:16
Well said, as usual, Jiggitykid. Excellent, in fact, as well as rational. Often I thiink of you as the soul of this board . . .
Posted by Bubblehead on September 26, 2004, at 9:46:10
In reply to Re: Effexor -tapering Q » Dave001, posted by Jiggitykid on September 25, 2004, at 19:42:16
Thank you Jiggitykid for writing what's in many of our hearts about this issue.
Posted by Dr. Bob on September 26, 2004, at 19:22:24
In reply to Re: please be civil, posted by Dave001 on September 24, 2004, at 17:56:41
> I want to make it clear that I would prefer that people not feel like they're walking on egg shells when posting to me, so if there is any way for you to "exempt" those whom you feel are being uncivilized toward me from suspension, it would be nice.
Thanks for being so accepting, but I'm afraid that if people could be uncivil to you, they might think they could be uncivil to others.
Bob
Posted by Dr. Bob on September 26, 2004, at 19:32:07
In reply to Re: Effexor -tapering Q » Dave001, posted by Jiggitykid on September 25, 2004, at 19:42:16
> the patronizing tone of the posts
>
> to imply what your original post ... did ... is insulting.Please don't post anything that could lead others to feel accused.
I've asked you to be civil before, so now I'm going to block you from posting for a week.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by Dave001 on September 26, 2004, at 23:30:02
In reply to Re: Effexor -tapering Q » Dave001, posted by Jiggitykid on September 25, 2004, at 19:42:16
> No one has brought up stock prices. It was mentioned, first by me, because you seem so ready to defend the drug. Also, how do you know that those who experience this awful withdrawal are indeed, a minority? Do you have proof of that? Do you have proof that the majority of people who take it have no problems? Or perhaps, could it be that most folks think they have a month-long flu or are having heart or neurological problems, like so many of us were told by physicians, until we came here and connected the dots? What makes people who have struggled or are struggling through this so angry and hurt (and unless you have been there, you CANNOT know or even begin to sympathize) is the patronizing tone of the posts, whether intended or not. Perhaps you truly are here to show both sides of the issue, but the feeling those of us who have been to hell and back get is that you are saying, "Hush now, your experience isn't all that important, so shut up."
>I'm sorry if it feels that way. In reality, though, all I said was that frivilous lawsuits hurt us all in the long run, and that I did not think that the reported withdrawal symptoms from Effexor -- however unpleasant they may be, are evidence of negligence. I am defending the rights of patients and doctors to use any medication necessary to combat depression. Doctors are already very reluctant to prescribe many classes of medication for fear of malpractice suits, and creating new legal battles as you describe only contributes to this fear. Also, have you considered how a fear-mongering attitude toward Effexor might steer away folks who could really benefit from it?
Anyway, this is my last post to this thread. I am sorry that you got suspended for your post. I didn't see anything uncivil about it.
Dave
Posted by AIK on September 27, 2004, at 16:17:09
In reply to Re: Effexor -tapering Q, posted by Dave001 on September 24, 2004, at 0:37:39
In response to the post below regarding dissolving the Effexor XR capsules in water or another solvent, please, any of you tapering down, do not do this unless you ask your doctor or pharmacist (someone who has expertise in this area). In refuting Dave's recommendation I have following input.
1. The contents of the capsule will not dissolve in water. It is formulated to dissolve at various pH levels throughout the GI tract. This is done in order to provide an extended release action.
2. Even if you are able to find a suitable solvent, you would be changing from the extended release action to an immediate release dose of Effexor. Changing dosage forms should never be done without the supervision and recommendation of a health professional.
It is unfortunate that this site has become a pissing contest for us that are looking for support with others during our experiences with the drug Effexor, whether it being the usage or it's withdrawal symtoms.
I am fortunate to say that since I logged on to this site a few weeks ago I have gained more knowledge and support from the same withdrawal symtoms I experienced (because I thought I had contracted a virus, infection, whatever) to find out it was the improper stoppage of the Effexor. I am also happy to say that since I have properly decreased by dosage slowly, I had the most energetic weekend that I can remember. We are on this site to support, share, and be there for one another. I don't want to sound disrespectful Dr.
Bob, "but you knocked off the wrong the person". I would appreciate it if you would post this message, at your discretion of course, so others will not attempt to concoct the "XR capsule recipe" into a tapering down formulation. This is not the place for a lay person to reformulate Effexor. I was under the assuption that this was a support group..like I said before, you knocked off the wrong person.
> > I have read a lot of posts about tapering and "cutting the pills". My effexor is in caplets (I think...plastic containers with little particles inside them). Is there some way to open these up and separate the contents? I have a whole bunch of 75mg that I am supposed to start next week, but I would rather stick to 37.5 for a while (what I am on now). Is it ok to dissolve the effexor in water or mix it in food or something instead of just taking the whole capsule?
>
> If I were concerned about withdrawal from Effexor, this is what I would do: check a recent copy of the Merck Index to find out the solubility of venlafaxine. Choose an appropriate solvent and dissolve the contents of the capsules into a solution from which you can easily measure precise
> amounts. By using a lot of solvent, you could make it easy to dispense doses with a reasonable accuracy of +/- 1/mg. I would probably fill a 100 ml graduated cylinder with the solution, and then use that to prefill syringes (you can get oral syringes from the supermarket) with the desired amounts for each day. For obvious reasons the most you would need per day in a solution would be < 37.5 mg if you have 37.5 mg caps, or < 75 mg if you have 75 mg caps. Don't know the stability of venlafaxine but you should refrigerate the solution, and preferably use something other than water.
>
> I doubt you would notice any withdrawal symptoms if you reduced the dose by 1 mg/day. If there's no pressing need to discontinue the drug, why not? :-)
>
> Dave
Posted by Dave001 on September 27, 2004, at 18:56:47
In reply to Re: Effexor -tapering Q, posted by AIK on September 27, 2004, at 16:17:09
> In response to the post below regarding dissolving the Effexor XR capsules in water or another solvent, please, any of you tapering down, do not do this unless you ask your doctor or pharmacist (someone who has expertise in this area). In refuting Dave's recommendation I have following input.
> 1. The contents of the capsule will not dissolve in water. It is formulated to dissolve at various pH levels throughout the GI tract. This is done in order to provide an extended release action.Wrong! Actually, I never said to dissolve in water. I said to check the Merck Index for solubility data, and specifically recommended *against* using water. However, seeing as how you've made the claim that it will *not* dissolve in water, I feel the need to correct your misinformation.
I just grabbed my copy of the Merck Index and have it right here in front of me, and it states the solubility of venlafaxine HCl is 572 mg/ml in water! And its partition coefficient is 0.43 (octanol/water). Not only will it dissolve in water, its water solubility is so high that I retract my original statement and actually *recommend* using water as the solvent. Just be sure to keep it refrigerated and don't dissolve too many days worth at once. Also, use distilled water; don't use tap.
> 2. Even if you are able to find a suitable solvent, you would be changing from the extended release action to an immediate release dose of Effexor. Changing dosage forms should never be done without the supervision and recommendation of a health professional.I think the intelligence of the OP is high enough to realize that dissolving (dissociating the drug into individual *molecules*) the Effexor will destroy the integrity of the extended release formulation! Sheesh! :-) Obviously, you just take several smaller doses spread out to maintain a consistent level.
I am by no means suggesting this is a convenient or even desirable method of tapering, but if the withdrawal effects are *that* bad, then it would certainly seem worth it to me.
Dave
<snip>
Posted by AIK on September 28, 2004, at 9:43:01
In reply to Re: Effexor -tapering Q, posted by Dave001 on September 27, 2004, at 18:56:47
You are right. I am wrong. The spheroids are not ph dependent. Would they be time dependent however? (for those of you who are following us, we are referring to the white balls inside the capsule). This has created some interest and experimentation on my part (like I don't have enough to do). Support group, this has nothing to do with ingesting the drug...don't attempt it at this point. In fact, Dave did say earlier that it may be an alternative to tapering with capsules, but doesn't recommend it. I think he has raised the hair on the back of our necks when he minimizes our physical and mental pain. Also using asterisks when he refers to "if the withdrawal effects are *that* bad". Yes, it is *that* bad for these readers or they wouldn't be on this site. Dave has contributed a good part to this as well. It has raised our awareness that playing around with dosage changes or altering dosage forms, (tablets/capsules in this case) other than what was prescribed for YOU without supervision, is not acceptable. You could wind up being more of a mess than when you started. To my support group I'd like to add that I'm on my 6th day of a dosage decrease and I haven't experienced throwing up or dizziness (like I did initially), and the mood swings have lessened as well. Just get these bursts of energy. In fact, on Saturday, it was non-stop. Upon awakening, I got cleaned up and dressed and motored the entire day. The "old me" would shuffle to the kitchen and perch somewhere (kitchen, sofa, desk) and remain there as the day passed by. Day after day. That's when I was on the drug. (To refresh your memory, I was put on this for pain, not anxiety; it didn't do "squat" for my pain...was I that brain-dead not to have realized this sooner?)OK folks, have a good one and a better one tomorrow. I'm here if you need to talk.
> > In response to the post below regarding dissolving the Effexor XR capsules in water or another solvent, please, any of you tapering down, do not do this unless you ask your doctor or pharmacist (someone who has expertise in this area). In refuting Dave's recommendation I have following input.
> > 1. The contents of the capsule will not dissolve in water. It is formulated to dissolve at various pH levels throughout the GI tract. This is done in order to provide an extended release action.
>
> Wrong! Actually, I never said to dissolve in water. I said to check the Merck Index for solubility data, and specifically recommended *against* using water. However, seeing as how you've made the claim that it will *not* dissolve in water, I feel the need to correct your misinformation.
>
> I just grabbed my copy of the Merck Index and have it right here in front of me, and it states the solubility of venlafaxine HCl is 572 mg/ml in water! And its partition coefficient is 0.43 (octanol/water). Not only will it dissolve in water, its water solubility is so high that I retract my original statement and actually *recommend* using water as the solvent. Just be sure to keep it refrigerated and don't dissolve too many days worth at once. Also, use distilled water; don't use tap.
>
>
> > 2. Even if you are able to find a suitable solvent, you would be changing from the extended release action to an immediate release dose of Effexor. Changing dosage forms should never be done without the supervision and recommendation of a health professional.
>
> I think the intelligence of the OP is high enough to realize that dissolving (dissociating the drug into individual *molecules*) the Effexor will destroy the integrity of the extended release formulation! Sheesh! :-) Obviously, you just take several smaller doses spread out to maintain a consistent level.
>
> I am by no means suggesting this is a convenient or even desirable method of tapering, but if the withdrawal effects are *that* bad, then it would certainly seem worth it to me.
>
> Dave
>
> <snip>
Posted by dbh on September 28, 2004, at 13:20:52
In reply to Re: Effexor -tapering Q, posted by AIK on September 28, 2004, at 9:43:01
AIK, that was an incredibly "lucid" post. I'm serious, that was a joy to read. It went right to the heart of the matter, IMO.
I started my own "tapering" process yesterday, stepping down from my normal 75mg XR to 37.5. My doctor (a GP), first suggested going to 37.5 for "a week or two" and then stopping completely. I said I would be more comfortable tapering off more slowly than that, so he then suggested alternating 75 and 37.5, then going to 37.5, then taking 37.5 every other day. How long I stayed at each level he left up to me. He gave me a box of 37.5 capsules plus a script for another 30. He then said he would see me in 6 weeks. :-/
So, here I am, "on my own" for the next 6 weeks, left to my own devices for deciding how much to take and for how many days.
I am going to follow his original advice and drop straight to 37.5 and just see how that goes. If it goes real easy, I might stay there for only two weeks. If it goes real bad, I will start alternating 37.5 and 75, although I am concerned about a possible "roller coaster" effect. I have read where the "half-life" of venlafaxine (Effexor) is only like 5 hours, but I don't know about the XR (timed release) version. So my concern is that by alternating dosages, my body could get even more screwed up than purely reducing the dosage.
In other words, this feels like a chemistry experiment.
So far (this is just the beginning of my second day at 37.5) I have had no strong symptoms. I have had MAYBE some mild symptoms, but so far nothing worth mentioning.
BTW, I tend to post a LOT, so if there is a more "appropriate" place for me to post, such as a new thread, please let me know.
David
Posted by AIK on September 28, 2004, at 13:49:47
In reply to Beginning my tapering off, posted by dbh on September 28, 2004, at 13:20:52
Call or better yet, go talk to your pharmacist and he/she will give that information to you as far as "half-life" of the drug and other questions you may have. If you do mail order for your medication, you may not get the response in a timely manner and have that "one on one" thing going on as you would face to face. If you can get through the next few days without getting severely ill with what your doctor told you to do, that would be great. Only your body, not mine or anyone else's, will determine it's own reactions, if any (please be one of the fortunate ones!).
> AIK, that was an incredibly "lucid" post. I'm serious, that was a joy to read. It went right to the heart of the matter, IMO.
>
> I started my own "tapering" process yesterday, stepping down from my normal 75mg XR to 37.5. My doctor (a GP), first suggested going to 37.5 for "a week or two" and then stopping completely. I said I would be more comfortable tapering off more slowly than that, so he then suggested alternating 75 and 37.5, then going to 37.5, then taking 37.5 every other day. How long I stayed at each level he left up to me. He gave me a box of 37.5 capsules plus a script for another 30. He then said he would see me in 6 weeks. :-/
>
> So, here I am, "on my own" for the next 6 weeks, left to my own devices for deciding how much to take and for how many days.
>
> I am going to follow his original advice and drop straight to 37.5 and just see how that goes. If it goes real easy, I might stay there for only two weeks. If it goes real bad, I will start alternating 37.5 and 75, although I am concerned about a possible "roller coaster" effect. I have read where the "half-life" of venlafaxine (Effexor) is only like 5 hours, but I don't know about the XR (timed release) version. So my concern is that by alternating dosages, my body could get even more screwed up than purely reducing the dosage.
>
> In other words, this feels like a chemistry experiment.
>
> So far (this is just the beginning of my second day at 37.5) I have had no strong symptoms. I have had MAYBE some mild symptoms, but so far nothing worth mentioning.
>
> BTW, I tend to post a LOT, so if there is a more "appropriate" place for me to post, such as a new thread, please let me know.
>
> David
Posted by Dave001 on September 28, 2004, at 13:52:48
In reply to Re: Effexor -tapering Q, posted by AIK on September 28, 2004, at 9:43:01
> You are right. I am wrong. The spheroids are not ph dependent. Would they be time dependent however? (for those of you who are following us, we are referring to the white balls inside the capsule). This has created some interest and
I don't know anything about the specifics of how the extended release preparation was designed. The entire issue becomes obsolete once you're dissolving things.
> experimentation on my part (like I don't have enough to do). Support group, this has nothing to do with ingesting the drug...don't attempt it at this point. In fact, Dave did say earlier that it may be an alternative to tapering with capsules, but doesn't recommend it. I think he has raised the hair on the back of our necks when he minimizes our physical and mental pain. Also using asterisks when he refers to "if the withdrawal effects are *that* bad". Yes, it is *that* bad for these readers or they wouldn't be on this site.
Nothing I said was intended to minimize anyone's pain. I've already said that, but I guess it's not enough. Yes, I used asterisks when I said, "if the withdrawal effects are *that* bad." That just means what it says: if they are *that* bad for *you*. Some people don't find the withdrawal that big of a deal; others have a lot of difficulty. It varies. For someone not having great difficulty tapering the conventional way, it probably wouldn't be worth the hassle to fiddle with the capsules. That's all that was meant. The OP didn't indicate having a problem with tapering; IIRC, she had not yet even begun the process.
> Dave has contributed a good part to this as well. It has raised our awareness that playing around with dosage changes or altering dosage forms, (tablets/capsules in this case) other than what was prescribed for YOU without supervision, is not acceptable. You could wind up being more of
Not acceptable to whom? I assume we are all adults here. I think it is the individual's choice whether to ask their doctor for "permission," which they will not receive, to reduce the dose in the manner described. A compounding pharmacist whom has specifically prepared custom Effexor formulations would likely know more about this than your doctor.
Dave
<snip>
Posted by AIK on September 28, 2004, at 14:10:35
In reply to Re: Effexor -tapering Q, posted by Dave001 on September 28, 2004, at 13:52:48
Amen to that Dave. A compounding pharmacist is the way to go as far as knowledge in reformulation of drugs. (Finding a doctor that works along with the pharmacist for an individual's special needs are hard to come by).
> > You are right. I am wrong. The spheroids are not ph dependent. Would they be time dependent however? (for those of you who are following us, we are referring to the white balls inside the capsule). This has created some interest and
>
> I don't know anything about the specifics of how the extended release preparation was designed. The entire issue becomes obsolete once you're dissolving things.
>
> > experimentation on my part (like I don't have enough to do). Support group, this has nothing to do with ingesting the drug...don't attempt it at this point. In fact, Dave did say earlier that it may be an alternative to tapering with capsules, but doesn't recommend it. I think he has raised the hair on the back of our necks when he minimizes our physical and mental pain. Also using asterisks when he refers to "if the withdrawal effects are *that* bad". Yes, it is *that* bad for these readers or they wouldn't be on this site.
>
> Nothing I said was intended to minimize anyone's pain. I've already said that, but I guess it's not enough. Yes, I used asterisks when I said, "if the withdrawal effects are *that* bad." That just means what it says: if they are *that* bad for *you*. Some people don't find the withdrawal that big of a deal; others have a lot of difficulty. It varies. For someone not having great difficulty tapering the conventional way, it probably wouldn't be worth the hassle to fiddle with the capsules. That's all that was meant. The OP didn't indicate having a problem with tapering; IIRC, she had not yet even begun the process.
>
> > Dave has contributed a good part to this as well. It has raised our awareness that playing around with dosage changes or altering dosage forms, (tablets/capsules in this case) other than what was prescribed for YOU without supervision, is not acceptable. You could wind up being more of
>
> Not acceptable to whom? I assume we are all adults here. I think it is the individual's choice whether to ask their doctor for "permission," which they will not receive, to reduce the dose in the manner described. A compounding pharmacist whom has specifically prepared custom Effexor formulations would likely know more about this than your doctor.
>
> Dave
>
> <snip>
Posted by Dave001 on September 28, 2004, at 14:16:56
In reply to Beginning my tapering off, posted by dbh on September 28, 2004, at 13:20:52
> AIK, that was an incredibly "lucid" post. I'm serious, that was a joy to read. It went right to the heart of the matter, IMO.
>
> I started my own "tapering" process yesterday, stepping down from my normal 75mg XR to 37.5. My doctor (a GP), first suggested going to 37.5 for "a week or two" and then stopping completely. I said I would be more comfortable tapering off more slowly than that, so he then suggested alternating 75 and 37.5, then going to 37.5, then taking 37.5 every other day. How long I stayed at each level he left up to me. He gave me a box of 37.5 capsules plus a script for another 30. He then said he would see me in 6 weeks. :-/
>
> So, here I am, "on my own" for the next 6 weeks, left to my own devices for deciding how much to take and for how many days.
>
> I am going to follow his original advice and drop straight to 37.5 and just see how that goes. If it goes real easy, I might stay there for only two weeks. If it goes real bad, I will start alternating 37.5 and 75, although I am concerned about a possible "roller coaster" effect. I have read where the "half-life" of venlafaxine (Effexor) is only like 5 hours, but I don't know about the XR (timed release) version. So my concern is that by alternating dosages, my body could get even more screwed up than purely reducing the dosage.
>
> In other words, this feels like a chemistry experiment.
>
> So far (this is just the beginning of my second day at 37.5) I have had no strong symptoms. I have had MAYBE some mild symptoms, but so far nothing worth mentioning.You could alternatively try taking 37.5 mg every 16 hours for an even smoother effect than alternating between 37.5 and 75 mg, but there would not likely be any noticable difference.
You are on a very low dose, and I would be shocked if you noticed any significant withdrawal effects. I really think that all these horror stories being posted are likely to do more harm than good, since they can set one up psychologically to expect an unrealistic and horrific response, in effect creating an adverse placebo effect. I don't see how that can rightfully be called "support." If you have a bad withdrawal reaction, certainly don't be ashamed of it or hesitant to post your experience, but don't needlessly set yourself up to experience one either. Many people have been on and off Effexor at doses over 5-fold greater than yours with minimal trouble discontinuing, so try not to worry or think about it too much.
Dave
Posted by AIK on September 28, 2004, at 14:42:21
In reply to Re: Effexor -tapering Q, posted by Dave001 on September 28, 2004, at 13:52:48
Forgot to add to Dave's response to me (AIK),that his statement "getting a doctor's "permission" which you won't get" (referring to tapering) is probably 100% correct.
> > You are right. I am wrong. The spheroids are not ph dependent. Would they be time dependent however? (for those of you who are following us, we are referring to the white balls inside the capsule). This has created some interest and
>
> I don't know anything about the specifics of how the extended release preparation was designed. The entire issue becomes obsolete once you're dissolving things.
>
> > experimentation on my part (like I don't have enough to do). Support group, this has nothing to do with ingesting the drug...don't attempt it at this point. In fact, Dave did say earlier that it may be an alternative to tapering with capsules, but doesn't recommend it. I think he has raised the hair on the back of our necks when he minimizes our physical and mental pain. Also using asterisks when he refers to "if the withdrawal effects are *that* bad". Yes, it is *that* bad for these readers or they wouldn't be on this site.
>
> Nothing I said was intended to minimize anyone's pain. I've already said that, but I guess it's not enough. Yes, I used asterisks when I said, "if the withdrawal effects are *that* bad." That just means what it says: if they are *that* bad for *you*. Some people don't find the withdrawal that big of a deal; others have a lot of difficulty. It varies. For someone not having great difficulty tapering the conventional way, it probably wouldn't be worth the hassle to fiddle with the capsules. That's all that was meant. The OP didn't indicate having a problem with tapering; IIRC, she had not yet even begun the process.
>
> > Dave has contributed a good part to this as well. It has raised our awareness that playing around with dosage changes or altering dosage forms, (tablets/capsules in this case) other than what was prescribed for YOU without supervision, is not acceptable. You could wind up being more of
>
> Not acceptable to whom? I assume we are all adults here. I think it is the individual's choice whether to ask their doctor for "permission," which they will not receive, to reduce the dose in the manner described. A compounding pharmacist whom has specifically prepared custom Effexor formulations would likely know more about this than your doctor.
>
> Dave
>
> <snip>
Posted by Bubblehead on September 28, 2004, at 20:51:42
In reply to Re: Effexor -tapering Q, posted by Dave001 on September 28, 2004, at 13:52:48
> I think it is the individual's choice whether to ask their doctor for "permission," which
they will not receive, to reduce the dose in the manner described. A compounding
pharmacist whom has specifically prepared custom Effexor formulations would likely
know more about this than your doctor.>
Sorry Dave, but I've got to disagree with ya here. I did not even ask my doctor to do this
(mixing the stuff in water) and guess what? Yep, He told me to. Actually he told me to
just dump out half of the capsule and take it that way. After reading what you all have
said about this; it makes me wonder what kind of ding-dong I was going to. See Dave,
this is what I was trying to express before. These Doctor's are not educated on the meds
and we are the ones paying the price for thier ignorance.
>> experimentation on my part (like I don't have enough to do). Support group, this has
nothing to do with ingesting the drug...don't attempt it at this point. In fact, Dave did say
earlier that it may be an alternative to tapering with capsules, but doesn't recommend it. I
think he has raised the hair on the back of our necks when he minimizes our physical and
mental pain. Also using asterisks when he refers to "if the withdrawal effects are *that*
bad". Yes, it is *that* bad for these readers or they wouldn't be on this site.>Nothing I said was intended to minimize anyone's pain. I've already said that, but I guess
it's not enough. Yes, I used asterisks when I said, "if the withdrawal effects are *that*
bad." That just means what it says: if they are *that* bad for *you*. Some people don't
find the withdrawal that big of a deal; others have a lot of difficulty. It varies. For someone
not having great difficulty tapering the conventional way, it probably wouldn't be worth
the hassle to fiddle with the capsules. That's all that was meant. The OP didn't indicate
having a problem with tapering; IIRC, she had not yet even begun the process.<
Oh my Dave, I think we all have seen the worst in you without even noticing the good. I
think your post about the withdrawl and the need to sue has given you a bad reputation.
Don't be confused, I am still in disagreement with you about this; but from reading your
prior posts I see where you are coming from. Let me see if I have this right. You feel that
by sueing the Drug company we are saying that there will be an end to them finding great
cures and helps for the others that need it in the world. Is that it? If I am right, let me just
say that, that is not our intentions. Have you seen what has been going on lately with the
Effexor? Children and young kids are killing themselves not only from the withdrawl but
some are doing it just from taking the meds. Now I don't know if you have kids, but I do
and I will do anything, I mean "ANYTHING" within my power to protect them. If my
child killed himself from taking this medicine and the company that produces the drug had
knowledge of its effects, I sure as heck am not going to stand by and take a slap on the
cheek. I assume you are trying to, for the drug companies, protect the rights to develop
new things by saying we should not sue. But like you we also are trying to protect. By
sueing we are protecting ourselves, others, and children most of all; from ever having to
suffer like this again. Do you understand what I am saying?Anyhow, I think we all need to agree to disagree and move on. We need to get back to
supporting one another through these hard times. Yes Dave, they really are hard. I
wanted to kill myself last night but couldn't because I have to much resposibilty to others
(sometimes that makes me angry). That responsibility is all that keeps me here somtimes
(especially during this withdrawl process).Kelly
Posted by Dr. Bob on September 28, 2004, at 22:20:48
In reply to Re: Effexor -tapering Q, posted by AIK on September 28, 2004, at 9:43:01
> I think ... he minimizes our physical and mental pain.
Please don't post anything that could lead others to feel accused.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by AIK on September 29, 2004, at 7:48:03
In reply to Re: Effexor -tapering Q » Dave001, posted by Bubblehead on September 28, 2004, at 20:51:42
Good Morning Kelly,
The horrible withdrawal you're experiencing seems to have you in a whirl-wind; please call or go see someone who has the ability to pull you through this. Your family needs & wants you, this site needs & wants you, and you need to want you!
The withdrawal has brought you here to defend and protect this generation and you have my support and respect for that. If you read my post yesterday with my attempted experiment, I took the spheroids out of an Effexor capsule and put them in 30 ml of water. @ 8:45 am yesterday. 24 hours later, they're all still accounted for
and have not dissolved. I do not have the equipment available to measure how much of the venlafaxine permeated into the water and/or if any remained inside the spheroids. In order to be consistant with tapering with the appropriate dosage, one would have to count the spheroids inside the capsule, divide them up equally, and go from there. Sounds ridiculous to me. I thought possibly to crush the spheriods before adding water but that may or may not change the action from sustained release to immediate release. It reminds me of what they do on the streets. Get a hold of oxycontin, crush them, and snort it. It's just wrong. Changing a drug form for which it was intended should not be done in a kitchen, but in a controlled environment. I also agree with you that there are ding-dongs out there and the great thing is that you realize it. Our knowledge has increased significantly and you will aid in educating others. Please write back to me and let me know how you're doing this morning. AIK
> > I think it is the individual's choice whether to ask their doctor for "permission," which
> they will not receive, to reduce the dose in the manner described. A compounding
> pharmacist whom has specifically prepared custom Effexor formulations would likely
> know more about this than your doctor.>
>
>
> Sorry Dave, but I've got to disagree with ya here. I did not even ask my doctor to do this
> (mixing the stuff in water) and guess what? Yep, He told me to. Actually he told me to
> just dump out half of the capsule and take it that way. After reading what you all have
> said about this; it makes me wonder what kind of ding-dong I was going to. See Dave,
> this is what I was trying to express before. These Doctor's are not educated on the meds
> and we are the ones paying the price for thier ignorance.
>
>
> >> experimentation on my part (like I don't have enough to do). Support group, this has
> nothing to do with ingesting the drug...don't attempt it at this point. In fact, Dave did say
> earlier that it may be an alternative to tapering with capsules, but doesn't recommend it. I
> think he has raised the hair on the back of our necks when he minimizes our physical and
> mental pain. Also using asterisks when he refers to "if the withdrawal effects are *that*
> bad". Yes, it is *that* bad for these readers or they wouldn't be on this site.
>
> >Nothing I said was intended to minimize anyone's pain. I've already said that, but I guess
> it's not enough. Yes, I used asterisks when I said, "if the withdrawal effects are *that*
> bad." That just means what it says: if they are *that* bad for *you*. Some people don't
> find the withdrawal that big of a deal; others have a lot of difficulty. It varies. For someone
> not having great difficulty tapering the conventional way, it probably wouldn't be worth
> the hassle to fiddle with the capsules. That's all that was meant. The OP didn't indicate
> having a problem with tapering; IIRC, she had not yet even begun the process.<
>
>
> Oh my Dave, I think we all have seen the worst in you without even noticing the good. I
> think your post about the withdrawl and the need to sue has given you a bad reputation.
> Don't be confused, I am still in disagreement with you about this; but from reading your
> prior posts I see where you are coming from. Let me see if I have this right. You feel that
> by sueing the Drug company we are saying that there will be an end to them finding great
> cures and helps for the others that need it in the world. Is that it? If I am right, let me just
> say that, that is not our intentions. Have you seen what has been going on lately with the
> Effexor? Children and young kids are killing themselves not only from the withdrawl but
> some are doing it just from taking the meds. Now I don't know if you have kids, but I do
> and I will do anything, I mean "ANYTHING" within my power to protect them. If my
> child killed himself from taking this medicine and the company that produces the drug had
> knowledge of its effects, I sure as heck am not going to stand by and take a slap on the
> cheek. I assume you are trying to, for the drug companies, protect the rights to develop
> new things by saying we should not sue. But like you we also are trying to protect. By
> sueing we are protecting ourselves, others, and children most of all; from ever having to
> suffer like this again. Do you understand what I am saying?
>
> Anyhow, I think we all need to agree to disagree and move on. We need to get back to
> supporting one another through these hard times. Yes Dave, they really are hard. I
> wanted to kill myself last night but couldn't because I have to much resposibilty to others
> (sometimes that makes me angry). That responsibility is all that keeps me here somtimes
> (especially during this withdrawl process).
>
> Kelly
>
Posted by AIK on September 29, 2004, at 9:32:03
In reply to Re: please be civil » AIK, posted by Dr. Bob on September 28, 2004, at 22:20:48
Dear Dr. Bob,
Thank you for bringing this to my attention. I will remember this in future posts.
Respectfully, AIK
> > I think ... he minimizes our physical and mental pain.
>
> Please don't post anything that could lead others to feel accused.
>
> If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
>
> http://www.dr-bob.org/babble/faq.html#civil
>
> Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
>
> Thanks,
>
> Bob
Posted by Bubblehead on September 29, 2004, at 14:46:49
In reply to Re: Effexor -tapering Q, posted by AIK on September 29, 2004, at 7:48:03
Thank you AIK for being so sweet. I'm doing okay. I really shouldn't have even wrote that. I'm so embarassed. No one needs to worry about me. There are others who need more concern than I do. I just have issues with anger. Unfortunatly, through my upbringing I learned that anger is not allowed. Due to this, I have somehow learned to turn the anger in upon myself. Which leads to, yep you guessed it, suicide. I punish myself for being angry. Pretty strange huh? The Effexor helped this problem but not in the way it should have. At 450mg I was in what I like to call "The Effexor Coma." Like a coma, I could not feel things like emotions and I could not express them. I know they were in there but there was something blocking them (the Effexor). I left my Doctor and started tapering the Effexor about 3 months ago. I went very slowly and I did well...until I took my last half a capsule. That was two weeks ago tomorrow. What a nightmare. I feel for each and every person who is going through withdrawl symptoms. I've never had to experience any type of withdrawl before this. I don't know how actual drug addicts do it. I used to be so mean thoughted about addicts going through withdrawl thinking that they deserved it. Now, my heart even goes out to them. No one desrves this.
Any how, I am gradually day by day getting better. I do have a support family through my church. Thank God for them. Somedays are just a bit harder than others and I apologize for that. I really shouldn't have put that in that post. That is information that people really don't want to see or hear.
Again, thank you. You are such a sweetheart for being so concerned.
Kelly
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