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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3021 to 3045 of 10407. Go back in thread:
Posted by mxgirl13 on December 25, 2002, at 19:15:50
In reply to Re: Effexor Withdraw COLD TURKEY, posted by Sioux on December 25, 2002, at 18:55:15
Yes, I understand in a perfect world that this is what I should do. I would love to. I'm really glad to hear that I can open the capsules. Is it harmful to me or just really difficult symptom wise to go cold turkey? As lack of insurance is what put me in this situation, I can't get other meds to assist and I only have a few capsules left. What's your recommendation?
> > Ok, I'm trying cold turkey. This is day 3
>
> Oh, my goodness! Cold turkey is not a good idea.
>
> The brain is designed to absolutely resist changes in its very complex chemistry. Drugs that modify the brain chemistry take time to ramp up and time to ramp down, to allow each of the various feedback systems to re-regulate.
>
> The capsules may be opened and the granules divided.
>
Posted by Sioux on December 25, 2002, at 19:24:51
In reply to Re: Effexor Withdraw COLD TURKEY, posted by Sioux on December 25, 2002, at 18:55:15
Source: Meoni P, Hackett D. Poster presentation. Data on file, Wyeth-Ayerst Laboratories.
EFFEXOR® XR (venlafaxine HCl) is indicated for depression, depression with associated anxiety symptoms, and generalized anxiety disorder.
EFFEXOR® XR is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs). EFFEXOR® XR should not be used in combination with an MAOI or within at least 14 days of discontinuing treatment with an MAOI because of potential for serious adverse reactions. Based on the half-life of EFFEXOR® XR, at least 7 days should be allowed after stopping EFFEXOR® XR before starting an MAOI.
The efficacy and safety of EFFEXOR® XR for pediatric use have not been established.
Treatment with venlafaxine is associated with sustained increases in blood pressure (BP) in some patients. Three percent of EFFEXOR® XR patients in depression studies (doses of 75 to 375 mg/day) and 0.4% in generalized anxiety disorder (GAD) studies (doses of 75 to 225 mg/day) had sustained BP elevations. The incidence of sustained increases in BP at doses greater than 300 mg/day has not been fully evaluated. Less than 1% discontinued treatment because of elevated BP. Experience with immediate release venlafaxine in depression studies showed that sustained hypertension was dose related, increasing from 3% to 7% at doses of 100 mg/day to 300 mg/day, to 13% at doses above 300 mg/day. Regular BP monitoring is recommended.
The most common adverse events reported in EFFEXOR® XR placebo-controlled depression trials (incidence >10% and >2x that of placebo) were nausea, dizziness, somnolence, abnormal ejaculation, sweating, dry mouth, and nervousness; and in GAD trials were nausea, dry mouth, insomnia, abnormal ejaculation, anorexia, constipation, nervousness, and sweating.
As with any psychotropic drug, EFFEXOR® XR may impair judgment, thinking, or motor skills; patients should be advised to exercise caution until they have adapted to therapy.
Patients should not be abruptly discontinued from antidepressant medication, including EFFEXOR® XR.
Posted by Sioux on December 25, 2002, at 19:36:32
In reply to Re: Effexor Withdraw COLD TURKEY, posted by mxgirl13 on December 25, 2002, at 19:15:50
>>>> Is it harmful to me or just really difficult symptom wise to go cold turkey? As lack of insurance is what put me in this situation, I can't get other meds to assist and I only have a few capsules left. What's your recommendation?
<<<<<Take the manufacturer's information which I just posted or get it from their website (www.effexor.com \ healthcare professionals) to an emergency room and tell them you need help in doing this and why; also go the hospital's caseworker section and they will identify funding sources for you; the pharmacy may be able to help, too, because manufacturers get tax-breaks for 'mercy' programs; pursue the chaplain's office, if need be, and/or any of the church-supported help lines.
I don't know which of the states you live in; the hoops are different for each one. Be informed, be polite, be persistent. You really should be taking 6 wks - 3 mos to get off the drug.
Take care of yourself! Suffering *is* harmful to you.
Posted by EGR on December 25, 2002, at 21:48:05
In reply to Re: Effexor Withdraw COLD TURKEY, posted by Sioux on December 25, 2002, at 19:36:32
> >>>> Is it harmful to me or just really difficult symptom wise to go cold turkey? As lack of insurance is what put me in this situation, I can't get other meds to assist and I only have a few capsules left. What's your recommendation?
> <<<<<
>
> Take the manufacturer's information which I just posted or get it from their website (www.effexor.com \ healthcare professionals) to an emergency room and tell them you need help in doing this and why; also go the hospital's caseworker section and they will identify funding sources for you; the pharmacy may be able to help, too, because manufacturers get tax-breaks for 'mercy' programs; pursue the chaplain's office, if need be, and/or any of the church-supported help lines.
>
> I don't know which of the states you live in; the hoops are different for each one. Be informed, be polite, be persistent. You really should be taking 6 wks - 3 mos to get off the drug.
>
> Take care of yourself! Suffering *is* harmful to you.I'd have to second that! Most hospitals have access to funding for situations like yours. In fact, hospitals, by law, can't turn you away because you can't pay.
Posted by mxgirl13 on December 26, 2002, at 11:38:19
In reply to Re: Effexor Withdraw COLD TURKEY » Sioux, posted by EGR on December 25, 2002, at 21:48:05
Thanks Sioux and EGR. I didn't know those were options for me. I really appreciate your assistance and information. I'll check it out right away.
> > >>>> Is it harmful to me or just really difficult symptom wise to go cold turkey? As lack of insurance is what put me in this situation, I can't get other meds to assist and I only have a few capsules left. What's your recommendation?
> > <<<<<
> >
> > Take the manufacturer's information which I just posted or get it from their website (www.effexor.com \ healthcare professionals) to an emergency room and tell them you need help in doing this and why; also go the hospital's caseworker section and they will identify funding sources for you; the pharmacy may be able to help, too, because manufacturers get tax-breaks for 'mercy' programs; pursue the chaplain's office, if need be, and/or any of the church-supported help lines.
> >
> > I don't know which of the states you live in; the hoops are different for each one. Be informed, be polite, be persistent. You really should be taking 6 wks - 3 mos to get off the drug.
> >
> > Take care of yourself! Suffering *is* harmful to you.
>
> I'd have to second that! Most hospitals have access to funding for situations like yours. In fact, hospitals, by law, can't turn you away because you can't pay.
>
Posted by jimmygold70 on December 26, 2002, at 13:03:44
In reply to Re: Effexor coming off of 5 years use. Help!, posted by mxgirl13 on December 23, 2002, at 9:58:48
You should move to a long-acting, cheap AD (i.e. Generic Prozac - $10-15/month) switch in that schedule:
1) Week 1 - 150mg Effexor XR + 20mg Prozac
2) Week 2 - 75mg Effexor XR + 40 mg Prozac
3) Week 3 - 75mg Effexor XR + 40 mg Prozac
4) Week 4 - No EffexorRisperdal might help you as well but it is pricey. In this case, you can add Klonopin (0.5 mg three time a day) for a couple of weeks, taking the dose down slowly over 2 weeks (1.5mg->1mg->0.5mg->Nothing).
I had luck with the above, and talking to some psychopharmacologists - they liked it.
Jimmy
Posted by joy on December 27, 2002, at 10:14:46
In reply to Re: Effexor and Xanax and Withdraw, posted by mxgirl13 on December 24, 2002, at 11:52:07
Hi. I would not stop the Xanax at this time. If you want to take a lower dose, that is okay, but don't stop it now. It's the only thing I can take to help me sleep through the night. You are dealing with enough now; take the Xanax for sleeping; don't switch to another benzo at this time. Best wishes.
Joy
Posted by askBob on December 27, 2002, at 22:53:13
In reply to Re: Effexor coming off of 5 years use. Help! » mxgirl13, posted by jimmygold70 on December 26, 2002, at 13:03:44
Jimmy has a good point. you should gradually replace one med with another in the same family. I think they call this "titration". You should also know that it can take 4 - 6 weeks for any of the SSRI family of antidepressants (Prozac, Zoloft, Paxil, Celexa) to take full effect. And you really ought to check it out with a good psychiatrist or at least an experienced pharmacist, such as at a mental health teaching hospital or university.
Bob
> You should move to a long-acting, cheap AD (i.e. Generic Prozac - $10-15/month) switch in that schedule:
> 1) Week 1 - 150mg Effexor XR + 20mg Prozac
> 2) Week 2 - 75mg Effexor XR + 40 mg Prozac
> 3) Week 3 - 75mg Effexor XR + 40 mg Prozac
> 4) Week 4 - No Effexor
>
> Risperdal might help you as well but it is pricey. In this case, you can add Klonopin (0.5 mg three time a day) for a couple of weeks, taking the dose down slowly over 2 weeks (1.5mg->1mg->0.5mg->Nothing).
>
> I had luck with the above, and talking to some psychopharmacologists - they liked it.
>
> Jimmy
>
Posted by bookgurl99 on December 27, 2002, at 23:39:59
In reply to Re: Effexor coming off of 5 years use. Help!, posted by mxgirl13 on December 23, 2002, at 9:58:48
If no one else has suggested it, could you ask your doctor for a starter pack or two -- they can give them out for free -- to cover you until you get insurance or until you can taper off?
I've quit ssri s and an sari nearly cold turkey before, was very hard. I sympathize!
I advise, give into your carb cravings -- your body is using it to make more serotonin. And take something to help u sleep. :D
good luck,
bookgurl99
Posted by bookgurl99 on December 27, 2002, at 23:51:20
In reply to Re: Effexor coming off of 5 years use. Help! » mxgirl13, posted by jimmygold70 on December 26, 2002, at 13:03:44
I wanted to point out that Effexor is not an SSRI, as Prozac is. Effexor is an SNRI (serotonin noripenephrine reuptake inhibitor). As such , the effects of each may be multiplied if they are taken together.
Posted by charlie mac on December 28, 2002, at 20:46:02
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
i have been on effexor for 2 months now and on 150mg for roughly 3 weeks. recently i have had what i call "heart shudders" which i explain as; a heart beat that feels a lot stronger than a normal beat, and stronger than a rapid beat as well, with a shift in vision as well as a shudder throughout my body. i have been having these heart shudders(heart palpitations?) for as long as i can remember, but as of recently they have increased in frequency with a factor of about 100. i went from having a few in one month to roughly 50-75 in a day. this change has occured in a short span of only 2 days, possibly 3(i wasnt keeping count before). is this a reaction to the effexor? should i possibly switch meds? should i be worried? any answers or insight would be greatly appreciated.
Posted by Sioux on December 28, 2002, at 22:16:18
In reply to Re: Anyone had success on Effexor XR? , posted by charlie mac on December 28, 2002, at 20:46:02
>> "heart shudders" which i explain as; a heart beat that feels a lot stronger than a normal beat, and stronger than a rapid beat as well,
<<This could be anxiety but must be evaluated by a cardiologist, Effexor or no. Hmmm? Do it and keep us posted.
-- S
Posted by daisyduke on December 29, 2002, at 21:32:11
In reply to Re: Effexor Withdraw COLD TURKEY, posted by mxgirl13 on December 26, 2002, at 11:38:19
> Thanks Sioux and EGR. I didn't know those were options for me. I really appreciate your assistance and information. I'll check it out right away.
>
>
> > > >>>> Is it harmful to me or just really difficult symptom wise to go cold turkey? As lack of insurance is what put me in this situation, I can't get other meds to assist and I only have a few capsules left. What's your recommendation?
> > > <<<<<
> > >
> > > Take the manufacturer's information which I just posted or get it from their website (www.effexor.com \ healthcare professionals) to an emergency room and tell them you need help in doing this and why; also go the hospital's caseworker section and they will identify funding sources for you; the pharmacy may be able to help, too, because manufacturers get tax-breaks for 'mercy' programs; pursue the chaplain's office, if need be, and/or any of the church-supported help lines.
> > >
> > > I don't know which of the states you live in; the hoops are different for each one. Be informed, be polite, be persistent. You really should be taking 6 wks - 3 mos to get off the drug.
> > >
> > > Take care of yourself! Suffering *is* harmful to you.
> >
> > I'd have to second that! Most hospitals have access to funding for situations like yours. In fact, hospitals, by law, can't turn you away because you can't pay.
> >
>
>I'm trying to go off cold turkey aswell.. Will it affect me long term do you know? Also what does the doctor to do get you off of this drug?? I am so dizzy that i can't have my eyes open for too long. I've gone with missing effexor before..and its deadly..i mean i feel like death. Can't move. Can't stand up. Throwing up constantly. If i split the capsules..Can i take the drugs without capsule? how would i do that? Any help would be great. THanks
Posted by bookgurl99 on December 29, 2002, at 22:08:57
In reply to Re: Effexor Withdraw COLD TURKEY, posted by daisyduke on December 29, 2002, at 21:32:11
I'm not an md, but you could always measure out half the capsules and mix them into yogurt or orange juice; I've heard of people titrating off meds that way.
Posted by bookgurl99 on December 29, 2002, at 22:09:21
In reply to Re: Effexor Withdraw COLD TURKEY, posted by daisyduke on December 29, 2002, at 21:32:11
I'm not an md, but you could always measure out half the capsules and mix them into yogurt or orange juice; I've heard of people titrating off meds that way.
Posted by daisyduke on December 29, 2002, at 22:14:11
In reply to Re: Effexor Withdraw COLD TURKEY, posted by bookgurl99 on December 29, 2002, at 22:08:57
> I'm not an md, but you could always measure out half the capsules and mix them into yogurt or orange juice; I've heard of people titrating off meds that way.
Thanks..I'll give it a try...Seems smart!!haha
Posted by daisyduke on December 29, 2002, at 22:17:30
In reply to Re: Effexor Withdraw COLD TURKEY, posted by daisyduke on December 29, 2002, at 22:14:11
> > I'm not an md, but you could always measure out half the capsules and mix them into yogurt or orange juice; I've heard of people titrating off meds that way.
>
> Thanks..I'll give it a try...Seems smart!!hahaDoes anyone know the lowest dose that is prescribed? i'm taking 75..so if i go down to half for a few days..would this be good enough to get off and feel ok? I just want the dizziness to go away..
THanks
Posted by askBob on December 29, 2002, at 22:45:07
In reply to Re: Effexor coming off of 5 years use. Help!, posted by bookgurl99 on December 27, 2002, at 23:51:20
> I wanted to point out that Effexor is not an SSRI, as Prozac is. Effexor is an SNRI (serotonin noripenephrine reuptake inhibitor). As such , the effects of each may be multiplied if they are taken together.
Wow -- thanks for waking me up, bookgirl! I think Sioux's advice is the safest, although lots of people (especially teens) quit cold turkey. If you don't have to work for a living, you can do it. I switched from Prozac (an SSRI) to St. John's Wort (herbal MOAI) and felt great for a year -- until I got overwhelmed with stress from my job and a family tragedy. Ended up in the hospital. That's why you are best off to get advice from a psychiatrist.
If you are broke, go to a hospital that has a psychiatric crisis center -- like someone said, they cannot turn you away for lack of funds. They may insist you stay there for observation while changing your meds, though, and you must ask about expenses and who pays BEFORE you sign any papers!!! And don't go alone. Bring a trusted (and level-headed) friend along who can verify you are not at risk, i.e., suicidal or homicidal.Titrating off meds by mixing half a capsule into OJ might work, but be sure to wash it down with lots of liquids -- otherwise you can burn the lining of your esophagus. If you look up the ingredients of these meds, most are acids, which are apparently safe once in your tummy.
Good luck, and God bless!
Posted by EGR on December 29, 2002, at 22:58:46
In reply to Re: mixing meds to switch to cheaper generic, posted by askBob on December 29, 2002, at 22:45:07
Effexor comes in 37.5 mgs... technically you could probably take 1/2 of those. When I was titrating down off Effexor, I had to take 2 weeks to go from 150 to none, simutaneously starting Wellbutrin. A pharmacist friend told me that going cold turkey could do nasty things to you. Like a) make you extremely dry-mouthed or drool excessively and b) give you diarrhea or the worst case of constipation imaginable. Then there's also the sweats and shakes. I would not go cold turkey. Check with your local hospital's social workers or your DHS office. There are funds available to help with prescription, especially in cases like this. Or follow the advice further up and check into a psyche ward... we don't need any of us nutting out and harming ourselves!
Posted by bookgurl99 on December 30, 2002, at 6:44:29
In reply to Re: Effexor Withdraw COLD TURKEY, posted by daisyduke on December 29, 2002, at 22:17:30
I don't recall if you had insurance problems or not. If you do have good insurance, it might be possible to ask your doctor for a liquid version of your antidepressant. (Sometimes they make them for kids.) That would make it easier to take smaller doses.
Posted by Lynnads on December 30, 2002, at 9:04:40
In reply to Re: Anyone had success on Effexor XR? , posted by charlie mac on December 28, 2002, at 20:46:02
To your question, yes it is the Effexor that is causing your heart palpitations. Go see your doctor as soon as possible and perhaps they can put you on an alternative anti-depressant.
I too have been on Effexor for a short while and suddenly started getting heart palpitations. I have had past problems with my heart and found that once on Effexor it became more aggrivated. I do have an appt. with my doctor and plan to get off Effexor imediately. Although extremely happy with the outcome of Effexor, I believe heart palpitations are nothing to mess with.
Posted by blueheron on December 30, 2002, at 11:10:06
In reply to Re: Effexor Withdraw COLD TURKEY, posted by daisyduke on December 29, 2002, at 22:17:30
Back in August I was fed up with the sexual side of effexor xr (was on 150/day) and wanted to see what these much feared withdrawl symptoms were all about, so I went cold turkey... 150 -> 0 in one day... Lucky I had LOTS of experience with recreational psycoactives in my past, 'cause going cold turkey is a trip. Lots of brain zaps, visual distortions, muscle twitches... you name it, I felt it... The first two weeks were very interesting, incredible manic high accompanied by wild withdrawl, then the high subsided, but the withdrawl lasted about 7 weeks until there were no more symptoms. It wasn't THAT bad, if you have a 60's/70's drug culture background, but I can see how it would freak you out if you thought the withdrawl would never end.
By the way, the sex thing?, No More Frustration!, YAAAYYYYY!!!! I can attest that when you go off effexor, orgasms are fun again (and plentiful too!!!).
A footnote... I went back on effexor, to 150/day, once I knew I could kick it, I wanted and got the positive side back. But the orgasms became harder to achieve so my doc suggested wellbutrin. I am in the process of weaning off effexor, 150 -> 112.5 -> 75 -> 37.5 -> 0 and I have to say this is way better than cold turkeybottom line... cold turkey is like working for a relative, not recommended, but an experience
Posted by Dimbulb on December 31, 2002, at 14:01:03
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
grrrr.........I spent a half hour typing a post then had to register, then my post wasnt available anymore. My first post was a literary jewel and now I am so ^#%$& this one is going to suck...
my comment or question started with my doctor prescribing Effexor which I havent started yet but this is my fifth or sixth anti depressant and my question relates to:
Will any antidepressant help me if my depression is caused by real world things and not by the infamous inbalance in my brain as I am told? I wont bore you with my problems but let me just say my problems would depress just about anyone and they are not things that will go away. They stem from medical problems and not something imaginary. Does any of the above make any sense at all?
Also my worry about the going off my anti depressant for ten days before I start on Effexor revolves around the possibility that the current anti depressant is actually helping me without me realizing it. If this is true I am going to be a basket case when I am on nothing for a short period.
I have a call in to my pharmacist and my doctor to further discuss this but I will not go off of my current medication until I hear something from somebody. I would very much like to hear from someone here who may have had similar thoughts to mine. And if there is anyone out there who is having similar thoughts to mine......sorry....
Brad
Posted by Lynnads on December 31, 2002, at 14:48:50
In reply to Re: Anyone had success on Effexor XR? , posted by Dimbulb on December 31, 2002, at 14:01:03
> grrrr.........I spent a half hour typing a post then had to register, then my post wasnt available anymore. My first post was a literary jewel and now I am so ^#%$& this one is going to suck...
>
> my comment or question started with my doctor prescribing Effexor which I havent started yet but this is my fifth or sixth anti depressant and my question relates to:
>
> Will any antidepressant help me if my depression is caused by real world things and not by the infamous inbalance in my brain as I am told? I wont bore you with my problems but let me just say my problems would depress just about anyone and they are not things that will go away. They stem from medical problems and not something imaginary. Does any of the above make any sense at all?
>
> Also my worry about the going off my anti depressant for ten days before I start on Effexor revolves around the possibility that the current anti depressant is actually helping me without me realizing it. If this is true I am going to be a basket case when I am on nothing for a short period.
>
> I have a call in to my pharmacist and my doctor to further discuss this but I will not go off of my current medication until I hear something from somebody. I would very much like to hear from someone here who may have had similar thoughts to mine. And if there is anyone out there who is having similar thoughts to mine......sorry....
>
> BradBrad,
If I were you, I wouldn't go off whatever meds you are on cold turkey. It could very possibly make you a basket case, not to mention other worse side effects. I am now on my fourth anti-depressant, and admitting that makes me feel like I shouldn't be throwing out any advice.When I started I had similar concerns to yours. I didn't understand how a pill could change my thought process. Since childhood, I hadn't known what it was like to be "happy". I too have had difficulties in my life ranging from family issues, medical problems, to worldly incidents.
Now on Effexor XR, life seems to be a bit more bearable. I still have what I'd like to explain as numbed thoughts lying on the back burner of my brain, but at least it isn't constantly prodding me.
But asside from all that rambling, I guess what I am trying to say is give the new meds (hopefully Effexor) a chance, but have your doctor taper off whatever it is you are currently taking.
Good Luck
Posted by Sioux on December 31, 2002, at 23:14:54
In reply to Re: Anyone had success on Effexor XR? , posted by Dimbulb on December 31, 2002, at 14:01:03
>>> grrrr.........I spent a half hour typing a post then had to register, then my post wasnt available anymore. My first post was a literary jewel and now I am so ^#%$& this one is going to suck...
<<<This is a literay jewel. ; ) Unfortunately, I know exactly that frustration.
On to your other question. I, too, have a compicated and nasty medical situation (a cluster of autoimmune disease) which causes nasty and complicated financial situations. The neuromuscular consequences come and go - so I have to adjust/readjust - and also affect my speech and facial expression which, of course, affect my social transactions not to mention my sex life. In real life I was a biological scientist.
So. Just like fearful situations cause adrenaline to rush, so chronic stressors (depressing situations) can cause "depression" rushes - releases of chemicals which, over a period of time, seem to alter the brain chemistry. Depressing situations also require a lot more eneregy to deal with them. Sometimes antidepressants work in this situation.
Myself I found, however, that getting a handle on it all was the best antidepressant. By that I mean I recruited a whole *lot* of help from other people. One tracks my meds so they are ordered and arrive on time, another tracks the insurance billing, another examines every hospitalization and argues the billing, another lets folks know how I am, another writes 'thank you' notes, another raises funds for and tracks my various assistive devices.
All of this leaves me with enough energy to put up with it all: fall over, drop things, break bones, need need need need one damned thing after another.
Now. I'll bet you don't have that much help. So my list above should help you understand exactly how much energy you no longer have for yourself. It takes half a dozen people just to deal with some of the more obvious external consequences of some kinds of medical conditions.
That's depressing. So you get depressed.
In sum - use absolutely everything and everyone that you can to make yourself comfortable. Your first step is to identify what it takes - daydreaming's a good place to start, but the miraculous cure doesn't count. (sorry) Then do the same thing with what would positively pump you. The third step is to see how much of that you can actually do with what you have or can acquire.
Hope you find this helpful.
In the end I had to not use antidepressants because they all dulled my mind (which is about the only thing left that works). I worked even harder to find out how I could actually a have bunch of *fun* and, in the end, that's what worked for me. (believe it or not, it turned out to be going to movies in the afternoon; I didn't even know I liked movies!)
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