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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1043 to 1067 of 1313. Go back in thread:
Posted by worm on July 13, 2004, at 12:17:42
In reply to to worm- how long, posted by snake on July 13, 2004, at 8:15:03
Of course, that's the whole issue here - what is "normal"? It's different for everyone, which is why I can only speak for myself. I did the phasing-0ut thing for about a week, emptying out half the capsules. (I was on 150 XR) Then I decided to go "cold turkey", and took a leftover Prozac if the symptoms got bad. This lasted about 2 weeks, with just 1 or 2 Prozacs needed the first couple of days. I still had residual symptoms up until about 4 months, but just occasionally - Brain zaps, dizziness, tiredness, moodiness, and foggy brain. Most of these were gone in the first month, but I feel like my brain has only cleared up recently. Names of people and places I should know are coming back to me faster. I was really worried about getting Alzheimers or something, I really couldn't think of very common words. It helps to time it so you can be on vacation, so that you can sleep around the clock if you want. I did a lot of sleepiung. Also, I kept up on my vitamin regimen - multivitamin, vitamin C, E, and a calcium supplement with vitamin D. Don't know if it helps, but couldn't hurt. If you are into herbals, there are some people here with very detailed herbal regimens, that they claim help a lot.
Hope this is helpful. Good luck!
Posted by Dr. Bob on July 13, 2004, at 17:25:38
In reply to Re: blocked for week » Frisky_Cat, posted by Dr. Bob on July 12, 2004, at 16:30:06
> If you have any questions or comments about this or about posting policies in general ... please ... redirect a follow-up to Psycho-Babble Administration
Here's a link:
http://www.dr-bob.org/babble/admin/20040527/msgs/365752.html
Thanks,
Bob
Posted by Larry Hoover on July 13, 2004, at 20:29:11
In reply to Re: Going through Effexor Withdrawl now, posted by SLS on July 11, 2004, at 7:35:21
Hey Scott. How ya doin', buddy?
> These are powerful drugs eliciting unpredictable effects on a brain that we have very little understanding of. Many drugs produce depression as a frequent side effect. Drug manufacturers are required to include this fact in the packaging of their products. It makes for a long list of very diverse drugs. Antidepressants are not teleologically exempt from producing undesirable mood alterations because they have some sort of biological "safety" that permits only antidepressant effects and precludes depressogenic effects.
Anybody who can work "teleologically" into a sentence, with skill, has my support.
> For any given individual, there may be certain antidepressants (or any other type of drug) that will exacerbate the clinical depression and induce suicidal states. Prozac has, and will continue to cause suicides as long as prescribing physicians continue to think like you do.
There are particular windows of vulnerability to suicide, which require more effective medical management. Suicidal induction is not novel with respect to SSRI antidepressants. It is a well-known phenomenon since the introduction of the tricyclics. One of the driving forces in the development of the SSRIs was to provide an antidepressant which itself was not generally fatal in overdose, as the tricyclics are.
I've been studying the literature, and plan to write a review article on the subject of antidepressants and suicide. Overall, suicide rates are declining, while SSRI prescription rates are increasing. There are two distinct effects, but the summary statistic is that suicides are reduced by SSRIs, notwithstanding temporary increases in susceptibility.
> > The most logical explanation for the fact that sometimes people who take antidepressants commit suicide is
> > 1. Coincidence
> > 2. the antidepressants give them enough energy to commit suicide.
>
> Both of these explanations are absolutely valid. However, I would appeal to you that you leave open your mind to the possibilities of a third, especially if you are in a position to influence the medical treatment of anyone suffering from depression.
>
> By the way, statistics do demonstrate that antidepressants cause suicide.I'm not convinced. Most of the data were collected for purposes other than that to which they have been put. Clinical trial data are not generalizable to the population at large, in my opinion. When you look at the epidemiological data, the government records of suicide, compared to prescription rates, and examination of post mortem toxicology, there is no obvious SSRI-suicide signal. Short-term clinical studies may happen to coincide with one risk window.
> It is statistics that are fueling the whole uproar regarding the use of SSRIs in pediatrics. I am sure that the statistics are there for adults too. We just need an expert like you to look for them once the trial data becomes public.
I'm not an expert statistician, but I am trained in methodology. I reviewed the pediatric paroxetine study, the full clinical dataset (over 500 pages).....the one where paroxetine was said to have a six-fold greater suicide risk than placebo....that conclusion is misleading, and is unsupported by the data.
It is a statistical fluke, combined with stringent adherence to protocols, which produced that disturbing statistic. For example, "emotional lability" is the category these events were collected under. Only four of the six incidents of emotional lability in the paroxetine group were "severe", and fully documented. One "severe" paroxetine case is due to one subject taking one or two extra tablets per week (b.i.d. dosing), over two consecutive weeks. Instead of taking fourteen tablets, she lost count and took fifteen or sixteen (out of 20 provided at a time), three weeks in a row. By protocol definition, and only because it was two (or more) consecutive weeks, that was a priori a case of severe emotional lability. The only true suicidal act occurred in the placebo group. They're comparing apples to oranges. Here's a link to a summary of my analysis:
I copied the actual case reports of the severe emotional lability incidents from the study appendices. Here's a link:
http://www.google.ca/groups?hl=en&lr=&ie=UTF-8&selm=zWEAc.39179%24nY.1241628%40news20.bellglobal.com&rnum=23Paxil is being framed, in my opinion.
> On a more anecdotal note: The following drugs made my depression moderately - severely worse. Reboxetine and moclobemide in particular induced a suicidal state.
>
> amoxapine
> bupropion
> donepezil
> idazoxan
> mirtazapine
> moclobemide
> protriptyline
> reboxetine
> triiodothyronine
> valproate
>
>
> Best wishes,
>
> - ScottI'm sorry you've had such a struggle with meds. Lithium made me suicidal, as did Serzone.
Lar
Posted by KaraS on July 13, 2004, at 20:46:32
In reply to Re: Effexor withdrawal side effects, posted by lorily on July 10, 2004, at 21:28:48
Lorily,
I cut back to half a pill last night and not a single problem yet. Yeah!!
- K
Posted by itsrick on July 13, 2004, at 22:06:31
In reply to Re: to worm- how long, posted by worm on July 13, 2004, at 12:17:42
> Of course, that's the whole issue here - what is "normal"? It's different for everyone, which is why I can only speak for myself. I did the phasing-0ut thing for about a week, emptying out half the capsules. (I was on 150 XR) Then I decided to go "cold turkey", and took a leftover Prozac if the symptoms got bad. This lasted about 2 weeks, with just 1 or 2 Prozacs needed the first couple of days. I still had residual symptoms up until about 4 months, but just occasionally - Brain zaps, dizziness, tiredness, moodiness, and foggy brain. Most of these were gone in the first month, but I feel like my brain has only cleared up recently. Names of people and places I should know are coming back to me faster. I was really worried about getting Alzheimers or something, I really couldn't think of very common words. It helps to time it so you can be on vacation, so that you can sleep around the clock if you want. I did a lot of sleepiung. Also, I kept up on my vitamin regimen - multivitamin, vitamin C, E, and a calcium supplement with vitamin D. Don't know if it helps, but couldn't hurt. If you are into herbals, there are some people here with very detailed herbal regimens, that they claim help a lot.
>
> Hope this is helpful. Good luck!
>
>
>how about claritan? i heard that helps with the symptoms?
Posted by SLS on July 14, 2004, at 7:06:34
In reply to Re: Going through Effexor Withdrawl now » SLS, posted by Larry Hoover on July 13, 2004, at 20:29:11
Hi Larry.
> Hey Scott. How ya doin', buddy?
Crappy. :-) Thanks for asking. I think I'll stop by the Alternative board more often to pay visits.
> Anybody who can work "teleologically" into a sentence, with skill, has my support.
I've been keeping that one in my back pocket for a special occasion.
> I've been studying the literature, and plan to write a review article on the subject of antidepressants and suicide.
I look forward to reading it (as much as my depression will allow). Where will you be submitting it?
> Overall, suicide rates are declining, while SSRI prescription rates are increasing. There are two distinct effects, but the summary statistic is that suicides are reduced by SSRIs, notwithstanding temporary increases in susceptibility.
I know. Even if antidepressants do exacerbate depression in vulnerable individuals, the net effect of their use in the general population is, thankfully, a reduction in the rate of suicide. However, beyond the bottom line of the *interpretation* of statistics is the fact that these drugs do lead to the commission of suicide in certain individuals who would not have done so were they not to have been treated with a provocative medication. Everyone *must* recognize the fact that there exists such a thing as IATROGENIC SUICIDE. Hopefully, this can be accomplished without using any one drug unjustifiably as a scapegoat.
This would be an interesting use of statistics: Treat 500 people with Prozac and 500 people with placebo. In the active treatment arm, take the number n of non-responders as a group and determine the rate of treatment-emergent suicidal-ideation. Now, take the same number n of randomly chosen non-responders to placebo and compare the rates.
I am very glad to see that you have chosen to come back. I only wish that I could read the volume of the posts you write.
- Scott
Posted by LynnPerley on July 14, 2004, at 7:23:03
In reply to Re: it does get better, posted by lorily on July 12, 2004, at 19:23:28
Today is day #2 without Effexor XR for me. I previously posted that I came down from 300mg gradually. I went down an increment (37.5.mg) at a time for a week each except I remained at 150 mg for a month and at 75 mg for a month. When I was at 75 mg and wanted to go further my psydoc said there was no sense remaining on 37.5 mg (for me). She gave me the 1 week sample strip of 37.5 mg and I took it last week.
The only really bad time I had was from 75mg to 37.5 mg - I had some annoying diarrhea for a few days and some headaches and brain zaps. Yesterday I was a lot more irritable than I had been, but I don't think it was any more irritable than a "normal" non medication state. I am using the techniques I learned from my counselor to deal with the irritability.
I mentioned before that I have some ritalin tablets from when I was on the 300mg dose. My psydoc confirmed to me over the phone that the ritalin dosage may be helping reduce any other potential discontinuation side effects. I am taking one or two 5mg ritalin tablets every morning at the smae time I used to take my effexor xr. If I am feeling a little queasy or if I feel a few weird brain feelings I take an additional dose about 5 hours later. I was unable to take prozac because I had unbearable bruxism, so taking a prozac to relieve side effects is not available to me.
Posted by KimberlyDi on July 14, 2004, at 7:45:21
In reply to Re: it does get better, posted by LynnPerley on July 14, 2004, at 7:23:03
Psycho-Babble was my lifeline going through Effexor withdrawal. Even when I was finally off Effexor, I still had the weird dizziness to deal with when I turned my head too quickly. Now, I don't have them at all. Ordeal over.
I just wanted to add that I had the best success tapering off with a planned schedule of varying dosage changes. I posted it several times months ago if anyone wants to try it. 2 steps forward, 1 step back. :)
Good Luck!
KDi in TX
Posted by lorily on July 14, 2004, at 9:53:38
In reply to It does get better-I'm living proof, posted by KimberlyDi on July 14, 2004, at 7:45:21
Kimberly,
Please do let me know how long that head turning syndrome lasted for you. I've cut down my effexor nice and slowly, yesterday and the day before I had none, but today I did feel too uncomfortable with that head thing and a headache during this time. So, I just took a VERY small amount, maybe 6 granules from the capsule this morning. I have that lightheaded feeling now, so, I guess it's a side effect from taking it, not not taking it :)
What do you mean 2 steps forward and one back?
I would love to get over this but am trying to be patient and avoid pain and don't want to push my brain too much.
Posted by lorily on July 14, 2004, at 10:04:28
In reply to Re: Effexor withdrawal side effects, posted by KaraS on July 13, 2004, at 20:46:32
Kara, good for you! yest and the day before I had none, but this morning I was too uncomfortable with the feeling of dizziness when turning my head, and I felt very emotional and have been having a headache. I took about 6 granules and have added light-headedness to my repritoir (SP?)
Posted by justjustine on July 14, 2004, at 10:38:20
In reply to Re: it does get better, posted by LynnPerley on July 14, 2004, at 7:23:03
it got a lot worse for me before it got better, for about a month i was sick. but i researched, and from what i read it seemed likely that a slower taper would have mostly kept me sick longer, although not so violently ill as i was for that long month.
unfortunately, i feel that i have been permanently changed by this drug. i'm acting out in ways i never did before. it's more like borderline symptoms than just 'depression' or 'anxiety' or even 'ptsd'.
Posted by Ultramundane on July 14, 2004, at 13:11:28
In reply to Re: Effexor withdrawl symptoms, posted by John2222 on November 7, 2003, at 22:33:18
Well, quite frankly I felt like I was going to die when I stopped taking effexor XR. I had been taking 300 MG for only two years and my doctor had decreased my dose from 300 to 150 for one week and then to 75 for a week. Did no good.
Headaches, could not sleep, racing heart beat.
I started taking Sam-E 300 MG twice daily for one week and after third day felt absolutely great. Ran out and felt like crap again. So, I am taking Sam-E now and I feel way better than I was taking Effexor. And, Sam-E is good for your liver and joints (supposedly).
For me, Sam-E 300MG 2x/daily completely got rid of withdrawl symptoms. Also, I have a sex drive back, and I am losing weight (Effexor decreased by metabolism and made me fat). In addition, my sleep is down from 10 hours to 7 hours and I feel much more aware.
Bye.
Posted by itsrick on July 14, 2004, at 13:26:26
In reply to Re: it does get better, posted by Ultramundane on July 14, 2004, at 13:11:28
> Well, quite frankly I felt like I was going to die when I stopped taking effexor XR. I had been taking 300 MG for only two years and my doctor had decreased my dose from 300 to 150 for one week and then to 75 for a week. Did no good.
>
> Headaches, could not sleep, racing heart beat.
>
> I started taking Sam-E 300 MG twice daily for one week and after third day felt absolutely great. Ran out and felt like crap again. So, I am taking Sam-E now and I feel way better than I was taking Effexor. And, Sam-E is good for your liver and joints (supposedly).
>
> For me, Sam-E 300MG 2x/daily completely got rid of withdrawl symptoms. Also, I have a sex drive back, and I am losing weight (Effexor decreased by metabolism and made me fat). In addition, my sleep is down from 10 hours to 7 hours and I feel much more aware.
>
> Bye.hi, what is sam-e exactly?
Posted by Ultramundane on July 14, 2004, at 13:36:09
In reply to Re: it does get better, posted by itsrick on July 14, 2004, at 13:26:26
> > Well, quite frankly I felt like I was going to die when I stopped taking effexor XR. I had been taking 300 MG for only two years and my doctor had decreased my dose from 300 to 150 for one week and then to 75 for a week. Did no good.
> >
> > Headaches, could not sleep, racing heart beat.
> >
> > I started taking Sam-E 300 MG twice daily for one week and after third day felt absolutely great. Ran out and felt like crap again. So, I am taking Sam-E now and I feel way better than I was taking Effexor. And, Sam-E is good for your liver and joints (supposedly).
> >
> > For me, Sam-E 300MG 2x/daily completely got rid of withdrawl symptoms. Also, I have a sex drive back, and I am losing weight (Effexor decreased by metabolism and made me fat). In addition, my sleep is down from 10 hours to 7 hours and I feel much more aware.
> >
> > Bye.
>
> hi, what is sam-e exactly?
Here is a website which will describe the drug better than I can. How much information the site posts is valid? Not sure, but I feel great. :)
Posted by SLS on July 14, 2004, at 15:11:21
In reply to Re: Going through Effexor Withdrawl now » Larry Hoover, posted by SLS on July 14, 2004, at 7:06:34
I'll make this the last post along this thread involving antidepressant-induced suicides. It is off topic here.> This would be an interesting use of statistics: Treat 500 people with Prozac and 500 people with placebo. In the active treatment arm, take the number n of non-responders as a group and determine the rate of treatment-emergent suicidal-ideation. Now, take the same number n of randomly chosen non-responders to placebo and compare the rates.
This is actually a pretty dumb idea. Not far off, but... never mind. I'll think about this some more. I'm sure with sufficient numbers, statistics with power can be teased out of trial data to unmask antidepressant-induced iatrogenic suicidal ideation. Someone smarter than me - or at least not so cognitively impaired by depression - should design a study to elucidate this. We know it's there. It's just a matter of using the right tools to produce the resolution necessary to prove it unequivocally.
- Scott
Posted by KaraS on July 14, 2004, at 15:34:56
In reply to Re: Effexor withdrawal side effects, posted by lorily on July 14, 2004, at 10:04:28
> Kara, good for you! yest and the day before I had none, but this morning I was too uncomfortable with the feeling of dizziness when turning my head, and I felt very emotional and have been having a headache. I took about 6 granules and have added light-headedness to my repritoir (SP?)
You're funny - at least you can laugh about it. If you have to go a little slower, that's ok. You're almost there!
Posted by itsrick on July 14, 2004, at 16:55:51
In reply to It does get better-I'm living proof, posted by KimberlyDi on July 14, 2004, at 7:45:21
> Psycho-Babble was my lifeline going through Effexor withdrawal. Even when I was finally off Effexor, I still had the weird dizziness to deal with when I turned my head too quickly. Now, I don't have them at all. Ordeal over.
>
> I just wanted to add that I had the best success tapering off with a planned schedule of varying dosage changes. I posted it several times months ago if anyone wants to try it. 2 steps forward, 1 step back. :)
>
> Good Luck!
> KDi in TXplease post again
Posted by LynnM. on July 15, 2004, at 14:23:55
In reply to Re: to worm- how long, posted by worm on July 13, 2004, at 12:17:42
I am completely off the Effexor now, and I guess I can expect to feel all these above effects for a while. Still getting the brain zaps, moodiness, tiredness, inability to think clearly or think of common words/places/people. But, slowly getting my energy back, and the WANT to do something again.
My reason for the Effexor to start with was mild depression. I can definitely live without the med., and I look forward to getting back to "normal", whatever that is.
Good luck, everybody. It's not easy, being on it, or coming off of it. But, I really believe I'm better off without it. To feel euphoric all the time (and not caring about anything else) is just not how I want to conduct my everyday life.
Posted by cpallen79 on July 15, 2004, at 14:33:54
In reply to Re: Snake: How long does withdrawal last?, posted by KaraS on July 9, 2004, at 2:38:56
hello, I know firsthand just how hard effexor withdrawal is, it feels terrible and can be lengthy for some, but it ends. best of luck to all of you, and you will get through it.
Posted by worm on July 15, 2004, at 20:42:24
In reply to Re: to worm- how long, posted by LynnM. on July 15, 2004, at 14:23:55
LynnM: That is EXACTLY how I feel. I actually embrace my bad moods and temper tantrums (well, to a point) because I am actually LIVING life, not just floating through it. Just my personal feeling. I *am* trying to keep the blow-ups to a minimum, both in length and number. I think talk therapy would be more helpful in this area than drugs, anyway.
Good luck, Lynn
Posted by itsrick on July 15, 2004, at 23:49:00
In reply to Re: Snake: How long does withdrawal last?, posted by cpallen79 on July 15, 2004, at 14:33:54
> hello, I know firsthand just how hard effexor withdrawal is, it feels terrible and can be lengthy for some, but it ends. best of luck to all of you, and you will get through it.
sign the petition: http://www.petitiononline.com/effexor/petition.html
Posted by alan38 on July 16, 2004, at 5:48:28
In reply to Re: It does get better-I'm living proof, posted by itsrick on July 14, 2004, at 16:55:51
How Long did your process take. I still am experiencing the occasional "Zap" but I am taking 1/2 of a claritin D 3 times a week. I am day 32 totally of Effexor. I know this season will end but like they say "Enjoy the process"!
Posted by alan38 on July 16, 2004, at 5:52:58
In reply to Re: to worm- how long, posted by LynnM. on July 15, 2004, at 14:23:55
I am on day 32 or beginning of week (5). Brain zaps have decreased substantially. However, I am still taking 1/2 of a claritin D 3 times a week (don't have problem doing that). Totally eliminates the fogginess, residual zaps, dizziness, etc. I am with you that this may take a few months to totally clear up.
question- I was on 3 different ADs prior to Effexor over a (1) yr period. Do all ADs have the ability to produce the Brain Zaps withdrawl....
Posted by alan38 on July 16, 2004, at 5:58:17
In reply to to worm- how long, posted by snake on July 13, 2004, at 8:15:03
Question- I primarily feel the Zaps ( when I do feel them) in the morning, same time... Does anyone else experience that?
Posted by lorily on July 16, 2004, at 8:16:19
In reply to Re: to worm- how long, posted by alan38 on July 16, 2004, at 5:52:58
We get the zaps because effecor has such a short half life. the others stay in your system for much longer enabling your brain to adjust slowly
I tried benadryl for the zaps, seems to help, I can't take antihistamines. They mess me up
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