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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by ed_uk on August 3, 2005, at 16:14:29
J Psychopharmacol. 2004 Jun;18(2):200-4.
Tolerability of high-dose venlafaxine in depressed patients.Harrison CL, Ferrier N, Young AH.
School of Neurology, Neurobiology and Psychiatry, Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
High doses of antidepressants are often used for treatment-resistant depression. Venlafaxine, a dual serotonin and noradrenaline reuptake inhibitor, has been shown to have a tolerable side-effect profile in previous studies using doses of up to 375 mg/day. We investigated the tolerability of higher than currently recommended doses of venlafaxine using the UKU side-effect rating scale. Seventy outpatients fulfilling DSM-IV criteria for major depressive disorder were recruited into two demographically matched groups according to their daily dosage of venlafaxine: high dose n = 35 (> or = 375 mg/day, range 375-600 mg, average 437 mg/day) or standard dose n = 35 (< 375 mg/day, range 75-300 mg, average 195 mg/day. Clinical characteristics were noted and the UKU side-effect rating scale was administered to a subsample of patients. The most frequently reported complaints in both groups were increased fatigue (48%), concentration difficulties (48%), sleepiness/sedation (37%), failing memory (44.4%) and weight gain (29.6%). Apart from weight gain, the complaints were found to be experienced significantly more severely by the high-dose group. Six patients discontinued venlafaxine due to intolerable side-effects but only two of these patients were on a high dose. There was a tendency for mildly raised blood pressure in 10% of patients on an average dose of 342 mg/day. However, no difference between the two groups was found. This preliminary open study demonstrates that venlafaxine is tolerated at higher than British National Formulary recommended doses (i.e. up to 600 mg daily). However, increased frequency and severity of reported side-effects in the high-dose group are not associated with increased rates of discontinuation.
~Ed
Posted by KaraS on August 4, 2005, at 0:03:29
In reply to High dose Effexor, posted by ed_uk on August 3, 2005, at 16:14:29
High dose Effexor side effects sound like too much serotonin. Doesn't sound like the NE or DA kick in much, does it?
Posted by ed_uk on August 4, 2005, at 13:39:55
In reply to Re: High dose Effexor » ed_uk, posted by KaraS on August 4, 2005, at 0:03:29
LOL no, not much DA!
~Ed xxx
Posted by KaraS on August 4, 2005, at 18:55:58
In reply to Re: High dose Effexor » KaraS, posted by ed_uk on August 4, 2005, at 13:39:55
> LOL no, not much DA!
>
> ~Ed xxx
Sounds like high dose Effexor would produce very happy people who can't think straight or manage to get off of the sofa!K
xxx
Posted by med_empowered on August 5, 2005, at 9:04:47
In reply to Re: High dose Effexor » ed_uk, posted by KaraS on August 4, 2005, at 18:55:58
I had a friend on high-dose effexor, along with tegretol (Bipolar I, the "classic" form). Anyway...it wasn't all that great in terms of treating the depression..I mean, it was OK, but the side effects were rough and, I think, out-of-proportion to the benefits. Worse still...when she switched docs, her new doc attempted a taper (he's one of those "avoid ADs in bipolar" docs). Anyway, fast-forward a week or two...she ended up in a mental hospital after *severe* depression and *severe* withdrawal effects pushed her to the brink and she attempted suicide. Now...she's back on Effexor. At a higher dose.
Posted by ed_uk on August 5, 2005, at 16:51:32
In reply to Re: High dose Effexor, posted by med_empowered on August 5, 2005, at 9:04:47
Hi Med :-)
What dose is she on now?
~Ed x
This is the end of the thread.
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