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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by michael on January 15, 2000, at 11:51:32
I'm taking effexor xr 75mg once daily. I take it when I go to bed, due to the sedative effects it has on me.
I'm also taking 150mg of wellbutrin sr twice daily.
The effexor seems to help me to focus/concentrate & think a bit more clearly, and I am somewhat more outgoing again (don't avoid conversations, actually start them, etc.) I am also somewhat less sleepy & run-down, and have a little more motivation to get things done (previously just couldn't manage to get started on doing "x"). But it has not eliminated the tired/run-down/sleepy/non-motivated/lack-of-energy feelings.
I'm wondering if increasing the dose, in an attempt to increase the positive effects, tends to increase the original/sedative effect, or if increasing the dose might move it from a sedative to more of a stimulant effect?Anyone have different effects at different doses, or just increase of original effects?
Thanks, michael
Posted by noa on January 15, 2000, at 15:34:01
In reply to effexor dosage & side effects, posted by michael on January 15, 2000, at 11:51:32
How long have you been at this dose with both meds?
Posted by michael on January 15, 2000, at 16:05:23
In reply to Re: effexor dosage & side effects, posted by noa on January 15, 2000, at 15:34:01
> How long have you been at this dose with both meds?
I think I started the effexor xr 3/99, & I've been on 75mg since the second week.I think the wellbutrin was added in 6/99 at 150mg twice daily.
Last appt. was end of november. Next in february.
Planning at this point to ask about increasing effexor dosage, or moving on to another... (I think)
Posted by Noa on January 15, 2000, at 16:17:37
In reply to Re: effexor dosage & side effects, posted by michael on January 15, 2000, at 16:05:23
Your effexor dose is very low, and the wellbutrin is on the low side, too. Since you have relief of some of your symptoms, it is worth thinking about increasing one or both (but not at the same time) of your meds. Increase slowly, gradually, to avoid yucky adjustment side effects.
Posted by michael on January 15, 2000, at 16:32:41
In reply to Re: effexor dosage & side effects, posted by Noa on January 15, 2000, at 16:17:37
> Your effexor dose is very low, and the wellbutrin is on the low side, too. Since you have relief of some of your symptoms, it is worth thinking about increasing one or both (but not at the same time) of your meds. Increase slowly, gradually, to avoid yucky adjustment side effects.
Prior to the effexor, I had been on wellbutrin sr alone, at 200mg twice a day, which I thought was the recommended upper limit.
Didn't do much for me, except help with smoking.
That's why I swithched to the effexor. Added the wellbutrin again, because I slipped up, and started smoking again, after I had discontiued taking the wellbutrin the first time.
(by the way, the wellbutrin hasn't helped with the anorgasmia related to the effexor)
That's why I was asking about increasing the effexor dosage - will a larger dose be likely to increase the sedative effect, or might a larger dose change the sedative effect that it has on me to a more energizing effect.
(i'm guessing it'd only increase the sedative effect, & so - at least for the moment - I'm kind of leaning toward trying something different in place of the effexor )
michael
Posted by Noa on January 15, 2000, at 17:10:26
In reply to Re: effexor dosage & side effects, posted by michael on January 15, 2000, at 16:32:41
Michael, it might do either. What I have learned here is that every med affects different people diffently. For me, effexor (reg and xr) have been very activating, annoyingly so sometimes. BUt others have found it sedating. I have also learned that it can be sedating at lower doses and more activating at higher ones.
I feel pretty certain, tho that the sexual problems will not get better at higher doses. That is when thinking about a third augmenting agent comes in, because although you might get more antidepressant effect from higher dose of effexor, chances are you aren't going to be happy with the unwanted effects. That is why I started to add augmentors. Not so much because of sexual side effects, but becuase of motor twitches, insomnia, fidgitiness, memory problems, etc.
Posted by michael on January 15, 2000, at 17:30:12
In reply to Re: effexor dosage & side effects, posted by Noa on January 15, 2000, at 17:10:26
> Michael, it might do either. What I have learned here is that every med affects different people diffently. For me, effexor (reg and xr) have been very activating, annoyingly so sometimes. BUt others have found it sedating. I have also learned that it can be sedating at lower doses and more activating at higher ones.
>
> I feel pretty certain, tho that the sexual problems will not get better at higher doses. That is when thinking about a third augmenting agent comes in, because although you might get more antidepressant effect from higher dose of effexor, chances are you aren't going to be happy with the unwanted effects. That is why I started to add augmentors. Not so much because of sexual side effects, but becuase of motor twitches, insomnia, fidgitiness, memory problems, etc.Yes, I agree. It seems that there is absolutely NO way to predict how any of these will affect a particular individual. Perhaps I should give a higher dose a try before trying something new...
I have pretty much resigned my self to the fact that there will more than likely be some sexual side effect - regardless of the med. I think you also responded to the other thread I started yesterday about that topic.
As far as additional agents go, I've also pretty much resigned myself to that being the most probable route for effectively addressing the sexual issues. I plan to discuss ritalin, buspirone, bromocriptine, amantadine, and selegiline at my next visit - especially if I opt for the higher dose of effexor. Any preferences?
as far as the wellbutrin - I'm just using that as a crutch to try to stop smoking)
Thanks for all the feedback... and any further in the futue.
michael
Posted by juniper on January 16, 2000, at 0:29:27
In reply to Re: effexor dosage & side effects, posted by michael on January 15, 2000, at 17:30:12
micheal,
have you been on other ADs aside from effexor and wellbutrin?
of the medications you listed, i don't think buspirone would help too good for your lack of energy....ritalin may help this (have you considered adderall? i think there are a few babblers who have had success on an effexor and adderall combo.) i do not know how bromocriptine affects energy, but it is certainly touted as one to increase sex drive and function.
if you do think that effexor has helped you, maybe augumentation for the side effects is the way to go. i am weary now of discontinuing a med that is helping because of side effects...i've done it a couple times, realized that i was better on the med even with side effects, and taken it again with no luck. i think that this is the same case for many people who discontinue an AD--for some reason it does not have the same effect if taken again. but, of course, talk with your doctor.
good luck!
juniper
Posted by michael on January 16, 2000, at 11:48:22
In reply to Re: effexor dosage & side effects, posted by juniper on January 16, 2000, at 0:29:27
> micheal,
>
> have you been on other ADs aside from effexor and wellbutrin?
>
> of the medications you listed, i don't think buspirone would help too good for your lack of energy....ritalin may help this (have you considered adderall? i think there are a few babblers who have had success on an effexor and adderall combo.) i do not know how bromocriptine affects energy, but it is certainly touted as one to increase sex drive and function.
>
> if you do think that effexor has helped you, maybe augumentation for the side effects is the way to go. i am weary now of discontinuing a med that is helping because of side effects...i've done it a couple times, realized that i was better on the med even with side effects, and taken it again with no luck. i think that this is the same case for many people who discontinue an AD--for some reason it does not have the same effect if taken again. but, of course, talk with your doctor.
>
> good luck!
> juniperThanks for the input - I'll add adderall to my short list to talk about with the doctor.
I was looking at the ones I had listed primarily for addressing the sexual side effects, rather than the energy issue. I actually do have a bit more energy etc. with the effexor, just not enough - like one step in the right direction, but not all the way there.
Ironically, if I take the effexor in the morning, it does make me sleepy - but even so, I was sleeping less with the effexor in the morning, than I was sleeping before I was taking the effexor.
So now I'm leaning toward increasing the effexor, in spite of the sexual side effects at my current lower dosage, to see what that does for/to me in the bigger picture. Like I said, I figure I'll probably have to deal with the sexual side effects as a secondary/seperate issue regardless of whatever med/dosage I end up on. But I'm gonna make that the second priority.
By the way, haven't tried any other AD's besides these two (effexor & wellbutrin).
Thanks for the feedback...
michael
Posted by Julie on January 16, 2000, at 20:19:31
In reply to Re: effexor dosage & side effects, posted by michael on January 16, 2000, at 11:48:22
My two cents on Effexor: I take 225 XR, with trazodone or clonazepam at night so I can get to sleep. I went up from 150; at that dosage I wasn't depressed, but a little sadder and grouchier than I wanted to be. I like Effexor a lot. Most important, it keeps me undepressed, without making me feel emotionally numb, as I did on Zoloft. The side effects are annoying, though: for me, insomnia, fidgetiness, a little more anxiety than on Zoloft and slightly decreased sexual response.
Posted by Cindy W on January 18, 2000, at 9:12:24
In reply to Re: effexor dosage & side effects, posted by Julie on January 16, 2000, at 20:19:31
> My two cents on Effexor: I take 225 XR, with trazodone or clonazepam at night so I can get to sleep. I went up from 150; at that dosage I wasn't depressed, but a little sadder and grouchier than I wanted to be. I like Effexor a lot. Most important, it keeps me undepressed, without making me feel emotionally numb, as I did on Zoloft. The side effects are annoying, though: for me, insomnia, fidgetiness, a little more anxiety than on Zoloft and slightly decreased sexual response.
Michael, another "two cents" on Effexor-XR...I've been taking it for a couple of months, and now am taking 225 mg/day. Am hoping my psydoc will let me increase it further, because I'm feeling less depressed and less controlled by my OCD. I've found it energizing, not sedating, and it didn't cause me any sexual side effects (unlike Prozac, Luvox, Zoloft). Serzone and Effexor-XR are not ssri's (ssri's tend to have sexual side effects). Good luck to you.--Cindy W
Posted by Sassy on January 21, 2000, at 18:35:46
In reply to effexor dosage & side effects, posted by michael on January 15, 2000, at 11:51:32
Michael,
I've been on both for approximately a month or so.
I started off at the mid or higher doseages right away.
At the beginning I did get tired from effexor on
150 mg twice a day. After about a week or so it was increased to 3 times a day and most definately the tireness went away. I instead have a layed back feeling.I don't know if higher doseage or getting adjusting to the med took care of this.Wellbutrin was added where I now take it 2 times a day 150 mg. I don't know if the addition is making things better mentally. Mentally, I felt fine with the effexor along. I did want something added for a little more stimulation.
Even though I am not having sex, even though all the other depressed people on this site are, I
did notice that the Wellbutrin stimulated my drive
and things.The side effects, however I experienced with the addition of the Wellbutrin had me severly bloated at first and now I have a constant feeling of fullness and being bloated and constipated. It appears I may be the only one that feels this way.
The wellbutrin did help with the enormous appetite I received from effexor. Again, different from every one else's experience.
I'm sticking with it to see if the physical problems go away.
Regards,
Cassandra
> I'm taking effexor xr 75mg once daily. I take it when I go to bed, due to the sedative effects it has on me.
>
> I'm also taking 150mg of wellbutrin sr twice daily.
>
> The effexor seems to help me to focus/concentrate & think a bit more clearly, and I am somewhat more outgoing again (don't avoid conversations, actually start them, etc.) I am also somewhat less sleepy & run-down, and have a little more motivation to get things done (previously just couldn't manage to get started on doing "x"). But it has not eliminated the tired/run-down/sleepy/non-motivated/lack-of-energy feelings.
>
> I'm wondering if increasing the dose, in an attempt to increase the positive effects, tends to increase the original/sedative effect, or if increasing the dose might move it from a sedative to more of a stimulant effect?
>
> Anyone have different effects at different doses, or just increase of original effects?
>
> Thanks, michael
Posted by michael on January 21, 2000, at 20:56:15
In reply to Re: effexor dosage & side effects, posted by Sassy on January 21, 2000, at 18:35:46
Cassandra,
Thanks for the feedback Cassandra - good luck with the side effects!
michael
> Michael,
>
> I've been on both for approximately a month or so.
>
> I started off at the mid or higher doseages right away.
>
> At the beginning I did get tired from effexor on
> 150 mg twice a day. After about a week or so it was increased to 3 times a day and most definately the tireness went away. I instead have a layed back feeling.I don't know if higher doseage or getting adjusting to the med took care of this.
>
> Wellbutrin was added where I now take it 2 times a day 150 mg. I don't know if the addition is making things better mentally. Mentally, I felt fine with the effexor along. I did want something added for a little more stimulation.
>
> Even though I am not having sex, even though all the other depressed people on this site are, I
> did notice that the Wellbutrin stimulated my drive
> and things.
>
> The side effects, however I experienced with the addition of the Wellbutrin had me severly bloated at first and now I have a constant feeling of fullness and being bloated and constipated. It appears I may be the only one that feels this way.
>
> The wellbutrin did help with the enormous appetite I received from effexor. Again, different from every one else's experience.
>
> I'm sticking with it to see if the physical problems go away.
>
> Regards,
> Cassandra
>
>
> > I'm taking effexor xr 75mg once daily. I take it when I go to bed, due to the sedative effects it has on me.
> >
> > I'm also taking 150mg of wellbutrin sr twice daily.
> >
> > The effexor seems to help me to focus/concentrate & think a bit more clearly, and I am somewhat more outgoing again (don't avoid conversations, actually start them, etc.) I am also somewhat less sleepy & run-down, and have a little more motivation to get things done (previously just couldn't manage to get started on doing "x"). But it has not eliminated the tired/run-down/sleepy/non-motivated/lack-of-energy feelings.
> >
> > I'm wondering if increasing the dose, in an attempt to increase the positive effects, tends to increase the original/sedative effect, or if increasing the dose might move it from a sedative to more of a stimulant effect?
> >
> > Anyone have different effects at different doses, or just increase of original effects?
> >
> > Thanks, michael
Posted by Julie on January 22, 2000, at 11:37:20
In reply to Re: effexor dosage & side effects, posted by Sassy on January 21, 2000, at 18:35:46
Sassy-
I noticed a big appetite on Effexor too, when my dosage was 150. I'd gained a lot of weight on Zoloft, and most had stayed on despite my steady exercising and trying to eat sensibly. I think both Zoloft and Effexor at 150 did increase my appetite (and do something funky to my metabolism? there are often threads on SSRI weight gain on this board). One of the reasons my pdoc increased my Effexor dosage to 225 was to see if it would decrease my appetite. And so far, it has. For the first time since I began Zoloft 7 years ago, I'm not constantly ravenous, and when I eat I get full more easily. Yahoo!
Posted by Cindy W on January 22, 2000, at 13:04:01
In reply to The effexor munchies: to Sassy, posted by Julie on January 22, 2000, at 11:37:20
> Sassy-
> I noticed a big appetite on Effexor too, when my dosage was 150. I'd gained a lot of weight on Zoloft, and most had stayed on despite my steady exercising and trying to eat sensibly. I think both Zoloft and Effexor at 150 did increase my appetite (and do something funky to my metabolism? there are often threads on SSRI weight gain on this board). One of the reasons my pdoc increased my Effexor dosage to 225 was to see if it would decrease my appetite. And so far, it has. For the first time since I began Zoloft 7 years ago, I'm not constantly ravenous, and when I eat I get full more easily. Yahoo!Julie, the Effexor-XR decreased my appetite too (I'm starting to lose the weight I gained on Zoloft).--Cindy W
Posted by Sassy on February 1, 2000, at 19:18:13
In reply to Re: The effexor munchies: to Sassy, posted by Cindy W on January 22, 2000, at 13:04:01
Julie and Cindy,
Just reading replies. The question is how high
can I go? I'm already on 450 mg a day.I stopped the wellbrutin on my own because the bloating was way out of control and wanted to see if it made a difference and it had not. I'm sure it is the effexor. It works so good on depression, I've got to find a solution.
I'm wondering if there is a certain level on toxins trapped in the body causing this reaction.
Trying every route I can think of sweating, steam,
whirlpool.I went to the weight doctor to get diet pills and water pills. I heardly released any water!
I'm going to request an increase based on your
lengthy years of experience. Thank you.Sassy
> >Sassy
> > I noticed a big appetite on Effexor too, when my dosage was 150. I'd gained a lot of weight on Zoloft, and most had stayed on despite my steady exercising and trying to eat sensibly. I think both Zoloft and Effexor at 150 did increase my appetite (and do something funky to my metabolism? there are often threads on SSRI weight gain on this board). One of the reasons my pdoc increased my Effexor dosage to 225 was to see if it would decrease my appetite. And so far, it has. For the first time since I began Zoloft 7 years ago, I'm not constantly ravenous, and when I eat I get full more easily. Yahoo!
>
> Julie, the Effexor-XR decreased my appetite too (I'm starting to lose the weight I gained on Zoloft).--Cindy W
Posted by Cindy W on February 1, 2000, at 21:49:10
In reply to Re: The effexor -How high can you go!, posted by Sassy on February 1, 2000, at 19:18:13
> Julie and Cindy,
>
> Just reading replies. The question is how high
> can I go? I'm already on 450 mg a day.
>
> I stopped the wellbrutin on my own because the bloating was way out of control and wanted to see if it made a difference and it had not. I'm sure it is the effexor. It works so good on depression, I've got to find a solution.
>
> I'm wondering if there is a certain level on toxins trapped in the body causing this reaction.
>
> Trying every route I can think of sweating, steam,
> whirlpool.
>
> I went to the weight doctor to get diet pills and water pills. I heardly released any water!
>
> I'm going to request an increase based on your
> lengthy years of experience. Thank you.
>
> Sassy
>
> > >Sassy
> > > I noticed a big appetite on Effexor too, when my dosage was 150. I'd gained a lot of weight on Zoloft, and most had stayed on despite my steady exercising and trying to eat sensibly. I think both Zoloft and Effexor at 150 did increase my appetite (and do something funky to my metabolism? there are often threads on SSRI weight gain on this board). One of the reasons my pdoc increased my Effexor dosage to 225 was to see if it would decrease my appetite. And so far, it has. For the first time since I began Zoloft 7 years ago, I'm not constantly ravenous, and when I eat I get full more easily. Yahoo!
> >
> > Julie, the Effexor-XR decreased my appetite too (I'm starting to lose the weight I gained on Zoloft).--Cindy WSassy, I've read that the max. dose for Effexor is 375 mg/day and for Effexor-XR 225 mg/day; however, I know that I've also read that these are the FDA doses, and that psychiatrists prescribe the medication dosage depending on what is appropriate for each person. I've read that some people may be on as high as 500-600 mg/day of Effexor, and 375 mg/day of Effexor-XR. Ask your doctor! Right now, I'm taking 300 mg/day of Effexor-XR for OCD and depression. The bloating you describe is interesting. I'm not aware of that being from Effexor-XR, for me....but my stomach has always been prominent (which makes me very afraid all the time of ovarian cancer, and makes it hard to get pants that fit!) 8) -- Cindy W
Posted by Julie on February 1, 2000, at 22:49:11
In reply to Re: The effexor -How high can you go!, posted by Cindy W on February 1, 2000, at 21:49:10
Cindy-
I know about that ovarian cancer fear for sure. My mom died of it. So I get really freaked out about bloating, unexplained weight gain, vague abdominal pains, etc-- and I've had all of the above with both Zoloft and Effexor. It is annoying, to say the least. Luckily, I have a gyn. doctor who takes me seriously. I did go down on the Effexor to 187; was feeling very jittery at 225. Sure enough, I started feeling very hungry again almost immediately. (Placebo effect?) Grrr.
Posted by Maurice Tolefree on April 5, 2000, at 10:30:29
In reply to Re: effexor dosage & side effects, posted by juniper on January 16, 2000, at 0:29:27
I haven't been taking the medicine long but so far I like the results of it. The only side effects that I have so far is headaches and upset stomach. But I recommend this drug to anyone that has ADD I think that you would enjoy it and feel a whole lot better about yourself. If you could respond and give me a little more information about the sex drive.
Thanks,
Maurice
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