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Cat Forum / Cat Anecdotes / March 2005{OT} Antidepressant Issues
This is my first vent here... I want to get off the Effexor I've been taking for depression for almost a year now. I've been more stable than DP's seen me to be in the past 8 years, in the last 6 months. Unfortunately, in those last 6 months I also sleep about 12 hours a day, and occasionally I get this "Stoned" sensation where stuff gets blurry and I have trouble thinking of words or figuring out just where I am...I'll wander and then snap out of my reverie like, two hours later, wondering where the time went. The stuff's expensive as hell, I have no drug coverage, and there's no way I can do a master's thesis in September if I'm sleeping more than I'm awake. If I want back on flight operations, I have to lose the drugs that could affect my ability to control an aircraft. So today I'm at the doctor's and he tells me that if I quit the stuff, I'm almost guaranteed to relapse. DP's afraid I will, sometime when no one's around to stop me from cutting my throat--or someone else's. I'm in my 20s. I don't want to be on this crap for the rest of my life. Hell, the concept of being stuck on drugs is one of the big reasons I left my depression untreated until I became a menace to people around me as well as myself. I think I know the symptoms well enough--if I start inflicting injury on myself and viewing life through a red rage haze, it's time to go back on the pills. I was depressed, I think, since about age 4 or so, but during that time I only had two severe (ie, want-to-kill-myself) episodes, and those 8 years apart. The minor rounds I could handle without chemical interference. At that rate, it'd be 2013 before I needed pills again. That's a lot of money and a lot of drug-free years. That red haze is starting to creep back a little, since the doc didn't in any way suggest that this was a "for the rest of my life" kind of thing until just now. I feel like I've gotten suckered into this situation, and that pisses me off. --Enfilade > That red haze is starting to creep back a little, since the doc didn't > in any way suggest that this was a "for the rest of my life" kind of > thing until just now. I feel like I've gotten suckered into this > situation, and that pisses me off. > > --Enfilade Aw Fil, I know *EXACTLY* how you feel. My doctor put me on Effexor because it's supposed to help with the pain of Fibromyalgia. Not *ONCE* did he tell me that the withdrawals from this drug are worse than the withdrawals from heroine - and last longer. Please, *PLEASE*, don't quit taking this drug cold turkey (that's what I did because my doctor wouldn't help me get off them in a gradual way). I ended up in the emergency room and found out later that I could have killed myself by doing this. My daughter was also put on Effexor, but for depression. She wanted to get off of them too, but couldn't, not even with a gradual withdrawal (as soon as she missed one dose she would have horrible, severe flu-like symptoms. Some other withdrawal symptoms of Effexor that I had are feeling like I was being electrocuted with pulsing shock like feelings all through my body, nausea, heart palpitations, cold sweats, insomnia, dizziness, headaches, shakes, going into fugue states and not remembering where I was or what I was doing (really scary when you're driving), crying jags and screaming rages. There is supposedly a class-action lawsuit against Wyeth-Ayerst Labs because they knew all about these symptoms but still pushed this drug for all kinds or medical problems besides depression. There are newsgroup and chat rooms dedicated to nothing but the horrible side effects and withdrawal symptoms of this drug. Here is the result of a google search on Effexor withdrawal symptoms: http://www.google.com/search?hl=en&q=effexor+withdrawals. Again, please be very careful how you go about getting off this drug, if you decide to. I've heard that ClaritinD helps somewhat with the withdrawals. Hugs, CatNipped <very gently snipped > > My daughter was also put on Effexor, but for depression. She wanted to get off of them too, but couldn't, not even with a gradual withdrawal (as soon as she missed one dose she would have horrible, severe flu-like symptoms. > Hi Nipped, That is one of the symptoms I had when I first stepped down the dosage - major flu like symptoms, and extremely exhausted. I am now over that, but it took almost a month. My dr. said it was a Fibromyalgia flare, and it was because the Effexor had been controlling the symptoms and it wasn't any more. Honestly, I felt WORSE after this drug than I ever did before as far as the fibro went. It is like it exacerbated it, rather than controlling it. Thanks for the tip on ClaritinD - I will most certainly try it. Patti > Hi Nipped, > [quoted text clipped - 4 lines] > more. Honestly, I felt WORSE after this drug than I ever did before as far > as the fibro went. It is like it exacerbated it, rather than controlling it. Yeah, for me too. I really didn't feel any diminishment of pain from the fibro while I was on the Effexor. It *did* help the depression that was caused by the fibro (finding out that you're going to be in constant pain for the rest of your life can be quite depressing). And you're right, the pain during withdrawals was definitely worse than the pain I had before I started taking it. I really don't know why they haven't taken this drug off the market - there's beeen thousands of complaints to the FDA about it. I think there's been some *marjor* payoffs regarding this golden goose of the drug company that manufactures it. Hugs, CatNipped > Thanks for the tip on ClaritinD - I will most certainly try it. > > Patti >>Hi Nipped, >> [quoted text clipped - 19 lines] > think there's been some *marjor* payoffs regarding this golden goose of the > drug company that manufactures it. It really does work for some people - me for one. When I started it I felt like I'd been woken up after years asleep. I'm not good at describing this sort of thing, but on this drug I actually started to feel like I could DO something - make choices and take actions - that might have some sort of effect on my life. I'd been through the usual list of other antidepressants - some didn't work at all, some worked for a while, one worked well but I had an allergic reaction to it. I'm down to a really low dose now, but am not keen to stop it altogether in case I slide back into that old black hole again. So I can say it's been good for me, but obviously it's not good for everyone and probably is dangerous for some. What gets to me about the antidepressant drug business is that it's very well known that some drugs will work for some people while others will work better for other people. But, the only way to find out which one's right for you is the brute force approach - try 'em all until you find one that works for you. There's very little research that examines which antidepressants work best for which people out in the community and why. <cynic> After all, drug manufacturers are probably doing quite well out of the brute force approach... it wouldn't be in THEIR best interests to sponsor research that might find a better way. would it? </cynic> > What gets to me about the antidepressant drug business is that it's very > well known that some drugs will work for some people while others will [quoted text clipped - 6 lines] > interests to sponsor research that might find a better way. would it? > </cynic> Actually, there is a lot of research, or at least experience that gets shared among the psychiatrists that really want the information. They may be specialists in psychopharmacology. Sometimes, the extra training there can get them networking with the right people. I remember a scathing editorial on Medscape.com by a pediatric psychopharmacologist, who was furious at all too many psychiatrists who overprescribe the newer drugs. Why? Not studying? Too much influence by pharmaceutical companies? Now, pharmacology has always been one of my interests. I've found a surprising number of doctors that don't know the biochemistry of the multiple classes of drugs useful in different kinds of depression and with different patients, including: Post-synaptic nonselective of ST and NE, operating on the catechol-O-methyl-transferase enzyme system Post-synaptic nonselective of ST and NE, operating on the monoamine oxidase enzyme system Pre-synaptic selective ST reuptake inhibitors "Atypical" pre-synaptic ST reuptake inhibitors Pre-synaptic nonselective ST/NE reuptake inhibitors Pre-synaptic selective NE reuptake inhibitors Anticonvulsants Lithium Stimulant amines like Ritalin Strattera ... need I go on? Something that often gets missed is a patient with mixed anxiety and depression, who may need an anxiolytic as well as an antidepressant. There are also drugs that can help minimize the side effects of some of the psychotropics, such as beta-blockers to minimize the hand tremor common with the anticonvulsant valproate. >>What gets to me about the antidepressant drug business is that it's very >>well known that some drugs will work for some people while others will [quoted text clipped - 49 lines] > effects of some of the psychotropics, such as beta-blockers to minimize > the hand tremor common with the anticonvulsant valproate. OK, I'm only a number-cruncher - I freely admit that I know nothing about pharmacology and I'm just spouting speculation. But it does seem to me that an awful lot of published drug studies don't reflect how medications are really used in the community as opposed to what happens in carefully controlled clinical trials. In Australia (don't know whether things are different in the USA) hardly anyone would be able to get their antidepressants prescribed by a psychiatrist - there are just so few of them that even if you're able to pay privately, the waiting list for an appointment will be months long. You really have to be so ill that you're a danger to other people (a danger to yourself isn't enough) to be able to see a psychiatrist quickly. So, most people have to go to a GP to get a prescription, and I guess the shared experience of specialist psychiatrists on choosing an antidepressant isn't reaching them. Then again, the shrinks are probably too darned overworked to publish what they know... I must say that cuddling a cat is one of the best ways I've found to deal with depression in the short term. I personally find a big, heavy one with long whiskers and loud purrs most effective. > >>What gets to me about the antidepressant drug business is that it's > >>very [quoted text clipped - 58 lines] > medications are really used in the community as opposed to what happens > in carefully controlled clinical trials. Precisely. In the US, the manufacturer applies to the Food and Drug Administration (FDA) with a New Drug Application (NDA) seeking licensing of a new drug. The FDA and the manufacturer agreee on the clinical trials that have been done [1] or need to be done, and, when there is sufficient information, an approval officer or panel decides whether to authorize a license. [1] Earlier in the process, a manufacturer, or independent researcher, can apply for an Investigational New Drug (IND) application, which gives the authority to use it in clinical trials. INDs are not available by prescription, although there is a "compassionate use" procedure by which a clinician can request a supply of the experimental drug for a patient in whom all other therapies have failed. Each NDA is for a specific list of "indications", or conditions the manufacturer asserts the drug will treat. Physicians are permitted to prescribe drugs for "off-label" indications not in the manufacturers' literature. Part of the time, off-label prescribing can be a good way to use the knowledge of experienced physicians, especially for rarer conditions where the manufacturer didn't want to pay for clinical trials for the other indication. An unfortunate other part of the time, however, we have seen pharmaceutical company representatives pushing off-label indications to increase sales, with no data backing it up. Incidentally, I'm not opposed to all pharmaceutical representatives, often called "detail men". Some are extremely knowledgeable, help independent researchers and clinicians meet one another, and act as a channel between practicing physicians and the company research department. Others have the ethics of used car salesmen --- and that's increasingly common in their profit-driven upper management. It's sad to remember that the accepted term for the US prescription drug manufacturers was the "ethical pharmaceutical industry." At one time, many of the manufacturers really did have a commitment to medicine over short-term profit. > In Australia (don't know whether things are different in the USA) hardly > anyone would be able to get their antidepressants prescribed by a [quoted text clipped - 6 lines] > antidepressant isn't reaching them. Then again, the shrinks are probably > too darned overworked to publish what they know... Quite frankly, then, I'll put in a suggestion to the Australian medical authorities that they might do well to use computer assistance from one of my research areas: expert systems for prescribing. While my work has more been in cardiology and infectious disease, it's quite possible to construct a "consultant in a box" that can help a primary physician select drugs and find alternatives. Unfortunately, there is an overall problem of specialist knowledge reaching GPs. In the US, there are several annual studies that show poor dissemination of knowledge. For example, cardiologists (a subspecialty of internal medicine, with their own subspecialties beyond that) usually know what drugs have been found good and bad in treating heart attack or congestive heart failures. Some of the effective drugs are NOT intuitive. Internists don't have as high a knowledge of the correct drugs. The percentage of primary care physicians that know the most up-to-date therapies tends to be even lower. > I must say that cuddling a cat is one of the best ways I've found to > deal with depression in the short term. I personally find a big, heavy > one with long whiskers and loud purrs most effective. Absolutely. Purring time should be reimbursable under all insurance plans! >>In Australia (don't know whether things are different in the USA) hardly >>anyone would be able to get their antidepressants prescribed by a [quoted text clipped - 13 lines] > construct a "consultant in a box" that can help a primary physician > select drugs and find alternatives. I can only say as a patient that such a thing sounds incredibly useful and worthwhile; I wish I'd been recommended the right medication for me years earlier. And, since almost all medicines in Australia are state-subsidised through the national pharmaceutical benefits scheme, those making the decisions in Canberra ought to be very interested too. Also, recent changes to how PBS data collections can be used in research should make it relatively easy to evaluate any effects on prescribing practices on a large scale - I'd think it would be possible to demonstrate clear cost savings and keep the bureaucrats happy as well as the patients. I say bring it on... that's one opinion out of 20 million or so anyway. This is my first vent here... I want to get off the Effexor I've been taking for depression for almost a year now. I've been more stable than DP's seen me to be in the past 8 years, in the last 6 months. Unfortunately, in those last 6 months I also sleep about 12 hours a day, and occasionally I get this "Stoned" sensation where stuff gets blurry and I have trouble thinking of words or figuring out just where I am...I'll wander and then snap out of my reverie like, two hours later, wondering where the time went. The stuff's expensive as hell, I have no drug coverage, and there's no way I can do a master's thesis in September if I'm sleeping more than I'm awake. If I want back on flight operations, I have to lose the drugs that could affect my ability to control an aircraft. So today I'm at the doctor's and he tells me that if I quit the stuff, I'm almost guaranteed to relapse. DP's afraid I will, sometime when no one's around to stop me from cutting my throat--or someone else's. I'm in my 20s. I don't want to be on this crap for the rest of my life. Hell, the concept of being stuck on drugs is one of the big reasons I left my depression untreated until I became a menace to people around me as well as myself. I think I know the symptoms well enough--if I start inflicting injury on myself and viewing life through a red rage haze, it's time to go back on the pills. I was depressed, I think, since about age 4 or so, but during that time I only had two severe (ie, want-to-kill-myself) episodes, and those 8 years apart. The minor rounds I could handle without chemical interference. At that rate, it'd be 2013 before I needed pills again. That's a lot of money and a lot of drug-free years. That red haze is starting to creep back a little, since the doc didn't in any way suggest that this was a "for the rest of my life" kind of thing until just now. I feel like I've gotten suckered into this situation, and that pisses me off. --Enfilade > Hi Fil, I have been on Effexor for about 3 years, and am now in the process of stepping down the dose in order to quit. I was having some of the same symptoms as you - the feeling of 'not being there' is one major one, and the just not caring about things. Plus, I am one of the 5 to 10% that develop high blood pressure while taking it. :P I finally told my doc that I WAS going to d/c this, with or without his help. He finally agreed, with the proviso that if I become depressed again I would tell him. It hasn't been completely easy, but at least I am able to feel again. I hope you can get your dr. to take you off this, and that everything goes ok! Patti > This is my first vent here... > [quoted text clipped - 36 lines] > > --Enfilade Hi Enfilade, Effexor is a big time drug to be on for depression - it is usually used for major depression and even some psychotic disorders. I understand that you want off of the medication because you feel good now - but remember, that is the medication helping you to feel better and control your depression. If you are wanting to try something that won't turn you into a zombie, ask your doctor about weaning off of it, while being started on something else. If you are taken off of medication completely and you begin to relapse, you could spiral downward before a new drug takes effect (anti-depressants usually take 3-4 weeks before full effect is reached). The consequesnces of that far outweight the benefits of being "drug-free." Also, a relapse is usually worse once being taken off of a medication because of the major changes in the chemicals in your brain... Please be careful :-) I know there is a stigma attached to being on medication for depression, but it is an illness.... Really think of the benefits of the medication vesus the possible results of being off of the medication. Talk to your doc first about switching to a different kind, one that still helps your symptoms, but with less side effects. Good luck :-) > Hi Enfilade, > [quoted text clipped - 16 lines] > medication. Talk to your doc first about switching to a different kind, one > that still helps your symptoms, but with less side effects. Good luck :-) This is wonderful advice, judging from my experience with clinically' depressed loved ones. Have your doctor help you find a drug that does not interefere with your quality of life--but remember that depression kills. It is a terrible, debilitating disease. >> Hi Enfilade, >> [quoted text clipped - 27 lines] > does not interefere with your quality of life--but remember that > depression kills. It is a terrible, debilitating disease. I would say AMEN to that. I used to think it must mean you feel sad all the time, which isn't very nice, but I have to say and emphasise that I had absolutely no idea what it could be like until I got it. It is the worst illness I have ever had. I totally understand why people kill themselves when they have it. It's completely disabling. I would rather have 10 eye operations (I've had 6 so I can say this..) than have another bout of clinical depression. Imagine that you cannot be bothered to get yourself a meal, even though you're hungry. So you don't. Neither can you be bothered to have a bath, or wash your hair, or get undressed for bed at night and it doesn't seem to matter. It's no good at all "giving yourself a strict talking-to" it makes no difference. Decisions are impossible. Faced with only two choices, you can't decide which. Driving is difficult as you cannot decide, at a busy junction, when it's safe to emerge. You realise this as the traffic builds up behind, but it's the only way to get to the supermarket. When you get in the supermarket, although you know what you want, somehow it's not possible to sequence things in the right order. Now normally, without depression, I go to the supermarket, know exactly what I want, and go round the aisles in the right order to get it. I could not do this! I wandered around for 2 hours hoping I would spot something I needed. I phoned a friend who is a mental health social worker. I sobbed and asked her if she thought I was completely mad or something. She came round and we talked. Everything was caused by depression, she promised. She was quite right. I am 7/8th recovered. I can work and my driving is okay now. I am good in the supermarket. I can multi-task at work. I bath and wash my hair regularly. Even so, I know I am not quite as before. Big hugs to anyone on the group who has the big D, it is a life-changing experience and one I would not wish on my worst enemy. Tweed Christina, this description is spot-on. The worst is how some people just can't/won't understand that it's not something you can just "snap out of," that it's not because you're "not trying hard enough" or because you're lazy. And you wonder if maybe they're right, but no matter how hard you try you can't make progress. > I would say AMEN to that. I used to think it must mean you feel sad all the > time, which isn't very nice, but I have to say and emphasise that I had [quoted text clipped - 32 lines] > > Tweed  Signaturemonique, who spoils Oscar unmercifully pictures: http://www.bounceswoosh.org/rpca Hi Enfilade, Just want to let you know I wrote you a private email on this subject. Let me know if you don't get it. regards, Christine > This is my first vent here... > [quoted text clipped - 36 lines] > > --Enfilade Is there a different antidepressant, with fewer side effects, that your doctor can help you switch over to? Nobody wants to be on meds for the long haul. That goes double for a med that's causing side effects that are as disruptive to daily living as the problem the medicine is supposed to be relieving. But some people, including me, would be in a permanent state of depression without meds. In my case, even what I USED to think of as a normal state was a low-level state of depression, and I've wavered between that and flat-out clinical depression since I was 10. (Which means I've been dealing with this for over 30 years.) But it was being downsized a few years ago that brought on a really, REALLY severe and unrelenting case of depression. Finally, I went to the doctor because the symptoms were not only debilitating, they were showing no signs of lifting. The prescription I'm on right now is Celexa (citalopram), and it has helped a lot. It also doesn't have the side effects you were describing. Maybe you can discuss switching over to that or to a different prescription that will help the depression, minus the side effects you're getting from the Effexor. My husband is on thyroid medication, permanently, because his thyroid doesn't produce enough hormone on its own. Friends and relatives of mine take insulin or pills to regulate diabetes, since their bodies don't produce enough insulin. And there's no difference between their permanent need for meds, and the fact that my body needs some help getting the serotonin level right. There's no shame in needing any of those meds, or any other prescription, not even if it's necessary over the long haul. It's not fun AT ALL to have to deal with these issues. :o( But see if you can work with your doctor to change to a different medication. And if this doc won't work with you on that, it's time for a second opinion. Keep us posted. Donna (Snip) >But some people, including me, would be in a permanent state of depression >without meds. In my case, even what I USED to think of as a normal state >was a low-level state of depression, and I've wavered between that and >flat-out clinical depression since I was 10. (Which means I've been >dealing with this for over 30 years.) I have to second this. These days with managed care, a lot of antidepressants are prescribed by general physicians who frankly don't have the right pharmocological background. I've been very lucky-- in a sense-- because my depressions have always been under a psychiatrist's treatment. I'm not saying this is true of everyone, but with my history, and my genetics, I have a very strong inclination towards depression. I would no more try to "tough" out a depression without medication than I would refuse insulin if I were diabetic. I have had the experience of withdrawing off a very tough drug (nardil), and while I never hope to repeat such a thing, it was incredibly important that I do it. I am now stable on a low dose of Wellbutrin, which seems to have little/no side effects for me. Theresa Stinky Pictures: http://community.webshots.com/album/125591586JWEFwh My Blog: http://www.humanitas.blogspot.com "Kreisleriana" <kreisleriana2@yahoo.com> wrote : > I have to second this. These days with managed care, a lot of > antidepressants are prescribed by general physicians who frankly don't > have the right pharmocological background. Yes. And they are prescribing them to people without clinical illness, in many cases. Sometimes I think half the people on antidepressants are not clinically depressed, they just want to "feel better." I think this is dangerous. I've been very lucky-- in > a sense-- because my depressions have always been under a > psychiatrist's treatment. I'm not saying this is true of everyone, [quoted text clipped - 6 lines] > incredibly important that I do it. I am now stable on a low dose of > Wellbutrin, which seems to have little/no side effects for me. Wellbutrin has been a wonder drug for a friend of mine. So few side effects for her. > Wellbutrin has been a wonder drug for a friend of mine. > So few side effects for her. I would recommend that one too. No sexual or other side effects - *AND* it will help you diet and quit smoking (it helps with impulse control). Hugs, CatNipped > > Wellbutrin has been a wonder drug for a friend of mine. > > So few side effects for her. > > I would recommend that one too. No sexual or other side effects - *AND* > it > will help you diet and quit smoking (it helps with impulse control). Again, no drug is completely safe, although this is one of the good ones. Any antidepressant can have sexual side effects. Welbutrin/Zyban (same drug) is especially safe in cardiac patients, but needs to be used in caution with anyone with a history of seizures. Howard Berkowitz <hcb@gettcomm.com> had some very interesting things to say about Re: {OT} Antidepressant Issues: >Again, no drug is completely safe, although this is one of the good >ones. Any antidepressant can have sexual side effects. Welbutrin/Zyban >(same drug) is especially safe in cardiac patients, but needs to be used >in caution with anyone with a history of seizures. On one e-mail list I used to be on, a male participant commented that his wife's antidepressant rather increased her drive. He wasn't complaining. :-) Signature"The universe is quite robust in design and appears to be doing just fine on its own, incompetent support staff notwithstanding. :-)" - the Dennis formerly known as (evil), MCFL > Howard Berkowitz <hcb@gettcomm.com> had some very interesting things > to say about Re: {OT} Antidepressant Issues: [quoted text clipped - 7 lines] > his wife's antidepressant rather increased her drive. He wasn't > complaining. :-) Not a suprise -- it's still a sexual side effect. Incidentally, there are some ways to deal with sexual side effects in the short term, just as there are short-term ways to deal with erectile dysfunction. The inability to reach orgasm appears to be related to effects on certain subtypes of serotonin receptors. There is a relatively old antihistamine, cycloheptadine, which protects those receptors for a period of hours -- not long enough to have any effect on the antidepressant properties, as long as they are not taken continuously. In article <97db03df321fa7b09c974507ed260cdb@localhost.talkaboutpets.com>, > Is there a different antidepressant, with fewer side effects, that your > doctor can help you switch over to? [quoted text clipped - 17 lines] > prescription that will help the depression, minus the side effects you're > getting from the Effexor. Celexa is in a different family than Effexor. Celexa, along with Paxil and a few others, is considered an "atypical" selective serotonin reuptake inhibitor. I've gotten biochemical enough without getting into why these are considered "atypical" with respect to Prozac, Zoloft, etc. Yes, yes, yes. If one psychotropic drug doesn't work well, there tend to be alternatives, both within the same family and in different families. For example, I have intolerable dry mouth with the tricyclic antidepressant amitriptyline (Elavil), but not with the closely related nortriptyline (Pamelor). > My husband is on thyroid medication, permanently, because his thyroid > doesn't produce enough hormone on its own. Friends and relatives of mine [quoted text clipped - 7 lines] > can work with your doctor to change to a different medication. And if this > doc won't work with you on that, it's time for a second opinion. Exactly. I find more physicians "stuck" with a very few psychotropic drugs than almost any other class of medications. If an infectious disease specialist only wanted to use 2 or 3 classes of antibiotics, they'd be considered candidates for psychotherapy, or at least intensive retraining. Why can't psychiatrists bother with the alternativews available to them? > This is my first vent here... > [quoted text clipped - 6 lines] > then snap out of my reverie like, two hours later, wondering where the > time went. Funny how things work -- we are looking at it as an alternative, but only if we can't tweak the dosage on my present drugs. If Effexor does have a positive effect as well as side effects, there is a reasonable class of alternatives: the "first-generation" tricyclic antidepressants (TCA). Cheap, and with a different side effect profile. Both Effexor and the TCAs differ from the "second generation" selective serotonin reuptake inhibitors (SSRI) in being nonselective: they elevate both serotonin and norepinephrine, rather than just serotonin. The two classes do it by different mechanisms. Effexor works presynaptically, slowing the reuptake into the transmitting cell. TCAs work postsynaptically, inhibiting the enzyme catechol-O-methyl-transferase, which metabolizes serotonin and norepinephrine in > The stuff's expensive as hell, I have no drug coverage, and there's no > way I can do a master's thesis in September if I'm sleeping more than [quoted text clipped - 3 lines] > So today I'm at the doctor's and he tells me that if I quit the stuff, > I'm almost guaranteed to relapse. Too many psychiatrists are overly fixated on single drugs or drug classes. They seem to fixate on the newest drugs, rather than older ones that can be quite effective -- and usually much cheaper. IIRC, a month's supply of nortriptyline is around USD $10. TCAs fall into two families, the first drug of one class being amitriptyline and the first drug of the second being imipramine. The second group tends to be less sedating, although you can usually minimize sedation by changing drugs within the same group. > I'm in my 20s. I don't want to be on this crap for the rest of my > life. Hell, the concept of being stuck on drugs is one of the big [quoted text clipped - 7 lines] > interference. At that rate, it'd be 2013 before I needed pills again. > That's a lot of money and a lot of drug-free years. That may be perfectly good reasoning. Having someone that can get creative with the drugs, seeking less sedating and cheaper alternatives, also can be valid. > That red haze is starting to creep back a little, since the doc didn't > in any way suggest that this was a "for the rest of my life" kind of > thing until just now. I feel like I've gotten suckered into this > situation, and that pisses me off. Personally, I don't have a "rest of my life" concern with psychotropic drugs, any more than my cardiac drugs -- _IF_ they are appropriately prescribed with plenty of thought. > Too many psychiatrists are overly fixated on single drugs or drug > classes. They seem to fixate on the newest drugs, rather than older ones > that can be quite effective Well, I'll tell you what. I work below a doctor's office, and EVERY (every single solitary) day, I watch pharmaceutical reps tote in expensive (and I do mean from the BEST places in town) lunches for everyone. It is absolutely *revolting* to see this kind of "bribing" taking place every day. And you should see the vehicles the reps arrive in. No matter how much pharmaceutical companies cry "but it is SOOOOO expensive to research these very necessary drugs" whenever ever drug prices are brought up, I don't believe it. I believe their marketing budget far outweighs their research. And how many pens and chairs (I kid you not, I saw two stadium chairs stamped with a huge Nexium logo woven right in at a garage sale this summer) and note pads do you see lying around? Makes me just want to urp. > Well, I'll tell you what. I work below a doctor's office, and EVERY (every > single solitary) day, I watch pharmaceutical reps tote in expensive (and I [quoted text clipped - 7 lines] > stamped with a huge Nexium logo woven right in at a garage sale this summer) > and note pads do you see lying around? Makes me just want to urp. My SIL worked as a biologist for a major pharmaceutical company and said basically the same thing. Signaturemonique, who spoils Oscar unmercifully pictures: http://www.bounceswoosh.org/rpca > This is my first vent here... > [quoted text clipped - 36 lines] > > --Enfilade Effexor isn't the only antidepressant out there, and your doc is greatly remiss in not considering exploring other meds. There are ADs that don't cause hypersomnia, and which might be less expensive than Effexor. The problem with Effexor is that quitting cold is not an option; it has to be done gradually and incrementally. Quitting all at once produces an extremely undesirable sensation known as "brain spins," "brain shivers," "brain surges," and other unsavory encephalitic phrases. One person described it to me as feeling like your brain is spinning inside your head. Alternatives are out there, and you deserve to have the chance to explore them. > Effexor isn't the only antidepressant out there, and your doc is > greatly remiss in not considering exploring other meds. There are ADs [quoted text clipped - 10 lines] > Alternatives are out there, and you deserve to have the chance to > explore them. I can only add to what everyone else has said. AD medication is not yet totally understood. As sufferers, we have to accept that. After all, we all would like a perfect world, but it just isn't there yet. The best thing is to find a practitioner who is willing to try different medication until the benefit outways the side-effects. Don't forget you need a few weeks to wean off the old drug, and a few weeks for the new one to start to work properly. It took me a year or two of trying several different drugs until we found one that has almost no side-effects and works really well. If this sounds like a long time, it's not really. Almost the first drug you try will help with the AD and you will feel better; from there it's just a matter of fine-tuning the process so that the side-effects are reduced. Some people will put up with a bit of sleeplessness, others loss of libido, others jitterness. You just need to find a drug whose side-effects are acceptable to you. Good luck, and don't give up, because it *does* help in the long run. I am feeling fine with my drugs and I've almost *no* side-effects. > > Effexor isn't the only antidepressant out there, and your doc is > > greatly remiss in not considering exploring other meds. There are ADs [quoted text clipped - 21 lines] > two of trying several different drugs until we found one that has > almost no side-effects and works really well. Absolute agreement. The withdrawal effects, and also trying to figure out if the new drug is starting to work, takes time. In some cases, it's not just clearing confusion. In the case of the MAO inhibitors, not letting another drug clear (about 2 weeks) can kill you. MAO inhibitors are effective, but they have so many drug and food interactions -- potentially lethal ones -- that they are avoided. A drug that won't let you have chocolate, chianti, or aged cheese? Perish the thought! > If this sounds like a long time, it's not really. Almost the first drug > you try will help with the AD and you will feel better; from there it's [quoted text clipped - 7 lines] > > > This is my first vent here... > I want to get off the Effexor I've been taking for depression for > almost a year now. <snip> The shock at realizing you might need drugs for the rest of your life isn't limited to Effexor - I knew someone who believed she'd grow out of epilepsy when she was 18, and was shocked and upset when, at 18, the doctor told her that she'd need the anti-convulsants for the rest of her life. It's not easy learning such things. I repeat what others have said - *don't* stop taking Effexor, or any of the newer anti-depressants, suddenly. You have to be weaned off them extremely slowly in order to avoid horrendous physical withdrawal problems. And, of course, there's a risk the underlying problems will flare up during the process. This being said, there seems to be a lot of trial and error in finding just the right drugs for each individual's depression, and some doctors are more willing than others to try different drugs. The process can take months - months to get off drug #1, more months for drug #2 to build up to therapeutic levels. And it needs to be supervised. The nasty thing about mental illness is that sometimes the patients aren't thinking clearly when they think they are, and so they might not spot trouble themselves. How much supervision is needed depends on the individual case - in some cases, it can be done as an outpatient, but I know someone who had to be hospitalized while going through the process, although afterwards, she was comparatively stable on fewer drugs with fewer side effects than before. Being on psychiatric drugs long-term must often be accepted; to use a common comparison, it's like a diabetic taking insulin long-term. However, getting the right combination of drugs, counselling and life-style changes for the best and longest term stability is difficult. Don't give up, though, it is possible, and many, many people find a way to manage their illnesses with an appropriate balance of treatments. I am not a medical professional - this is just my opinion. SignatureCheryl > This is my first vent here... > [quoted text clipped - 36 lines] > > --Enfilade Over the years, I worked my way through just about all the prescription drugs for depression. At this time, I've been on Venlafaxine for several years now; according to my shrink, I'll never develop an "immunity" to it, the way I gradually did to each other. Ask your doctor to consider it. > That red haze is starting to creep back a little, since the doc didn't > in any way suggest that this was a "for the rest of my life" kind of > thing until just now. I feel like I've gotten suckered into this > situation, and that pisses me off. > > --Enfilade I was on Effexor for about three years, and went off it for much the same reasons you mentioned. I've been off antidepresants for a couple years now, but it's getting to be time to start again. Going to have to visit the doc to get a prescription for something other than Effexor. If you do it carefully, with the doc monitoring you closely, I'd sure think it ought to be possible to wean yourself off the Effexor until you can start with something else. Of course if you don't have health insurance the "close monitoring" thing might be a problem too. We'll be sending our best purrs that you are able to find a way to make the transition off of Effexor. > If you do it carefully, with the doc monitoring you closely, I'd sure > think it ought to be possible to wean yourself off the Effexor until you [quoted text clipped - 3 lines] > We'll be sending our best purrs that you are able to find a way to make > the transition off of Effexor. Howdy folks! Thanks for all your comments. I really appreciate it. "Close monitoring' is easy for me because DP is a medical student. Also, in Canada, visiting the doctor is free. The only thing I have to pay for is the pills. Now, with DP being a medical student, he and I have gone 'round on this one...while he thinks I should be on /something/, he also is willing to live by my decision, if a bit nervously. At first he insisted that Effexor couldn't possibly make me sleepy because his medical journals say it causes insomnia; however, today he met up with a neurophysician friend, who said that there are instances of that side effect on record, so NA NAAAA *sticks out tongue* *Serves you right to believe the studies instead of me PPPPPPTHHH!!!* *ahem* As for side effects, once in a snowstorm I did without for three days and aside from a bit of dizziness (I've had far worse from the flu) I was fine. What I don't like is, the doc says the stuff isn't addictive, and yet if I'm not supposed to go off it EVER, I might as /well/ be addicted. What am I on it for? Well, for the most part, I have my stuff pretty well together. For 25 years I'd hit "lows", which never lasted more than about 6 hours. I'd spend those days in my room, watching videos if I could concentrate and lying around if I couldn't, waiting for the "weather to pass." I could handle this. My first bad time hit when I started feeling abandoned by my friends, broke up with my boyfriend, had health issues, my grades slipped a bit, and I and got kicked out of the house by my mom for taking a spare to address the grades thing. I was living on people's couches and/or the public airport, and wanted a lot of support from my friends that they didn't or couldnt or didn't know to give (I'm an independent SOB who didn't know how to ask for help, so it wasn't entirely their fault.) I was 17, had done all I wanted to do in my life, and didn't know how I was going to keep myself fed and sheltered until I got to university, or if it wasn't maybe ready for me to call my life "finished" since I'd met all my goals. My more recent one involved 7 months of looking for work when my EI ran out and I took a job at the mall. Another 2 months with a jealous co-worker actively trying to get me fired, a position that involved coercive selling despite what I was told at my interview, more unsuccessful job interviews, and me with a master's degree going apesh!t from boredom, while DPs life was at its high point and he was celebrating being here in this city while I wanted to grab my duffel bag and go back to living in cars and airports if it'd get me out of here. It takes some pretty bad sh!t to set me off...so while I /am/ a little, er, short-fused at those times, normal life doesn't evoke depression in me. I'm hopefully in a master's program full time next year--academia is a stabilizing lifestyle for me. Better to do another master's than end up in the nutty house. Anyway, I think my life will be pretty stable then--DP is such a calming influence on me. Sometimes I feel like he's my nurse. Of course, on his part, he sometimes tends to be quite naive and carefree/careless, and needs me watching his back. "Just because YOU wouldn't steal a car doesn't mean someone else wouldn't...so LOCK THE CAR." ;) --Fil Woe, *after* reading all you guys (& gals) probs with Effexor, THIS story shows up on the news: http://www.theindychannel.com/health/4275414/detail.html > This is my first vent here... > [quoted text clipped - 36 lines] > > --Enfilade --? The ONE and ONLY lefthanded-pathetic-paranoid-psychotic-sarcastic-wiseass-ditzy former-blonde in Bloomington! (And proud of it, too)? email me at nalee1964 (at) insightbb (dot) com http://community.webshots.com/user/mgcmdjeep > Woe, *after* reading all you guys (& gals) probs with Effexor, THIS story > shows up on the news: > > http://www.theindychannel.com/health/4275414/detail.html Yep, the article say it takes 6 weeks to 8 months to come off of it - and you can probably bet on the high end of that range. The problem is, if you lose your insurance like I did, *and* your job (which is usually the reason you're losing your insurance), then it's not likely that you can afford the $600.00 a month for the prescription. And believe me, you *DON'T* want to just quit taking them cold turkey - I went through torture for months and still sometimes feel the effects of it a year later. I truly believe this drug needs to be taken off the market for new prescriptions. There's already a class action law suit against the company, brought by the *THOUSANDS* of people you have had their lives nearly destroyed by this drug, there have been even more *THOUSANDS* of complaints to the FDA about this drug, yet Wyeth Pharmaceuticals is still making *BILLIONS* of dollars selling it! Hugs, CatNipped
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