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Poor Metabolizer having success on Effexor-XR » jp

Posted by Corafree on July 7, 2004, at 9:41:45

In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14

Yes, I am having success with it, after a bit of changing the dosage regimen. Upon first starting, I took my initial 75mg upon waking and took a followup of 37.5 at bedtime. I was experiencing side effects, mainly anxiety, from around 4-5p until bedtime. I now take the follow-up dose of 37.5mg approx. 5 hours after taking my waking dose, and have virtually no anxiety or side effects, and it lasts all day! I can truly say it is the best drug I have ever been on, and I've been on all the SSRIs. I am what is called a 'POOR METABOLIZER'. Many factors go into the pharmacokinetics of a drug, making the dosage regimen individual to individuals. There are EXTENSIVE METABOLIZERS (normal metabolizers) and, like me, POOR METABOLIZERS. Some factors which go into deciding which you are, are: 1) hepatic drug clearance (low intrinsic clearance - the effect can be increased by giving a second liver enzyme boosting agent, and hepatic blood flow - how much is initially gobbled up by the liver, because the slower the flow, the higher the extraction, and vice-versa; 2) protein binding (drugs get stuck and can't go anywhere); and 3) ionization (highly ionized drugs cannot cross lipid membranes and basically can't go anywhere.) So, dosage regimens should depend upon whether you are a low metabolizer or an extensive (normal) metabolizer. It took me a while to realize I was a low metabolizer and that I would actually need more of a drug. Anyway, now I'm doing very well with Effexor-XR, and I think probably better than I did on regular Effexor tablets. I am interested to learn more about a new drug on the horizon called Cymbalta. Is Effexor going to have a competitor in its now stand-alone category?


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