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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Anna Laura on February 19, 2002, at 5:10:49
Hi all,
I've been back on Venlafaxine since mid December: i had to discontinue it because i wanted to try MAOIs.
I thought it wasn't going to be effective the second time around since i wasn't noticing any significant effect till the 7 th week or so.
Strangely, it's having a different effect this time. Feeling more lively and feeling/showing more emotions, though i must say i feel kind of "insecure" and "moody" on it (feels like i'm back to my teen years somehow, even though i'm still depressed).
I get weepy and sad and even desperate at times, i look hysterical and this is quite weird for me, even though it's somehow "pleasant" compared to plain old apathy.
It's like all the bottled up feelings are coming on the surface, and i end up shouting and screaming, feeling relieved after that.
Before Effexor i was like sitting on the couch muttering: "I'll never find a cure", whereas now i'm weeping, jumping and shouting: "I'll never find a cure" .
Is this a good sign or a bad sign?
Could it be related to serotonin excess? I don't seem to be the serotoninergic type since i was rather self-confident, over active and risky taking back in the old good days.
But again, may be it's just a natural, "humanly" reaction after 11 years of dhysthymia without relief. I guess anybody would get hysterical from time to time after that. Or may be it's just temporary, who knows.
Could this "disinihibition thing" be an underlying symptom of a bad functioning of the drug? (may be i'm taking the wrong drug for me, who knows).
Hope i made myself understood.my actual combo: Effexor, 300 mg, Reboxetine, 8 mg.(same as the first time).
Any input appreciated
Posted by Ritch on February 19, 2002, at 8:28:13
In reply to Venlafaxine disinhibition: good or bad?, posted by Anna Laura on February 19, 2002, at 5:10:49
> Hi all,
>
> I've been back on Venlafaxine since mid December: i had to discontinue it because i wanted to try MAOIs.
> I thought it wasn't going to be effective the second time around since i wasn't noticing any significant effect till the 7 th week or so.
> Strangely, it's having a different effect this time. Feeling more lively and feeling/showing more emotions, though i must say i feel kind of "insecure" and "moody" on it (feels like i'm back to my teen years somehow, even though i'm still depressed).
> I get weepy and sad and even desperate at times, i look hysterical and this is quite weird for me, even though it's somehow "pleasant" compared to plain old apathy.
> It's like all the bottled up feelings are coming on the surface, and i end up shouting and screaming, feeling relieved after that.
> Before Effexor i was like sitting on the couch muttering: "I'll never find a cure", whereas now i'm weeping, jumping and shouting: "I'll never find a cure" .
> Is this a good sign or a bad sign?
> Could it be related to serotonin excess? I don't seem to be the serotoninergic type since i was rather self-confident, over active and risky taking back in the old good days.
> But again, may be it's just a natural, "humanly" reaction after 11 years of dhysthymia without relief. I guess anybody would get hysterical from time to time after that. Or may be it's just temporary, who knows.
> Could this "disinihibition thing" be an underlying symptom of a bad functioning of the drug? (may be i'm taking the wrong drug for me, who knows).
> Hope i made myself understood.
>
> my actual combo: Effexor, 300 mg, Reboxetine, 8 mg.(same as the first time).
>
> Any input appreciated
You might need to add a mood stabilizer. Has your doctor ruled out bipolar disorder? Effexor has a tendency to trigger hypomania in susceptible people. It sounds like it isn't really making you hypomanic as much as agitated, though. But, you did mention disinhibition-could you say you are more impulsive now than before?Mitch
Posted by Mark H. on February 19, 2002, at 10:12:11
In reply to Venlafaxine disinhibition: good or bad?, posted by Anna Laura on February 19, 2002, at 5:10:49
Anna Laura,
I think it is a very good thing. For me, what you describe has always been a long way "up" from depression. I must admit, however, that I usually have experienced your symptoms most strongly when I am going off of Effexor, as a rebound effect.
A little hypomania can be a refreshing change. If it starts to go over the top for you (becoming a mixed state of depressive agitation), then you might want to ask your doctor about periodic use of Zyprexa, which is used now as a single therapy for bipolar and works right away. I find I need to take a very small amount perhaps 3 or 4 days a month at most, some months not at all. I'm grateful for a medicine I can use as needed to help me regain my natural balance.
Since you're the *only* case I know of regarding venlafaxine disinhibition, I think there is a good chance that it is a sign that it is beginning to relieve your chronic, long-term depression.
Think positively, go with it, and work with your doctor if it becomes too intense.
Congratulations!
Mark
Posted by IsoM on February 19, 2002, at 11:45:41
In reply to Venlafaxine disinhibition: good or bad?, posted by Anna Laura on February 19, 2002, at 5:10:49
Anna Laura, your background is very different in many ways from mine (as you know from my e-mails) but what you're experiencing right now is the way I would feel when an SSRI starting working but the dose was still too low. When it was increased, my mood stabilised & I could still feel the anger & sadness in appropriate situations(the negative emotions) but would start feeling a lot more positive emotions too like a normal person should.
For me, the first emotions that tend to return with AD treatment is the sadder emotions. Before treatment, I'd just feel extreme bleakness & irritation. Then came sadness (got all weepy) or anger (felt like righteous indignation to me) & then with the proper amount of AD, happiness & joy would also return.
*IF* this is your case too, it's possible the amount of Effexor that worked for you before may now need an increase instead. It doesn't sound like it's a serotonin excess effect but it may affect diff people differently???
Posted by Anna Laura on February 19, 2002, at 18:49:24
In reply to Re: Venlafaxine disinhibition: good or bad? » Anna Laura, posted by IsoM on February 19, 2002, at 11:45:41
> Anna Laura, your background is very different in many ways from mine (as you know from my e-mails) but what you're experiencing right now is the way I would feel when an SSRI starting working but the dose was still too low. When it was increased, my mood stabilised & I could still feel the anger & sadness in appropriate situations(the negative emotions) but would start feeling a lot more positive emotions too like a normal person should.
>
> For me, the first emotions that tend to return with AD treatment is the sadder emotions. Before treatment, I'd just feel extreme bleakness & irritation. Then came sadness (got all weepy) or anger (felt like righteous indignation to me) & then with the proper amount of AD, happiness & joy would also return.
>
> *IF* this is your case too, it's possible the amount of Effexor that worked for you before may now need an increase instead. It doesn't sound like it's a serotonin excess effect but it may affect diff people differently???
Hi Judy,Thanks for the info! I have experienced these states before (even without medications, but it was quite a long time ago) and it's so frustrating to experience these tiny little "awakenings" which seem rather promising but eventually fade away with time!
I'm currently taking 300 mg. of Effexor already: since i don't have a pdoc at the moment, i'd be rather scared to raise the Effexor dose myself (well, may be a could, but just a little).
The psychopharmacologist lady i called last week is having a conference and she'll be back next Monday for an appointment.
My father will be in France next week and he's supposed to get me the Adafrinil.
Posted by Mr. Scott on February 19, 2002, at 19:09:30
In reply to Venlafaxine disinhibition: good or bad?, posted by Anna Laura on February 19, 2002, at 5:10:49
IMHO...A touch of hypomania. Whether thats good or bad depends on whether it's part of a cycle and eventually leads back to depression or if its justmed induced and temporary. I would say it's a function of degree.
I've also noticed what I think involves the SSRI's strangling off Dopamine and causing an ADHD situation by lack of activity in the frontal lobes which cause a sort of..."giddiness."
Scott
Posted by Anna Laura on February 19, 2002, at 19:11:09
In reply to Re: Venlafaxine disinhibition: good or bad?, posted by Mark H. on February 19, 2002, at 10:12:11
> Anna Laura,
>
> I think it is a very good thing. For me, what you describe has always been a long way "up" from depression. I must admit, however, that I usually have experienced your symptoms most strongly when I am going off of Effexor, as a rebound effect.
>
> A little hypomania can be a refreshing change. If it starts to go over the top for you (becoming a mixed state of depressive agitation), then you might want to ask your doctor about periodic use of Zyprexa, which is used now as a single therapy for bipolar and works right away. I find I need to take a very small amount perhaps 3 or 4 days a month at most, some months not at all. I'm grateful for a medicine I can use as needed to help me regain my natural balance.
>
> Since you're the *only* case I know of regarding venlafaxine disinhibition, I think there is a good chance that it is a sign that it is beginning to relieve your chronic, long-term depression.
>
> Think positively, go with it, and work with your doctor if it becomes too intense.
>
> Congratulations!
>
> MarkHi Mark
Thanks for your encouragement, but i'm quite sure i won't go "up" that much as i have experienced something similar several times before without getting anywhere.You now, i have like a couple of "promising" days and then everything fades away. I'm afraid that this time won't be different.
I think it might be a good sign though.
May be this is the wrong med: i have read somewhere that the latter the effect kicks in, the higher the possibility you're taking the wrong med. I don't remember the neurochemical interactions involved since the're rather complex, but it's pretty much about "kicking" the wrong circuitry which "reverberates" thus grazing the right one at last. (Does it make any sense?)
Posted by Mark H. on February 19, 2002, at 20:26:28
In reply to Re: Venlafaxine disinhibition: Mike H. ?, posted by Anna Laura on February 19, 2002, at 19:11:09
Anna Laura,
It makes wonderful sense! As you may suspect, I am not convinced that you should be taking mood stabilizers. Perhaps this is foolish for me to suggest, but I sense they will just make matters worse.
Effexor can be truly awful to get off of, so be sure you've given it a fair trial before you undertake the ordeal of withdrawal. On a scale of one to ten in terms of severity of withdrawal, I'd rate Effexor a solid ten.
If you must quit taking it, then I would suggest you taper over a period of perhaps three to four weeks. Occasionally, a person is able to quit Effexor with no withdrawal symptoms, but it is very rare indeed.
Please keep posting --
Mark H. (marcare?)
Posted by IsoM on February 19, 2002, at 20:38:47
In reply to Re: Venlafaxine disinhibition: good or bad?, posted by Anna Laura on February 19, 2002, at 18:49:24
Anna Laura, I'm so glad to hear your father's going to pick up the adrafinil for you. I hope SO MUCH that you'll feel that extra boost you need so bad. I'm sure the addition of adrafinil boosts the Celexa a little too. I think it helps with dopamine receptors/neurotransmitter a lot!
You may feel an immediate effect like some mentioned but do remember that most don't (like me) for a couple of weeks though.
This is the end of the thread.
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