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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by pasdenom on July 13, 2003, at 10:14:39
Hi, has anyone else started smoking after starting effexor or any other medication? I started again after a 15 yr hiatus. My dose of effexor xr is 150 mg a day. I wonder if my dose were increased if this would help as norepinephrine is the predominant neurotransmitter affected at higher doses and is the reason why Zyban helps people quit smoking? I can't take Zyban because I have a seizure disorder.
Does anyone think that effexor increases impulsivity? Maybe it's because I'm bipolar that it does in me. Anyhow, I am also on lamictal and lexapro. I love the effexor, not only because it relieved my depression, but also because it erased my anxieties. I used to panic in an MRI even though I am not clostrophobic. Last time I took one I did not feel anxious at all. If it hadn't been so noisy I could have slept.
Boy, do I run on. I would appreciate responses from any and all on this.
So, am I the only weirdo out there?
Posted by Maximus on July 13, 2003, at 11:36:12
In reply to effexor and smoking, posted by pasdenom on July 13, 2003, at 10:14:39
> Hi, has anyone else started smoking after >starting effexor or any other >medication? I started again after a 15 yr hiatus.
I'm not a smoker, well a big smoker. I smoke 2 or 3 cigars per week. I don't like particularly the stuff but i love the buzz, the energy boost. And yes, when i'm on SSRIs, SNRIs, i have to seek out stimulants.
>My dose of effexor xr is 150 mg a day. I wonder >if my dose were >increased if this would help as norepinephrine is the predominant neurotransmitter affected at higher doses and is the reason why Zyban helps people quit smoking?
You have to understand the mechanism of action of Effexor. Yes, at 150 mg and higher you will get a robust norepinephrine reuptake. HOWEVER, you will also get a higher reuptake of serotonin. There is no flip flop or inverse mode of action. The serotonin reuptake is always there and stronger when we increase the dose.
In my opinion Zyban, aka Wellbutrin, aka buproprion works a lot better (smoking cessation) because it does target Dopamine and Norepinephrine only.
> Does anyone think that effexor increases >impulsivity? Maybe it's because >I'm bipolar that it does in me. Anyhow, I am also on lamictal and lexapro.
I'm also more impulsive on Effexor. I have the same problem here. I'm bipolar. But i take lithium because my lamictal has stopped working after 3 years of great service.
Good luck with your quest.
Posted by Janelle on July 13, 2003, at 14:20:36
In reply to effexor and smoking, posted by pasdenom on July 13, 2003, at 10:14:39
Smoking either raises or lowers serotonin, I can't remember. It either boosts SSRI's or lessens them.
Based on what you wrote, I would say NO, do NOT increase the EffexorXR - it is known to increase impulsivity and possible mania/hypomania in those with BiPolar 1 or 2, and you are on two other meds that also can increase impulsivity, definitely the Lexapro.
Lamictal is also activating.
I would say to stay where you are, although I wonder why you are on both Effexor 150mg and Lexapro? Those are both ad's and you could get *Serotonin Syndrome* from being on two SSRI's. Don't mean to scare you, just wondering ...
Posted by pasdenom on July 13, 2003, at 17:29:44
In reply to Re: effexor and smoking » pasdenom, posted by Janelle on July 13, 2003, at 14:20:36
Thanks for responding, Maximus and Janelle. I am on both Effexor and Lexapro because of a horrible depression I experienced starting in January. I definitely suffer from SAD and the Jan-March time of year is hard for me because it is the anniversary of a troubled pregnancy and the death of my 4 hour old daughter. Suicide is a constant threat when I am depressed, beckoning me to find refuge in its cold embrace(how corny!). I have noticed absolutely no signs of serotonin syndrome but I'll keep my eye's open. I'm pretty sure my psychiatrist will not keep me on Lexapro for too much longer.
By the way, my 9 year old has bipolar I. She is somewhat stabilized and also on three meds: Lithium, Depakote, and Zyprexa. Finally, they seem to be working. My point is that my family is somewhat resistant to some drugs. When I was a teen I suffered from Migraines. The meds I was prescribed would work maybe for 1-2 times, then-- nothing!
Another strange thing: when I smoke I gain rather than lose weight. Figures!
Posted by Capri on July 13, 2003, at 21:54:49
In reply to Re: effexor and smoking, posted by pasdenom on July 13, 2003, at 17:29:44
Hi,
I am not a big smoker but I can totally agree with you!!
I smoke generally on the weekends or at a party. I was taking Effexor for 6 weeks and I had a few cigs every night (which is so not like me). I find SSRI's in the beginning give me a huge cig craving. I am now on Lexapro and that too gives me the craving. Although after 2 weeks now I'm starting to level out and the craving is starting to slowly go.
Good luck.
Posted by noa on July 14, 2003, at 0:35:27
In reply to Re: effexor and smoking » pasdenom, posted by Maximus on July 13, 2003, at 11:36:12
Yes, I think I am much more impulsive on Effexor. I think the serotonergic drugs are disinhibiting, which is why SSRIs are used for social phobia.
I can't comment on the smoking thing. But I know that on meds (Effexor now, Paxil and Prozac before that) I have intense cravings for sweets and other carbos that I didn't have before.
Posted by NThompson on July 14, 2003, at 8:10:08
In reply to effexor and smoking, posted by pasdenom on July 13, 2003, at 10:14:39
Well, good morning. I dobelieve that Effexor does increase the urge to smoke. As I just came in from smoking. I use to only smoke once in a blue moon. Mainly if I was out with friends and drinking. Which I usually was the designated driver because I have 2 children, and if something happened in the middle of the night I would want to take care of them. Anyway, I am now smoking 3-4 cigarettes a day and can't figure out why I am doing so. However the good side to that is I now have less of a craving for Pepsi! Which will hopefully help me lose weight.
And on a personal note, I now wht it is like losing a baby. I have lost 3. I didn't get as far as delivering them however. I had 2 miscarriages and one etopic pregnancy(tubal). It is amazing the way that they(the babies) can make you feel. It's this powerful joy and happiness that is so warm and comforting. When you lose them you feel a cold whole in your body that seems to go on and on. I think my husband and I were lucky, after the 2 miscarriages, I got pregnant again, put on bed rest, gained 120 pounds and after a shaky pregnancy, had a very healthy baby girl(now 6) then a few years later I got pregnant again, on bed rest again, and that pregnancy went so much better. However, our baby boy was born blue, the cord wrapped around his throat, but they got him breathing and gave him oxygen. He is a very healthy and loving 2 year old. Then I got pregnant again and in the third month I had horrid pains, doubled over and couldn't stand. I thought that I was miscarriaging again, though I hadn't been bleeding this time. I went to the doctors and they did and ultrasound, found out that the baby was in my right tube and that the baby was over 4cm and about to burst my tube. I had emergency surgery. They had to remove my hole tube. It was already ripping.
I feel as though I go through the questions of why? Why did they die and not make it? Did I do anything that wrong? Was there something I could have done that would have saved them. What would they have been like? I have found that if I ask myself these questions it literally drives my insane. Because the truth is that I don't know why or what if. All I know is that with having patience, I received 2 beautiful children. I almost screwed that up by atempting suicide at the beginning of June this year. I am starting to feel better now. But I was in a very dark and lonely place. I wanted to go to sleep and just stay there. I thought that my family would be better off without me. Boy, I was wrong. that's when I found out how much I was loved, wanted and needed. I am getting help now. I do feel better and try to stay warm. That cold lonely place is a ruff place to be. Just remember, if I had completed the suicide, I would have been remembered for that. Not the wonderful memories I had created for my family and friends.
Take care of yourself and please, find us if you need help or someone to talk to.
NThompson
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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