![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by valene on March 13, 2007, at 8:19:50
I know there are many threads on Effexor, so forgive me starting a new one.
I have been on xanax monotherapy many years with a 3 year period of taking prozac 20mg. Prozac did little for me IMO. Got off it no problems at all. Reduced xanax dosage to 1.75mg.
Now am extremely depressed, desperate no known reason, and my pdoc has prescribed effexor xr 75mg. increasing to 150mg after a week. I am scared to death, already being "hooked" on xanax and not successful in complete w/d.
She says that the SNri's are most like the trycyclic Elavil which helped me in the past. Is this true? (Can't take tricyclic due to heart condition).
I fear the effexor so much due to "discontinuation" and would rather try Lexapro which a famous psychpharmacologist recommended to me a year ago.
I have GAD, social anxiety and depression. Should I go with the effexor (can you ever get off it) or the lexapro?
Thanks,
Val
Posted by Phillipa on March 13, 2007, at 12:07:03
In reply to Effexor XR dilemma to take or not?, posted by valene on March 13, 2007, at 8:19:50
Valene you opened a can of worms. More positive responses on lexapro I think. Love Phillipa
Posted by Racer on March 13, 2007, at 12:41:35
In reply to Effexor XR dilemma to take or not?, posted by valene on March 13, 2007, at 8:19:50
>
> Now am extremely depressed, desperate no known reason, and my pdoc has prescribed effexor xr 75mg. increasing to 150mg after a week. I am scared to death, already being "hooked" on xanax and not successful in complete w/d.It's understandable that you'd be frightened, especially with all the bad things one hears about Effexor. The bottom line is that it works for some people, it doesn't work for others, and it requires a bit of planning to discontinue. It's not terrible, it's not perfect, but if it works *for you,* then it's a good choice *for you.*
>
> She says that the SNri's are most like the trycyclic Elavil which helped me in the past. Is this true? (Can't take tricyclic due to heart condition).That's true. A lot of tricyclics affect norepinephrine, as do many (or most?) of the tricyclics. If Elavil worked for you, it's probably worth trying another noradrenergic medication. Like Effexor or Cymbalta.
>
> I fear the effexor so much due to "discontinuation" and would rather try Lexapro which a famous psychpharmacologist recommended to me a year ago.I won't lie to you about this: during the time I was on Effexor, my pdoc wasn't very good about getting refills authorized, and I ran out a few times. (In fact, that's part of the reason I stopped taking it.) When I ran out, it was pretty hellish -- headache, dizziness, nausea, generally feeling as though I was about to die. But that was cold turkey from a high dose. When I actually went to stop it for real, I tapered down slowly, and didn't have any of those problems. And there are things you can do -- benedryl, low dose prozac, etc -- that reduce the discomfort even more. And when I stopped Cymbalta, it was a cake walk -- reduced the dose a bit, then stopped, no problem. Don't let fear of discontinuation stop you from trying it. It might be the right answer for you, and you'd hate to miss out on that, wouldn't you?
As for Lexapro, it's another good drug, for those it works for. It was not successful for me, so I'm probably biassed. What I can tell you, though, is that it's another SSRI, like Prozac. It may be more targetted, it may have fewer side effects, it tends to be more sedating than Prozac. It's pretty targetted at serotonin, though, so if you really do need some norepinephrine in the mix, it won't do it for you. It's also worth trying, though. Just -- a lot of doctors seem to call it a wonder drug, because it's more selective, because it's newer, because the drug rep's been by more recently, because they like the name, because of any number of things that may or may not have anything to do with your needs. Even if it's a big name doctor, keep in mind that what works for some may not work for you.
>
> I have GAD, social anxiety and depression. Should I go with the effexor (can you ever get off it) or the lexapro?
> Thanks,
> ValWhat does your doctor say? Your doctor is suggesting Effexor, based on your history -- Prozac didn't help, Elavil did. I take it you're not seeing the famous psychopharmacologist? Did you consult him, or see him for a while and change? I don't know the story, but I think it's worth giving your doctor's prescription a try.
Good luck.
Posted by Gee on March 13, 2007, at 13:15:33
In reply to Effexor XR dilemma to take or not?, posted by valene on March 13, 2007, at 8:19:50
For me, starting effexor was a whole lot worse than coming off it. I started at 37.5 mg and it was horrible. I was so sick. Looking back, I should have said, no this is not right, but I was young and stupidly trusted my doctor (long story). Maybe you could try starting at a lower dose, and see how your body reacts to it physically?
For me, effexor really helped with my anxiety (and I think depression). I wasn't sure if I was going to be able to get off it, but I was. I've been off it for just over a month and a bit now, and the brain zaps and all that weird stuff is gone. I found that taking some benedryl now and then really helped, and also going the gym and giving it all I could (while I was discontinuing completely I felt really dizzy so I always took a friend with me) and it really really helped get rid of the dizziness and all that.
Good luck with the dicision!
Posted by Phillipa on March 13, 2007, at 14:03:05
In reply to Re: Effexor XR dilemma to take or not? » valene, posted by Phillipa on March 13, 2007, at 12:07:03
Looks like I'm wrong again but remember I did tell those two former babblers that had no problems going on or coming off of effexor. So everyone is different. You know the SSRI's except luvox and SSNRI's don't work for me. But we're all so very different. Good luck with your decision and Racer had a good point why not call the guy in Boston and ask him what he thinks. Love Phillipa ps she didn't say call him I am.
Posted by valene on March 13, 2007, at 16:00:26
In reply to Re: Effexor XR dilemma to take or not? » Phillipa, posted by Phillipa on March 13, 2007, at 14:03:05
I just found the copy of letter that Dr. Salzman, the "expert" sent to my pdoc last year. In it he s recommend that I take another SSRI (Lexapro) along with my xanax to "maximize the anti-anxiety effect and the effect on my social anxiety disorder"
"Other treatments that may be tried include adding venlafaxine or duloxetine at low doses to xanax with the goal of very slowly tapering the dose of Xanax." My pdoc's starting prescription is 75mg effexor, increasing to 150mg. after a week. Is this considered low-dose?
so I guess I have an answer of some sort. Dr. Salzman would be very difficult to reach at this point. It was a one-time consult as a favor to my pdoc, he charged me cash $300. does not take insurance.
I would still appreciate input from this forum. TIA,
Val
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.