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my pdoc wants to put me on effexor


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I think because I've been in a slump for months now. Up and down, but with a general trend going down, and I've been incredibly depressed and suicidal the last two weeks; I've been much worse, and it's been compounded by the death of my grandmother. So I think she's pulling out the big gun to deal with it...

...but with the potential for (hypo)mania, rapid cycling, hideous side effects, and a bastard of a discontinuation syndrome, I just hope I won't be sitting in my pdoc's office in three weeks asking her what kind of crack she is on.

is it a good idea I ask?

[edit: this should have been in the anti-depressant forum. oops]

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Yeah I've read up on Wellbutrin, but it's not available in Australia. Well, it is, but only in the form of a smoking-cessation medication called Zyban. I'm not sure it can be used in the form it's in as an anti-depressant, and if I wanted to it would be considered an off-label use and I would have to pay full price for it. I will look into it now you have brought it up though.

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Honestly, effexor was the Drug from Hell for me, for all the reasons that you've listed there. It actually lead directly to me finally being diagnosed with BP 4 years ago. I was seeing an extremely dodgy pdoc who kept increasing the dose til I went over the edge and wound up in the ER having my arms stitched up. Ditched that doc and went to my current one, and the first thing she did was whip me off the effexor - she said I was clearly BP and shouldn't have been put anywhere near the stuff.

My horror story aside, since then I have occasionally seen people here and on another website (for BP types) report that it's done good things for them. I have a close friend with BP1 who has done extremely well on it - so it's not out of the question that it might work for you. My #1 concern would be that your pdoc monitor the whole process very carefully - eg start slowly at 75mg and not slap you on to a high dose such as 225mg in a very short period of time. Do you trust her? Do you feel she has a good grip on your flavour of bipolar and won't keep pushing you to stay on it if you feel it's doing more damage than good? If so, then I'd give it a shot hon. You really aren't doing well at the moment - you know I'm worried about you - and maybe, just maybe this is going to be what it takes to catch you from dipping any lower.

If it doesn't work - well, yes, the discontinuation sucks royally, but the new pdoc bombarded me with valium for a week and I got through it in one piece.

It's true that wellbutrin is supposed to be the safest anti-depressant for BP - it's the only one that my pdoc has been prepared to prescribe to deal with my downward slides in the past couple of years. It was also first released here as zyban before the official brandname version became available. According to crazymeds, Zyban is just the "repacked" form of sustained release wellbutrin, which is what I'm on. But cost is a big issue, and your pdoc may not be prepared to go down the route of an off-label script like that.

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Right. I've heard of countries that only allow Zyban for a very limited time (while the prescribee is quitting smoking), but I have heard on The Other board (crazymeds) about an Aussie who was prescribed Zyban for her mood, so I think it is possible. I don't know how the Australian health insurance system works, so I don't know whether Zyban would be more expensive if taken "off-label"...

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You can buy Zyban privately in Australia. We don't have private health insurance geared towards medication the way it is in the US; we have it but it's like an extra tacked on to your hospital cover and it doesn't pay out much. It's because we have subsidised pharmaceuticals, whereby a good chuck of the cost is covered by the government on the pharmaceutical benefits scheme (PBS). For example, seroquel could cost me $130 for a pack of 90 100mg, but I only pay $5

I found an online Australian pharmacy that sells zyban at this private price:

Zyban 150mg Tablets 90

Private $166.30

It ain't so bad I guess for 3 months worth, that is if 150mg is the dose I need.

Though I already pay lamictal at a private price of $100 for 6 weeks, because it's only covered by the PBS for epilepsy.

It gets expensive.

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My #1 concern would be that your pdoc monitor the whole process very carefully - eg start slowly at 75mg and not slap you on to a high dose such as 225mg in a very short period of time. Do you trust her? Do you feel she has a good grip on your flavour of bipolar and won't keep pushing you to stay on it if you feel it's doing more damage than good? If so, then I'd give it a shot hon. You really aren't doing well at the moment - you know I'm worried about you - and maybe, just maybe this is going to be what it takes to catch you from dipping any lower.

Yeah I trust her. She's knows the ins and outs of all the meds, and does have a grip on the flavour of my bipolar, and is quite intuitive, I think, with her decisions. I don't think she'd keep pushing me to stay on it if it was really wrecking me. She has a high standard of care. When I complain about some side effects she's very much like, "oh we can't have that can we?" - that sort of thing, and will do something about it.

It's true that wellbutrin is supposed to be the safest anti-depressant for BP - it's the only one that my pdoc has been prepared to prescribe to deal with my downward slides in the past couple of years. It was also first released here as zyban before the official brandname version became available. According to crazymeds, Zyban is just the "repacked" form of sustained release wellbutrin, which is what I'm on. But cost is a big issue, and your pdoc may not be prepared to go down the route of an off-label script like that.

Yeah I think that she'd be more worried that I'd be forking out money for another private script - the first being lamictal. I'd be paying a fair bit for my meds then. If effexor turns out to be a disaster then I'll ask her about zyban.

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hi, sj

I hope it works well for you!

My pdoc has me dx'd as BP (probably II since I don't have really dramatic manic modes)

I take 300 mg Effexor XR and it has worked wonders for me

But I also take Elavil at night

Nothing like going on the med-go-round ;)

Good luck

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Honestly I think it depends on what your pattern is and what other meds you are on. Effexor XR has been absolutely amazing for me. It helped stabilize my moods and stopped my anxiety. I have a long history of failure with medications and bizarre side effects. But I don't have bipolar. The bottom line is, if you trust your doctor give it a shot. If not, time for a new Dr.

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I am on lamictal and seroquel, so that will hopefully hold me together.

I think it's day 4 on it and I'm just sooooooooo tired. I've been in and out of bed all day. Though I know I've just started, so effects like this are to be expected. Just thought I'd have a whinge! The first night I took it I actually woke up at 4am and was wide awake, but fell back asleep. So I thought take it in the morning, which I did the next day, and I've been so tired since. I'm going to take it again at night time tonight and see how I go again.

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did you sleep ok?

can i just say,

1. sleep sounds great right now and

2. i love it when you post - between your avatar and your sig you are very colourful, and that is awesome. i particularly like the pills - the combination of blue and that bit of yellow is beautiful!.

i have a bit of a thing for colours ;)

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I thought my pdoc was nuts when she suggested it too, but it's been a godsend for me. SSRIs throw me right into mania, and lamictal alone wasn't controlling my depression. I just couldn't seem to get on something that would work. We added 150 of Effexor almost 2 years ago, and I haven't had a problem with depression since. I didn't notice any rapid cycling, or increase in mania. I'm pretty happy with my current cocktail (seroquel, lamictal, effexor), so I'd say, give it a shot. Yeah, it's a bitch to get off if you have to, but the alternative is feeling like shit, so it's a wash, in my opinion.

Best of luck!

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did you sleep ok?

can i just say,

1. sleep sounds great right now and

2. i love it when you post - between your avatar and your sig you are very colourful, and that is awesome. i particularly like the pills - the combination of blue and that bit of yellow is beautiful!.

i have a bit of a thing for colours ;)

Sleep iiiiis great right now. I've been sleeping ok, thanks for asking! I think I'll be taking it at night time from now on. All my pills are sedating except for lamictal.

I have a thing for colours too, and I like dressing in colour. Especially red, which is my favourite. Melbourne is still into black a lot. We're still a little chromaphobic. I would love to go to India because it is so full of colour.

Where abouts are you from? (I might have asked you before)

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I'm from adelaide. its cold here too :) this morning we've had lots of rain and some hail.

i also like dressing in bright colours. I have synaesthesia. all my numbers and letters and feelings have colours.

Its sad that people wear so much black - I always feel happier when i wear brighter colours. I make a big effort to wear happy colours, and really bright colours, when i'm feeling down. I think it helps to make me feel more confident and less...reclusive.

my favourite colour is green, although i also like blue and purple. then yellow, red, orange, pink, and variations on all of those.

you know what i like doing? ;) i go to Bunnings warehouse and collect heaps of paint colour cards, and use them to make artwork. i have quite a few stuck to my walls. Others i keep in a box, and when i am bored or unhappy, i pull them out and count them and organise them into different combinations of colours, and it somehow makes me feel better ^_^ I made my brother come with me into bunnings to help me to collect a stack of them. i literally took one of every single colour. I was a bit worried they would think i was stealing so i asked the guy at the paint counter and he said it was definitely ok for me to take them all :)

i also love buttons - i have large quantities of very colourful, interestingly shaped buttons. - i mean clothing buttons not badge buttons.

sorry, dragging your thread very much off topic.

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