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Afraid of Effexor


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I could really use some advice and have no one to talk to.

I first went to see a pdoc in fall 2009 and was diagnosed with depression and generalized anxiety. He gave me some samples of Lexapro (10mg increasing to 20mg a day). When I returned after 2 weeks, I reported that nothing significant seemed to be happening, except for side-effects, and he said that it was time to move on to the next med, Cymbalta. He gave me some samples and said to come back in another 2 weeks.

I was concerned that I hadn't given the Lexapro enough time to start working and that Cymbalta seemed to be a more "serious" AD with stronger potential side effects. I was also looking for someone who provided "talk therapy" in addition to the medication. I posted my concerns in this forum and people were very helpful in expressing that it seemed a little early to quit Lexapro and to talk to the doc. I called the pdoc and left a messages on his voice mail. In the meantime, I continued the Lexapro (weeks 3-4) which had actually begun showing benefits (increased energy, not sleeping in everyday, working out again, engaging with friends, family, coworkers). I also was referred to another pdoc who combined med management with talk therapy.

After meeting with the new 2nd pdoc, I decided he was great and he gave me a prescription for the Lexapro, only to find that my insurance needed prior approval. They wouldn't cover it unless I tried and failed 2 generics on their list ("formulary"?). So 2nd pdoc prescribes Celexa, which is on the list. 3 weeks into Celexa, the benefits of the Lexapro have faded and I'm not feeling anything from the Celexa. So now the 2nd pdoc has prescribed Effexor.

I'm disturbed by what I'm reading about Effexor, particularly in regard to discontinuation syndrome, "brain zaps", the possibility that I could be "hooked" on it for the rest of my life, increased blood pressure (I have hypertension), and the understanding that a lot of people wish they had never taken Effexor in the first place. I feel as though I trust this doctor more than the first, but I'm also freaked about the step I'm about to take with this new drug.

In terms of the drug progression, does my story sound "normal"? (I know it varies from person to person) Am I being overly cautious?

I deeply appreciate any feedback from anyone here. Thanks for your time and my apologies if this is not posted in the right place.

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You aren't being strange or paranoid. Side effects can really suck. I was on Pristiq which my doctor told me was a brother drug to Effexor, and I was fine. However, Pristiq is newer, and I haven't been on Effexor. I can tell you that you don't HAVE to be hooked all your life if that's really what happens; just like other illegal drugs or alcohol you'll just have to push yourself to get off of it. I wouldn't worry so much though. You should try Effexor and if you hate it then get off. The meds you really want to worry about with side effects aren't depression meds. It won't hurt you to try, and what if it's your wonder drug?

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I think it's only right that you have doubts in your minds about medications and their pros and cons. It would be naive of us to just shovel drugs into our faces without a hint of knowing what they could do to us.

I know Effexor has a lot of bad press but it also have a lot of good press aswell, you just need to find it. I always think people are more likely to complain than they are to talk about how something has helped them. You know the whole "everyone is entitled to complain" kind of thing.

Also you're in a similar situation to me. I see my pdoc tomorrow and I'm actually going to ask to be put on Effexor and change my antipsychotic. Long story that boils down to, Lexapro and Abilify made me gain about 40lbs and I can't keep my eyes open.

Please keep us or even myself updated with your progress, if you decide to start Effexor.

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I was on effexor for a couple of months and went off it with no problem, some people do have discontinuation problems and some don't, and discontinuation symptoms can happen with SSRI's as well, so it's not solely related to Effexor. I hear it about Cymbalta as well.

The problem I had with Effexor were the START UP effects, those were pretty bad for me, but I was on it for several anxiety disorders, no depression. That being said, I was a little concerned about the possible increase in blood pressure as well, that's not something a person with health anxiety wants to hear. Whatever the case, you might as well give it a try if p-doc suggests it, the DC syndrome is a MAYBE, not something pre-determined to happen to every patient who takes effexor.

Good luck, I personally went through several SSRI's and other things before p-doc put me on Effexor, so I don't know, I don't think there's any standard as to how many drugs you try before you try Effexor. It seemed like, however, if one SSRI was good for you, then they might as well try others. I don't know, just my two cents, and in no way am I a doctor, so it could just be crap what I'm saying.

The hypertension thing is something you should definitely discuss. They monitered my blood pressure the entire time I was on effexor, they monitor it no matter what drug I'm on, and if it makes you feel better, you could purchase a blood pressure monitor to keep at home. Just some shit to think about.

I hope it works out for you!

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I had huge success with Effexor. I took it for about 4 years, I think. When it stopped working I took Prozac while I discontinued Effexor and I did not have any problems. The brain zaps can be managed. I think with Effexor it's maybe a little more important to take it at the same time every day. If I forgot in the morning before I went to work I could have brain zaps by the end of the work day. The good news is I would take the Effexor and lay down and it took only about an hour to make the brain zaps stop.

I'm on Lexapro now and have been for a couple of years. I don't know but I wouldn't think you would respond differently to Celexa, but Ive never taken that. I find that overall I'm much more stable on my meds but I still get bad days. Could that be what's going on with you and Celexa?

I also believe that it takes a good couple of months before you can be sure a med works or not. It sucks as a process but in the end it's worth it.

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Thanks so much for the responses. It's hugely helpful to gain some perspective on this and not be lost in my head.

It's true that when I see the term "addictive", I usually have a mental concept of hard drugs/narcotics and their consequences. I'm wary of Effexor's potential effects, but I shouldn’t automatically demonize it based on a quick internet search.

If I decide to start the Effexor, I will definitely monitor my blood pressure (I own a bp monitor). Plus, if I’m ever going to truly trust the new pdoc, I’ve got to be able to address my concerns with him directly. So I just left a message for him.

@S9: It’s hard to tell if I’m more stable now that I’m on the meds. I could just distinctly feel that as the Lexapro faded, everything started getting dark and heavy again, and my general anxiety returned. I noticed I was slow, lethargic in mornings again, skipping workouts, drinking alcohol again (which has probably messed up the progress of the Celexa too), not social. My head’s so fuzzy, it’s hard to tell if the emotions are more stable.

If I start the Effexor, I will report results here. I appreciate the interest.

Thanks again for your thoughts and encouragement.

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Effexor isn't any worse or better than any other AD. You could have had discontinuation symptoms from quiting the lexapro. It can happen with any of the ADs. You will not be stuck on it for life if you really want to come off of it. Yeah, sometimes coming off of it can really suck for SOME people. Others breeze right through it. I felt like shit for awhile but I got over it.

One of the biggest problems with coming off of effexor is that people can't tolerate even a little bit of discomfort so they go running back to the effexor. You sometimes just have to go through some discomfort. Sorry. That's life.

Another thing that could help if you if you do come off of it and feel really bad is you could try a cross taper to Prozac and then come off of the prozac.

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Effexor isn't any worse or better than any other AD. You could have had discontinuation symptoms from quiting the lexapro. It can happen with any of the ADs. You will not be stuck on it for life if you really want to come off of it. Yeah, sometimes coming off of it can really suck for SOME people. Others breeze right through it. I felt like shit for awhile but I got over it.

One of the biggest problems with coming off of effexor is that people can't tolerate even a little bit of discomfort so they go running back to the effexor. You sometimes just have to go through some discomfort. Sorry. That's life.

Another thing that could help if you if you do come off of it and feel really bad is you could try a cross taper to Prozac and then come off of the prozac.

Yes, I have heard that 10mg Fluoxetine(Prozac) helps with Effexor withdrawal. I was put on Prozac immediately after coming off Effexor and I didn't have any problems, just, Prozac didn't work for me. But no brain zaps or unbearable discomfort.

and beetle's right that a lot of people complain because they can't handle discomfort very well. I can't, this is the reason why I can't stay on ANY SSRI long enough to give it a fair shot, Prozac was the only one I was on longer than a week, all because the other ones made me feel quite insane and I couldn't handle it very well. Now that I've been on Effexor, however, and experienced those start-up effects and toughed it out, I'd be willing to try another SSRI.

But yeah, you might feel like shit starting it, you might not. I did, it only lasted a few weeks, and then for another week when my dose was upped. I'm really thinking about going back on it to be honest, it's the only thing that's helped me a bit so far, besides the benzos.

Anyway, good luck, keep us updated.

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This sort of thing is so variable. Effexor freaked me out too, after reading all those "Effexor ruined my life!!!!" stories on the internet. As Emperor said, you do feel like shit when starting up - but I lived and I was a very extreme case (up to 300 mg in 4 days). The side effects were practically non-existent in a week and a half.

On discontinuation - you wouldn't have to discontinue if it works, rightwink.gif ?

But seriously, although I may be a genetic freak, I want to post this so anyone lurking knows horrible things don't always happen when discontinuing. I needed to get off of SNRIs fast to start an MAOI as quickly as possible. So with no Prozac taper, I went from 120 mg of Cymbalta (twice the FDA max) to zero in four days. I had one week of sucky symtoms, and only one day that was so bad I was non-functional. This is the fastest taper I have ever heard of. I realize not everybody is as lucky as me, but like Beetle, I think those people who say it was six months of TORTURE to get off of Effexor have a serious problem tolerating any type of physical discomfort.

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I want on and off effexor during the period of time I needed it with no problems at all

I liked it much better than anything similar I had tried to that point ...I had no start up side effects and tapered off in a couple of weeks more out of paranoia than need ..

I did gain a lot of weight that was the single bad thing I can say about how this med worked for me (as one individual who will not/can not speak for everyone) honestly .I really ate with reckless abandon!

not a single migraine while on it either ..that part I loved

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just to add one more positive piece of news - it's been a wonder drug for me as well. it yanked me out of a very nasty depression. other drugs helped finish it off (I added them progressively), but the effexor was when I started seeing improvement. so it can truly be great.

i've gone off it once before, and the only lesson I learned from that was that I need to be on anti-depressants (i.e. round two happened). i didn't have problems w/ a very gradual taper.

so...i know the horror stories exist, but I've had a very positive experience.

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Thanks again to everyone for the great feedback and perspective. It's definitely tempered my fears. I also discussed my concerns with the doc and he was understanding, so I plan to start the Effexor today. I figure if I deny any help that has a risk of discomfort, I may never feel better. Wish me luck and I'll post the results here.

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Good luck!

I wanted to chime in kind of late. I love Effexor. This is the second time I've been on it. Nothing quashes the icky obsessive thoughts like it. The mood cycling isn't as bad for me as some AD's. The only side effect I've had is some nutty ass dreams.

I will admit that the first time I had to discontinue it, it was absolutely brutal. But I lived. And there are things you can do to make yourself more comfortable. Like Prozac, benzos, or maybe Seroquel - just depends on what you need. The discomfort didn't last that long. It ended up not being a huge deal.

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This is day 6 on Effexor. I'm at 75mg per day. Overall it hasn't been too negative an experience. The only really notable side effects so far are waking up throughout the night, crazy dreams, some muscle twitching when in bed, and a general jitteriness (may be the coffee). I do sort of feel clearer. Ongoing personal issues (relationship, money) are stressful but not crushing and paralyzing as I would expect. So far so good I guess.

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I just got off Pristiq and it was the worst time in my life. Period. No comparison to any other event in my life. It was that bad. I was so physically and mentally ill that my husband took me to the ER. It was great for a while when I was taking it, then it quit working. I tapered off properly, didn't go cold turkey, but I had a mammoth reaction to it. I know i'm kind of late responding, but I just wanted to add my story.

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This is day 6 on Effexor. I'm at 75mg per day. Overall it hasn't been too negative an experience. The only really notable side effects so far are waking up throughout the night, crazy dreams, some muscle twitching when in bed, and a general jitteriness (may be the coffee). I do sort of feel clearer. Ongoing personal issues (relationship, money) are stressful but not crushing and paralyzing as I would expect. So far so good I guess.

That's good that you are doing so well starting on it. I was on it for anxiety, and I had a BAD time getting on that drug. I just felt braindead for the first few weeks and liked to stare at walls and such. I started at 75mg too, then he bumped it up to 150. Hopefully the sleeping issues and jitteriness aren't too unbearable for you, I bet they are related to the Effexor, but those will go away after some time. Talk to your doctor if they become too bothersome for you.

Glad it's not so bad for you, keep us posted.

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I just got off Pristiq and it was the worst time in my life. Period. No comparison to any other event in my life. It was that bad. I was so physically and mentally ill that my husband took me to the ER. It was great for a while when I was taking it, then it quit working. I tapered off properly, didn't go cold turkey, but I had a mammoth reaction to it. I know i'm kind of late responding, but I just wanted to add my story.

Going thru the SAME thing right not with the Pristiq... dear GAWD!! Hello brain zaps from hell.. ya, real fun having to go to work 9 hours a day feeling like this... especially after not being able to sleep because of it! I'm psyched the doctor told me how shitty it is to get off of this Pristiq shit (BTW, Pristiq is pretty much the SAME as Effexor, just doesn't break down in the liver)... How long until these brain zaps stop, without taking another drug to stop them???

Thanks.

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I just got off Pristiq and it was the worst time in my life. Period. No comparison to any other event in my life. It was that bad. I was so physically and mentally ill that my husband took me to the ER. It was great for a while when I was taking it, then it quit working. I tapered off properly, didn't go cold turkey, but I had a mammoth reaction to it. I know i'm kind of late responding, but I just wanted to add my story.

Going thru the SAME thing right not with the Pristiq... dear GAWD!! Hello brain zaps from hell.. ya, real fun having to go to work 9 hours a day feeling like this... especially after not being able to sleep because of it! I'm psyched the doctor told me how shitty it is to get off of this Pristiq shit (BTW, Pristiq is pretty much the SAME as Effexor, just doesn't break down in the liver)... How long until these brain zaps stop, without taking another drug to stop them???

Thanks.

Oh man, I am so sorry. The brain zaps were really bad for about 10 days. When I say really bad, I mean can't drive, can barely walk, feeling so nauseous that I gag over the trashcan for 10 minutes. They're pretty much gone now after 3 weeks. Exactly three weeks today. The worst was about 4 or 5 days after I took the last pill. It will end, I promise it will end. I thought I was dying and that I would permanently suffer from that drug, but it did end. I'm still pretty mentally disturbed, but functional. Definitely closer to normal than not. I started feeling mentally better by the end of the second week. The first two weeks, I was really really bad off.

Ativan helped me with the brain zaps and vertigo. I took 1 or 1.5 mg as needed. I tried not to take it at all, but in the afternoon I would be so messed up, that I would need to take it. Of course, that much ativan made me sit around like a zombie, but at least I didn't have the brain zaps quite as bad. it didn't help me sleep though. I couldn't sleep because the vertigo and tinnitus were too bad. I had to take benadryl to knock myself out.

I know that Effexor and Pristiq help some people, but I feel like the potential problems outweigh the benefits. I really wish they would take it off the market, or at least give people a better warning that you can become physically addicted to it. Getting off of it is so painful, it took a lot of willpower to say "NO! I am going to suffer through this because I DO NOT want to take this medicine anymore!"

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