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1 hour ago, BrianOCD said:

Well after 2 weeks and a few days I don't feel much different.  Just feel as dysphoric as I ever did, I'm supposed to go up again on the Pristiq so hopefully that will help.

I was talking to my PDoc and I said that maybe I'm just immune to Venlafaxine at this point after being on it for years, and he told me people "don't get immune"  Is that true?  I've always thought the drugs eventually poopout for everyone...

Maybe not everyone, but did he mean that a drug wil basically work forever? Cuz a couple hours around this site would provide lots of evidence to the contrary. Now I’m not sure if immune=poop out In what they were trying to say, but if med cocktails worked forever a lot of pdocs would be short on business 

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1 minute ago, Iceberg said:

Maybe not everyone, but did he mean that a drug wil basically work forever? Cuz a couple hours around this site would provide lots of evidence to the contrary. Now I’m not sure if immune=poop out In what they were trying to say, but if med cocktails worked forever a lot of pdocs would be short on business 

He seemed to act like the drugs always work, I mean that's the impression I got from him, and he's definitely a respectable PDoc, he's been in for 40 years.    Maybe he was telling me that for effect?

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4 minutes ago, BrianOCD said:

He seemed to act like the drugs always work, I mean that's the impression I got from him, and he's definitely a respectable PDoc, he's been in for 40 years.    Maybe he was telling me that for effect?

Perhaps he was trying to avoid the “reverse placebo”

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On 8/8/2019 at 5:34 PM, BrianOCD said:

Does anyone know why they charge so much?  It seems pretty fucked up to me...If I could get it for 200-300 a month I might be able to pull that, but wtf thousands a month?

Not to sound like an ass but they charge so much because they can. They spent millions in coming up with Effexor and it is, unlike many drugs, unique. Based on nothing else out there, One would assume they have made back their investment and received lots of profits. If it did not work this way pharmaceutical companies would not develop unique, new drugs. In pharmaceuticals most drugs fail and never get to patients. So the few that do have to make huge peofits. 

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I think sometimes pdocs get frustrated when people want to quickly ditch a med after a symprom reoccurance, and this leads them to try to avoid providing “poop out” as the first explainaton - to avoid the “reverse placebo” of I won’t ever feel good until I ditch this med.  I AM NOT SAYING THAT PATIENT IS YOU, just why I think docs don’t like to admit the possiblity of a quick loss of effect 

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maybe it's time for lithium per your other thread.

i failed a few ADs....went outside of the box with my current cocktail and have never been better.

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15 hours ago, notloki said:

Not to sound like an ass but they charge so much because they can. They spent millions in coming up with Effexor and it is, unlike many drugs, unique. Based on nothing else out there, One would assume they have made back their investment and received lots of profits. If it did not work this way pharmaceutical companies would not develop unique, new drugs. In pharmaceuticals most drugs fail and never get to patients. So the few that do have to make huge peofits. 

I get that too of course.  It's just people at the bottom like myself are somewhat screwed, especially after being on it for years and then losing the ability to get it.

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On 8/17/2019 at 12:52 AM, BrianOCD said:

Well after 2 weeks and a few days I don't feel much different.  Just feel as dysphoric as I ever did, I'm supposed to go up again on the Pristiq so hopefully that will help.

I was talking to my PDoc and I said that maybe I'm just immune to Venlafaxine at this point after being on it for years, and he told me people "don't get immune"  Is that true?  I've always thought the drugs eventually poopout for everyone...

No they don't poop out for everyone by default but the statistic is really high the longer you take a medication. The missing part there though is that once you reach poop-out, switching to another medication doesn't always fix the problem. For many who have reached poop-out, switching the antidepressant for another antidepressant helps less than 50% of the time. Usually augmentation is required to reverse tachyphylaxis.

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7 hours ago, browri said:

No they don't poop out for everyone by default but the statistic is really high the longer you take a medication. The missing part there though is that once you reach poop-out, switching to another medication doesn't always fix the problem. For many who have reached poop-out, switching the antidepressant for another antidepressant helps less than 50% of the time. Usually augmentation is required to reverse tachyphylaxis.

Cool stat about the less than 50% on a switch I didn’t realize it was that low 

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17 hours ago, Iceberg said:

Cool stat about the less than 50% on a switch I didn’t realize it was that low 

Make sure to take that stat in context. That stat doesn't cover those where it SEEMS like the antidepressant poops out but a dose increase resolves the problem. If your antidepressant "stops working" but you do respond to a dose increase, that isn't antidepressant tachyphylaxis. That just means you weren't on the optimal dose to begin with. However, if you hit poop-out on a moderate to maximal AD dose, then you switch to another antidepressant. Here's a purely hypothetical scenario:

Pdoc starts you out on 10mg of Prozac and after a few weeks increases you to 20mg. You're on 20mg for a few months and find that it isn't working the way it used to in the beginning. So your pdoc bumps you up to 40mg and you do well for several more years. After many years of treatment with 40mg of Prozac, you start to feel like it isn't working again, so the pdoc increases it to 60mg. This causes more side effects but not a whole lot of improvement. So the pdoc tries bumping it to 80mg, but you are unable to tolerate the dose and you don't notice much of any improvement over the 60mg dose. So the pdoc decides to switch you to either 50mg of Zoloft or 30mg of Paxil.

The statistic indicates in this SPECIFIC example that with the switch from Prozac to either Paxil or Zoloft the chances of you responding to Paxil or Zoloft after being on Prozac for several years and maxing out the dose are <50% and with each subsequent switch, the chances of treatment success (i.e. prognosis) actually get WORSE not better.

This scenario above and the corresponding statistic also does not apply to antidepressant-induced hypomania. For example, you've been diagnosed with major depressive disorder but the pdoc is not yet aware of your manic tendencies and prescribes Prozac first at 10mg then to 20mg as in the previous scenario. Except this time, after just a few weeks you feel depressed again and need to increase to 40mg, which resolves the depression but again after a few weeks you're depressed again. This is cycling. Separating undiagnosed bipolar disorder from antidepressant tachyphylaxis is really tricky business.

For someone with MDD, each subsequent AD trial reduces the chance of treatment success, and for someone with bipolar disorder each AD failure increases likelihood of bipolarity. It's very weird separating the two.

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I couldn't tolerate pristiq despite being on effexor for about 11 years (at the time) - the dr  thought as it was a 'cleaner' drug, maybe i wouldn't have the side effects from E.  on the 4th day of pristiq i had the worst anxiety  i  had every experienced - not sure if it was from swapping out effexor or the start up of pristiq, but it just kept getting worse

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5 hours ago, surfer girl said:

I couldn't tolerate pristiq despite being on effexor for about 11 years (at the time) - the dr  thought as it was a 'cleaner' drug, maybe i wouldn't have the side effects from E.  on the 4th day of pristiq i had the worst anxiety  i  had every experienced - not sure if it was from swapping out effexor or the start up of pristiq, but it just kept getting worse

Why did you switch, side effects or did Effexor stop working?

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