Effexor XR anyone?

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psisci said:
Like I have said many times, there are 2 ways to know something: the anecdotal way..IE. it happened to me so it must be true, or the scientific way which says this happens to 99% of people etc. based upon well structured research. The fact is Effexor is not addictive, it has SE's if you come off it wrong as do most drugs, but it and Paxil seem to be the worst of the ADs for this. This is science, and true, and helpful for people looking to use these drugs or get off them. 99.99% percent of people who taper off Effexor and Paxil very slowly, with a replacement drug on board do fine with no brain zaps, alien abductions or multiple personalities.

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Hehehehe. That made me giggle.

Can be explained by the availability heuristic though ... basing your expectations on impact / recall rather than actual probability ...

I meant the 'it happened to my friend so it might happen to me' stz.

like i've said many times, i counted the little balls in the capsules and i'd say that six months was coming off of it slowly.

i'm not arguing with you about it, i'm relating my experiences and trying to be supportive to the people who are worried about it and also trusting that the people who are relating their problems are telling the truth.

i guess 99% of the people who have taken effexorxr don't post in support forums.

empathy goes a long way on a mental health support forum.

What is addiction? The DSM defines 'addiction' by a number of features, the most important two being: tolerance and withdrawal.

There are a number of legal prescription medications that people develop tolerance and withdrawal to, and so I do indeed think that is is fair to say that these prescription medications are addictive.

Of course there are other features of 'addiction' too such as lying about how much one is taking and partaking in socially devient behaviours in order to obtain it. I don't mean to say that people typically develop these behaviours to prescription meds like effexor.

With respect to the science: Typically people start taking a low dosage of Effexor and the doctor gradually increases the dosage to theraputic levels. Why? Because of the side-effects of suddenly starting on anything other than a low dose. Basically what is happening is that it takes time for your body to develop a tolerance to the drug so that you can tolerate a theraputic dosage. You have already noted about how people often taper off Effexor very slowly indeed.

They only make Effexor in a limited number of different sizes. People often find that the jump in size between one dose capsual and another dose capsual is too great for the purposes of tapering off the drug without seriously disturbing side effects. One way around this is to split the capsuals. (Basically, you open the capsuals up and count the number of grains in them for around a week or something like that. Then you know the average number of grains in a capsual. Then you can gradually reduce the number of grains that you take). If you do that (ever so gradually) then you should be able to wean yourself off it with minimal withdrawal symptoms.

It is indeed important not to over-react to the possible harmful consequences of a medication. If you look at any medication (take a look at panadol, even) there are a rather large number of possible side-effects. Most people don't experience any of the side-effects, however, much less more than one of the side-effects. I'm not at all saying that Effexor is comperable to panadol with respect to side-effects but I am cautioning against generalising from one anecdotal report to what one is likely to experience.

On the other hand... Who is it who does the studies on side-effects do you suppose? Do you suppose that the drug companies fund studies for the side-effects of their medications as much as they fund studies for the effectiveness of their medications? Of course they don't. Effexor is this years (or the past couple of years) 'wonder drug'. Past 'wonder drugs' include Xanax (anybody see the problem with Xanax?) and Prozac. For quite a long time clinician's were told that there was NO PROBLEM with withdrawal from Effexor by the drug company representatives (where doctors recieve most of their information).

That is simply not the case. The MAJORITY of people who take Effexor need to start it gradually (because they need to build up tolerance to it) and need to taper gradually or they have SEVERE withdrawal responses from it. One can minimise / eliminate the observable withdrawal symptoms by splitting the capsuals (as I said above).

I'd like to see the study that says that 99.99% of people who taper off Effexor slowly (without capsual splitting?) do fine with no serious withdrawal effects. I'm not so interested in the absence of 'alien abductions' or 'multiple personalities' as I'm interested in withdrawal effects such as the following:

- Severe anxiety
- Severe nausea
- Vomiting
- Aches

You can stop those with capsual splitting but I'd be surprised if they have done studies on withdrawing by way of capsual splitting.

Sure one should be careful of anecdotal reports (especially when it is a side effect only one person has experienced). In some cases, however, the anecdotal reports are overwhelming.

See for example:

http://www.dr-bob.org/babble/wdrawl/...gs/457503.html
(The longest thread in the history of the 'withdrawal' board which suggests people have had more trouble with withdrawing from this medication than any other medication. Though maybe... It has to do with the sheer number of people who are prescribed the drug).

I would like to say that if your depression / anxiety is bad... Some people say that Effexor is indeed a terrific drug for them (there is indeed a reason why it is the current 'wonder drug').

I would also say that withdrawal will indeed be manageable if you do the gradual taper by splitting the capsual method.

thank you, Alex, for "grains".......i simply could not come up with the term......... xoxox pat

If there is one thing that is worse than an appeal to science it is an appeal to the current studies that have been done with no appreciation of the fact that running studies is EXPENSIVE and TIME CONSUMING and the majority of the studies are SPONSORED BY DRUG COMPANIES where drug companies have NO INTEREST WHATSOEVER in running studies that show the HARMFUL CONSEQUENCES of their medication.

In fact there is a problem right now with the fact that the drug companies aren't obliged to disclose all the studies they run. If 90 out of 100 studies show that Effexor is no more effective for depression than eating weet-bix then the drug companies withhold publishing those 90 studies and publish the 10.

It takes TIME and considerable EXPENSE to replicate the weet-bix vs Effexor study and people simply aren't likely to fund that unless it is a matter of Effexor vs Brand New Wonderdrug That We Just Invented.

Looking at LOTS of anecdotal reports is (IMHO) going to be the best way of assessing liklihood of negative side effects for some time yet...

By LOTS of anecdotal reports - what do you mean?

Surely there are some meta-analysis reports that look across studies (although shocking to conduct with diff methodologies much of the time without losing detail / info).

i would think that Alex is referring to those of us who have posted our experiences with Effexorxr........notice the word "experience".........

and there are websites full of reports of the ill effects of coming off of Effexorxr.........and i hardly think that people are just logging on to lie...bored? no life? no, they are talking about something very real that happened to them and they need help and they need to know that they aren't alone......speaking for myself, there.......pat

> By LOTS of anecdotal reports - what do you mean?

What I mean is that if you find ONE anecdotal report that 'I tried to stop taking Effexor and I had severe nausea' then even if the nausea was due to the Effexor (rather than eating something bad, say) then one is probably unlikely to experience that side-effect oneself. If only one person in every hundred thousand people experience a side-effect you probably don't need to worry about it too much.

If there are lots and lots and lots of anecdotal reports then it becomes less likely that they are ALL due to other things (eating something bad, having a bad day etc) and it becomes more likely that they are indeed effects of people coming off the drug.

Of course what we would most like is follow up studies for every single person who has ever taken Effexor. We would like to know:
- How much were they taking?
- How long were they taking it for?
- How much did they reduce the medication for and over what amount of time?
- What experiences did they have that they think was related to the reduction in medication?

Do doctors compile these statistics? No, they do not.
Do medication companies compile these statistics? No, they do not.
Do researchers compile these statistics? No, they do not.

Do they do the studies on a smaller scale? Not really. Why? Because most of the funding for studies comes from the drug companies. If you want some research funding to do a project then you won't get funding to do your research if you don't design a study that the funding companies like. This is what some academics refer to as 'selling out'. It is tempting for scientists (chemists and nuclear physicists and defence researchers in particular) to 'sell out' aka to make one hell of a lot more money producing findings (or applications) that people are prepared to sponsor...

(Philosophers can sell out by writing dence and incomprehensible rationales for stupid policys and decisions on where to spend the funding and so on and so forth)

Even if there is a lack of scientific research to show that people have severe withdrawal from Effexor that doesn't mean that people don't have severe withdrawal from Effexor (it is possible the studies have not been done).

By analogy: Even if there is a lack of scientific research to show that cellphones are harmful that doesn't mean that cellphones are not harmful (it is possible the studies have not been done).

By analogy: Even if there is a lack of scientific research (as there surely used to be) that smoking is harmful that doesn't mean that smoking is not harmful (it is possible that the studies haven't been done and it is also possible that the political clout of the tobacco industry (or drug companies) mean that 'suspicions' that it is harmful simply aren't followed up on with respect to doing the studies.

Drug companies have to disclose findings that support the hypothesis that their drug is HARMFUL. This can be avoided by manipulating statistics, however.

There was one anti-depressant that was shown to be better than placebo if you compared people aged 14-45 on the drug to people 14-45 off the drug (the precise numbers have been changed because I don't remember but the take home message is the same).

Trouble was that if you homed in on the 14-19 age group... More people committed suicide on the drug than off the drug.

They only homed in on the statistics (examined them more thoroughly) after several parents sued the company after their kids committed suicide on the drug. That was part of the reason behind the proposed 'warning this antidepressant may cause suicide' label. It was also part of the reason behind the proposal that drug companies should have to disclose ALL of their findings and not just the ones that were favourable.

See how manipulation of statistics alters the 'our drug harms' vs 'our drug helps' conclusion?

I don't have a beef with science...

But it is surely wise to think critically about it.

Reading numerous anecdotal reports is one way around this. I've heard a number of people say that when they told their doctors that they were having nausea etc from reducing Effexor their doctors told them 'rubbish - no side effects have been reported from Effexor withdrawal'. That is changing now. Doctors are starting to take Effexor withdrawal seriously (and actually report them to their peers etc). But for a while there... Doctors didn't report their patients withdrawal symptoms because they REFUSED to believe there were any. That is called a confirmation bias and it is BAD science (there is a lot of bad science out there especially when there is a lot of money to be had in the vicinity)

Wise not to over-estimate science. Especially when there is such a political agenda behind it.

Don't get me wrong - medication does indeed help a lot of people out there and I think that most people do go on it in something of a last resort kind of way. Still, I think people should be informed about what it is they are getting themselves into. Anecdotal reports are fine. What you want, however, is LOTS of them. And... Try and think critically about them (e.g., people who are disgruntled are more likely to be vocal than happy customers... Perhaps?)

I agree Alexandra K - it is indeed withdrawal - benzodiazepams for example are notorious for causing 'addiction' and many prescription drugs are used by teens rather than street drugs to get highs. So, yes, there can be withdrawal effects, and you're right - a non-significant result is not published, and the studies ARE sponsored by drug companies. That's why herbal meds barely have studies to back them up (not because they don't work)

I found something interesting under the "Withdrawal" heading on this page: http://www.anxiety-and-depression-so...al/effexor.php

> Addictive effects are not indicated in withdrawal, but are rather the results of the brain attempting to reach neurochemical stability after an abrupt change.

Hmm. How is 'the result of the brain attempting to reach neurochemical stability after an abrupt change' not an affect of addiction?

Very odd...

I don't know. What defines a chemical addiction? I wish I knew. Unfortunately, I'm not a scientist. I'm a graphic designer and a writer.

lol. seems that they purposely try and reserve the term 'addiction' for non-psychiatric medications. one way of trying to keep the distinction is to build in a 'pleasure' component to substances that are addictive. trouble with this is that the absence of withdrawal can be a pleasure... basically, there is no principled distinction but they don't want to put people off taking the drugs (ahem medications)

lol

http://en.wikipedia.org/wiki/Addicti...s_of_addiction

sky, i'm not arguing with you or anyone else here. you're welcome to your interpetation of anything and all that i say.

when you took effexorxr, did it come in a capsule? mine did. see, a capsule holds little grains of the medicine. it was so hard for me to get off of it that the pharmacist and i opened the capsules and counted out the little grains.......understand now?

olivia voiced a concern about effexorxr and did her research. as i keep pointing out.......this is a support forum and she came looking for information and she's getting it. most of us aren't trying to hit her over the head with it or argue with others. life experience beats book knowledge any old day when it comes to the hell of coming off a med as nasty as effexorxr is........take it to the bank. pat

http://www.doctorslounge.com/psychia...opic-1013.html

the above is another thread on withdrawal from effexor (in case you haven't found it already).

this is precisely why i try and persuade people to try other strategies (therapy, progressive muscle relaxation, visualisation, meditation, exercise etc) and only take medication as a last resort...

you really should be okay if you do a GRADUAL taper (splitting caps) as your body is ready to do that.

but yeah, last resort, i guess.

i had side effects after taking it for 5 days. just a day and a half of nausea. but that was after only 5 days on the stuff...

fayerody, alexandra_k,

Also thanks to all who replied. Dr. Wylie, this thread has become long, but I do appreciate your input as well.

You see I don't ingest anything that has potential to change my "virgin" (to effexor) brain cells until thoroughly researched; so your answers have been of great assistance to me. I have already been burned years ago with benzodiazepine "dependence".

I hope there can be an understanding of why I am so fearful of becoming "hooked, dependent, brain neurons changed forever, habituated, need like insulin" you name it.

I didn't have any bad withdrawal symptoms when I stopped Effexor. I only took the lowest dose for 1 month, though, and I tapered the dose and got off it over a nearly 2 week period. The side effects while I was on it were so unpleasant, I felt much, much better as it started to leave my system. It wasn't the right medication for me.

I have the same kind of fears, Olivia. It was very difficult for me to start taking medication. I resisted for years. I research the heck out of everything before I consider taking it.

I think part of it is because of the way I was brought up. My parents were all about health food and natural remedies. We didn't even take aspirin.

I was the only one of my friends who didn't try alcohol in junior high. I didn't have my first drink until I was of legal age (I never have more than 1 or 2 drinks) and I have never tried illicit drugs -- never been tempted. I like to be in CONTROL -- perhaps a big reason why I have anxiety problems. I'm scared of anything that may affect my brain and make me lose control.

I had a bad reaction to Wellbutrin last year. It made me very depressed and I while I was taking it, I became convinced that the medications I had taken in the past had permanently damaged my brain. My perception was seriously skewed while I was taking Wellbutrin. I know now that my brain is fine, but that was my fear of medication cropping up while I was in that Wellbutrin-induced depression.

I did find medication (and therapy) that worked for me, though, and I feel comfortable taking my medication. I'm glad I did my research and worked with my doctor to find something that works well for me. I hope you find a solution that works for you too.

Thank you, Juliana......the support is much appreciated. I'm seeing my psychologist tomorrow who has done research into how psychotherapy exerts effects on the brain......rather than always relying on drugs.....

http://www.medscape.com/viewarticle/506084_5

Kind regards,
OliviaC

I have never come across someone trying to sell Effexor XR™ (venlafaxine) in a bar. To me, addictive substances are defined, in part, by drug seeking behavior. Effexor XR™ does not affect dopamine levels, except at very high doses (eg. > 450mg/day). It increases levels of serotonin and norepinephrine. One of the major pleasure seeking centers of the brain is the nucleus accumbens, which is stimulated by dopamine. It is increased dopamine neurotransmission that "soothes" the addiction.

Just my thoughts - Cam

sure.

you can define addiction however you like (why not - everyone seems to have a definition) ;-)

but that doesn't change the fact that the dose needs to be built up slowly so the body gets to tolerate it...

and that the dose needs to be reduced gradually (more gradually than most doctors realise) so the body gets to tolerate having less of it...

I can tell you a horror story about effexor xr and if you really look into it you can find many horror stories.

My partner was put on effexor xr five years ago. Her OBGYN put her on it "in case" she had depression due to menapause. During the first year she kept getting more and more depressed, therefore the doc kept uping her dose. She was sleeping more and more, she was only out of bed enough to work eight hours a day, on her days off she was only out of bed to use the bathroom and grab some food.

She started having high blood pressure and heart issues after eight months on effexor xr. She was put on high blood pressure medication and nitro pills. I told her doctor that I thought her problems were connected with the effexor, of course the doc said this was impossible. At 13 months the seizures began, the blood pressure got worse, she was let go from a job that she had been working for five years because of the seizures and medical problems, suicide became a daily thought, and her dosage was increased to the maximum amount. I fought with her dr. and finally convinced her that the effexor was causeing these problems.

Getting off the effexor was another hell in itself but after a year she was off all medications, her blood pressure was normal, the seizures stopped, the heart started doing much better, and she no longer thought of suicide.

She is now a very healthy person who holds a full time job that she loves. I could tell so much more but I think this is enough to give you an idea.

i'm going to clarify something about myself.

i am here to give support and ask for support.

i am not arguing or countering with any experts here. i'm stating what has happened to me and telling a poster about a life-changing experience that i had with effexorxr. and i have great empathy for Olivia and have demonstrated that in various ways. (and for anyone who has problems/questions about these meds)

i detailed the weight loss, while on it, i detailed how it made my head feel and i've talked about the hell of getting off of it.

last time i checked, we have freedom of speech here. i've taken the drug. i can talk about the drug. and i will talk about the drug. it almost killed me. i went from a size 6 pants to a size 0.....if i prevent one person from going through what i went through......99.9% of the others are safe, right?

i didn't even disagree with those statstics in this thread. because i don't have a dog in that hunt. i don't prescribe meds.

i do agree with Alex pointing out that drug companies pay for those studies. i am presently working as a therapist for geriatric patients, i married a doctor, i worked in a psych hospital, i worked in an emergency room......i know how those studies and the med companies that pay for them work. i may have been born at night, but it wasn't last night.

i wasn't in a "blind study" or any other clinical study. i was on my own, without the support of the doctor who put me on it and i suffered. no one interviewed me after my experience.

how hard is it for someone to understand that those who have taken the drug, and had to take most of a year out of their life to get off of it, know more about the withdrawal than those who read about it?

i do not counter views. i keep presenting what happened to me. and i will not be sweeping such a bad experience under the rug.

Doc John has never said a word to me about discussing our experiences with our meds... he pays the cost to be the boss.....so, i will report to him any future communications about this thread.

and i want to state that i do not want to argue, i don't deserve lectures and i will believe what i believe about effexorxr.......

(((((Fayerody))))))
Sweetie...
I really don't think that people meant to come across as undermining or being invalidating or dismissive of your experiences.

I think that it is great that you shared your experience with the med, and I think that it is great that others have shared their experience with the med too.

Because some people have negative experiences with it (like you did) and some people have positive experiences with it. It is nice to get a bit of a range of responses so one gets some idea of possible side effects and the like and also some idea of things to minimise withdrawal and so forth.

> if i prevent one person from going through what i went through......99.9% of the others are safe, right?

Sure. But the trouble is that EVERY medication has some nasty side effects. Asprin, for example, can thin the blood. In some instances that can lead to people bleeding to death. That side effect is sufficiently rare, however, that the potential benefits outweigh the potential harms for the people who choose to use the drug. Similarly with Effexor. I'm not at all doubting your experience. The concern, however, was that someone might not take the drug because of your experience with the drug when it is highly unlikely that they will have a similar experience. You were really very unlucky with your experience there :-( But if we banned every medication that affected a small percentage of people badly then there wouldn't be any medications at all.

That is why I provided links to a number of threads (with a number of posts). Seems that negative experiences aren't all that uncommon on Effexor (though I do think it is fair to say that such and INTENSELY negative experience, like yours, is indeed much rarer).

Some people take medication as something of a 'last resort' strategy. They have tried everything else and they are reluctant to take it but they are at the point where they are willing to try about anything in order to get a little relief. Some people have found that Effexor is the drug that gives them that relief. If the drug was banned then these people would have to go back on the drug hunt trying to find something that worked for them that didn't give them horrible side effects.

I think there is a balance between looking at what statistics are available (and yeah, there are some) and thinking critically about those... And looking at anecdotal reports of peoples experiences and thinking critically about those (not in the sense of doubting the persons experience but in the sense of thinking about how likely it is that ones experience will be similar).

Of course that goes for positive and negative experiences too...

It's hard to know what to believe anymore. Drug companies cover up negatives about their drugs, people are paid to endorse drugs, the people selling the drugs want to make as much money as possible, doctors are paid or given benefits for prescribing the drugs, individuals have great experiences and horrible experiences.

Also, just because a drug relieves or eases one or a few symptoms, doesn't mean it doesn't cause harm in another way, even a way you don't know right away.

Drugs are typically gradually increased until at a level that seems to help. However, you may have an effect that you don't really notice because of that gradual change. You might lose intensity of emotions (which can be good or bad), but because it often happens slowly, you may not realize you've become rather numb by the time the meds reach a helpful level for the condition you're treating, and you may not realize that you weren't always so numb. When things creep up on us gradually, we don't always notice them.

I'm not anti-meds, but I do believe you have to research them, and seriously consider them before deciding to try them. I also recommend keeping a chart or diary of how you feel, not just physically and in terms of your condition, but your moods, your creativity, your levels of concentration and comprehension, grades (if applicable), and other abilities and skills, from at least a week before you start the drugs (if possible), until at least a few weeks after you've reached the highest dose.