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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Janelle on July 13, 2001, at 13:46:33
Thanks for that info ... believe it or not I knew that Paxil (which I was on for many years) inhibits norepinephrine reuptake a bit, more than any other SSRI and that Effexor is a norepinephrine *and* serotonin reuptake inhibitor.
However, I did not know one would have to go ABOVE 150 mg [the lowest theraputic dose for depression], for it to affect NE significantly as well, nor that this action on NE might not have any clinical significance, though.
But what do you mean by in light of this, maybe the NE action of Effexor isn't what's causing me trouble? At the low dose I'm on and even at 150 mg that awful day, from what you mentioned, I would not be having NE action from Effexor. So, maybe you're saying that Effexor not seeming to work for me has nothing to do with its NE action since I'm not getting its NE action at the dose I'm on? Hmmmmm ...
What do the **'s mean?
(and how do you know SOOOOOOO much - do you work in the med field, do a lot of reading, both? just curious, thanks!)
Posted by Simcha on July 13, 2001, at 14:54:25
In reply to PELLMELL: re Effexor and NE, SRI, etc:, posted by Janelle on July 13, 2001, at 13:46:33
Janelle,
I was on 150mg EffexorXR and I had the sweats characterized by hightened amounts of Norepinephrine. My heart would beat faster during my workout. My doc said that 150mg was enough to cause these side effects. My side effects lessened the longer I took EffXR.
> Thanks for that info ... believe it or not I knew that Paxil (which I was on for many years) inhibits norepinephrine reuptake a bit, more than any other SSRI and that Effexor is a norepinephrine *and* serotonin reuptake inhibitor.
>
> However, I did not know one would have to go ABOVE 150 mg [the lowest theraputic dose for depression], for it to affect NE significantly as well, nor that this action on NE might not have any clinical significance, though.
>
> But what do you mean by in light of this, maybe the NE action of Effexor isn't what's causing me trouble? At the low dose I'm on and even at 150 mg that awful day, from what you mentioned, I would not be having NE action from Effexor. So, maybe you're saying that Effexor not seeming to work for me has nothing to do with its NE action since I'm not getting its NE action at the dose I'm on? Hmmmmm ...
>
> What do the **'s mean?
>
> (and how do you know SOOOOOOO much - do you work in the med field, do a lot of reading, both? just curious, thanks!)
Posted by Janelle on July 13, 2001, at 16:10:01
In reply to Re: PELLMELL: re Effexor and NE, SRI, etc:, posted by Simcha on July 13, 2001, at 14:54:25
Simcha,
Thanks for responding under this post - I appreciate it. I am now going to be on what I most likely need most - a mood stabilizer, but thought you'd be interested to hear that my doc said that I probably did NOT titrate up too quickly on EffexorXR as I had feared, but rather since I'm so anxious and agitated to begin with, the higher I went the more stimulating the Effexor got for me, so 150mg of EffexorXR may be too much for me, given my anxiety stuff.
What's weird is shortly after taking it in am I'd feel drowsy, then by mid afternoon, boom, the anxiety started to mount, panic, (no sweats), I got short of breath and my heart would beat faster. Sounds like your doc and mine are "in sync" (agreement) that 150mg is indeed enough to cause these side effects. Glad to hear that your side effects lessened the longer you took EffexorXR. I'm holding at 75 mg one more week, then doc and I will decide if I should gradually increase it or go with something else.
Posted by pellmell on July 13, 2001, at 16:57:25
In reply to SIMCHA: just got back from doc, and: (info): » Simcha, posted by Janelle on July 13, 2001, at 16:10:01
Sorry 'bout that...must've been misinformed about Effexor's actions at low doses. I still think I'm right that its /primary/ action at low doses is to inhibit serotonin reuptake. In most people.
Which reminds me: I've been forgetting to add YMMV (Your Mileage May Vary) to the end of my posts. :)
-pm
P.S. - No, I don't work in the medical field...I just read a(n) (un)healthy amount about this stuff. I'm actually an English major, albeit with a decent background in science. I started off school in biochemistry before I found out that even though I was good at the conceptual stuff, I was a complete moron in the lab. :)
Posted by Janelle on July 13, 2001, at 17:16:44
In reply to Re: SIMCHA: just got back from doc, and: (info):, posted by pellmell on July 13, 2001, at 16:57:25
I bet you ARE right that Effexor's primary action at low doses is to inhibit serotonin reuptake, in most people, and this would explain why in MY particular case, it seems to be increasing my anxiety and agitation, (i.e., might be too stimulating for me), and would also explain why at this low dose, it is NOT working on my anxiety.
So, I could be in a catch-22 situation: if I increase the Effexor in order to get it to work on the Norepinephrine (calm my anxiety), I imagine its rerotonin reuptake properties (which could be stimulating me too much) would increase too.
Therefore, I think I need to stick with an a-d that is EXCLUSIVELY for serotonin reuptake, and go on some other med for the anxiety stuff. In fact, some docs prefer patients to be on several separate, individual meds for each individual symptom (for example, and this is just off the top of my head example: Zoloft for depression, Xanax for), rather than one pill like Effexor that is a combo because you cannot adjust the combo within the one pill, but you can tinker/adjust each separate, individual med to get the right dose of each.
Thanks for explaining that you don't work in the medical field, that you juts read a lot about this stuff. IMHO (In My Humble Opinion) the amount you read does not sound unhealthy! It is admirable. Those of us with these conditions NEED to educate ourselves (my doc made at least one big blunder with me awhile back!), and be our own advocates. Knowledge is power, so keep reading!
This is the end of the thread.
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