![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Joyful on March 26, 2003, at 12:08:40
I began on Effexor XR 7 weeks ago. I began with 37.5 mg for 1 week, then 75 mg for one week, then 150 mg for 4 weeks, and now 225 mg for one week, to see my dr. again in one month. Is this a strange dosage? My dr. said that 150 mg was the minimum therapeutic dose and many people take 300 mg or slightly more, but that doesn't seem to be true of most of you that have written to this site. <p>
I have not yet experienced any lift to my depression. I'm trying to be patient. The good thing is that the side effects have been tolerable: dryness, constipation, great fatigue, feeling very hot and sweaty, pounding and pressure in my head when I move quickly, and the inability to achieve orgasm. Will this ever go away? It may be what I have to accept. How do you know? <p>
I want so badly for this drug to work. I've experienced depression for the last five years. I've never had an anti-depressant work for me before. What does that feel like? I have had some head injuries and brain damage in the past, which makes me very sensitive to drugs and their side effects. I do tolerate Desyrel, but my dr. thinks it provides sleep but is not effecting my mood. Previously I have tried Pamelor, Prozac, Paxil, and Wellbutrin but I couldn't function due to side effects. So I fought the depression without drugs (except Desyrel for sleep) and seeing a counselor about every six weeks to keep on track. But that isn't enough anymore. Now, I'm not functioning due to depression. My dr. said that if Effexor XR doesn't work, there aren't too many more options and we may have to consider Electroconvulsive Therapy, which I am greatly opposed to and do not believe I will consider it seriously. Is that always a bad, dreadful experience or does it acually help? <p>
Thanks for your support.
Hoping to be, Joyful
Posted by T_R_D on March 26, 2003, at 14:03:04
In reply to Trying to be patient, posted by Joyful on March 26, 2003, at 12:08:40
Hang in there! I know it can be tough but it may take just a little bit more time and more of the drug. I suffer from treatment resistant depression (hence my little moniker there) and I had to be on 375mg of Effexor daily (the max outside of a hospital setting) plus have it augmented with other drugs (Wellbutrin and then Cytomel after an allergic reaction to the W.) It sounds like you might be in the same boat as the other drugs not working for you.
I always wrestle with the "what does it feel like?" or the "is this as good as it gets?" questions while being treated. I've been depressed for so long I'm always wondering what is "normal." Some of the things that I look for are motivation and enthusiasm for life and doing more enjoyable things: reading books, listening to music, spending time with people and actually enjoying myself, no more lethargy and generally, forgetting that I'm feeling as bad as I am, if that makes any sense. I don't expect to be ecstatic 24/7 but if the depression is not helping you function normally (don't want to get out of bed, loss of productivity at work--so many symptoms) then it's clear you're not being adequately treated. And oh yes, right now sex drive is a big one...depression always takes that away...a return of my sex drive is always a good sign that I'm getting better.
There are lots of other drugs out there so don't give up hope. Plus with the option of combination/augmentation you've got a long time to go before thinking about ECT. I know it's frustrating feeling like a lab rat or a pin cushion but until I've exhausted EVERYTHING and I mean EVERYTHING--every drug, every combination--no way am I going near an ECT machine. It's very much a last resort of me too. I've heard it can help when nothing else works but the short term memory loss kind of bugs me.
So keep doing what you're doing...one factor to consider for a drug is, have you experienced at least a bit of an improvement? If so, generally the practice is to keep cranking up the volume until you are at the max. therapeutic dose. If you're still showing some signs of improvement but still feel you've got further to go, that's when augmentation or combination therapy should be used. If there's nothing to add to the mix and you're not getting any effect, the drug clearly isn't for you.
Take care and keep me/us posted!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.