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Doctors' Answers to "Frequently Asked Questions" - Effexor


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 09/20/2000]
Question: What is the best way to get off of effexor. Even if I miss a day, I must stay in bed as I feel dizzy and even some numbness in the face. I don't feel that I am depressed any longer and would like to get off this medication. The reason I was taking it was that I had heart by-pass and my husband died 5 months later.

Answer: Tapering over 1-2 weeks by cutting the dosage in 1/2 then 1/4 etc. But, you will probably experience symptoms for about two weeks.

[posted 07/30/2000]
Question: I am currently taking effexror xr and I was wanting to know if dramatic weight loss is a possible side effect? I have lost nine pounds in two weeks and my diet has not decreased.

Answer: About 20-30 % of patients lose weight on this drug. But, ensure your thyroid functions have been checked.

[posted 08/10/2000]
Question: I have noticed many people complain of weight gain on effexor even though it is not commonly listed as a side effect in pharmaceutical literature. How common is weight gain? I am also wondering how common sexual dysfunction in women is? Thank you very much.

Answer: 30% gain weight. The sexual dysfunction ranges from 50-75% depending on the study and the question asked.

[posted 08/11/2000]
Question: I have been having daily headaches, have had MRI (nothing), neck surgery to repair C4-5, Botox injections (which helped but the headaches came back after only 3 months)and have now been given Effexor. I have been taking 1 1/2 tablets and the headaches are less freguent and severe (1 to 3 a week). Yet all I read about Effexor says it causes headaches. How could I have been prescribed that? My doctor said I can increase as needed but I'm unsure about increasing the dosage because of that reason and I've heard others have gained so much weight from it. Is that true for everyone? I like the weight I am (5'7" 135lbs).
Thank you.

Answer: Well, it worked good move by your md. The headaches usually occur right at first or not at all. As to the weight, some patients lose weight some gain, some have no effect. You'll have to see what it does to you to see.

[posted 06/25/2000]
Question: I have been taking Effexor XR for about one year now. Does it affect dreaming? If so why, and what can be done. This has become a problem for me due to restless sleep.

Answer: It affects the level of sleep more than dreaming. That is, you will be more aware of the dreams you are having. Not much that can be done except change dosage/drug.

[posted 06/15/2000]
Question: My 13-year-old cousin was diagnosed with major depression and OCD, he also has learning disabilities. I have had great success with effexor and my depression and would like to know if someone his age could take effexor?

Answer: Used all the time, but not currently approved by the FDA.

[posted 06/15/2000]
Question: I have been taking effexor (now 150mg) for three months and it has worked very well for my depression. I have heard that it also helps with back pain but for the past two weeks I have had considerable lower back pain. Why hasn't the effexor helped with my pain?

Answer: This is not a usual medication used to treat acute pain. We do use it with chronic pain to help with the emotions of pain and occasionally it is of use with chronic pain.

[posted 06/4/2000]
Question: Since I've been taking effoxxor my sexual drive has dissappeared. Is this a side affect. And can I take ambein at night for sleep with these drugs?

Answer: Pretty common side effect. Ambien is usually ok, check with your md.

[posted 05/28/2000]
Question: I have recently been put on Wellbutrin to counter act the side effects of Effexor. More for lack of intrest in sex. Would you agree with this? I am on Effexor for Bi-Polar.

Answer: Sometimes works, buspar is also sometimes effective in this problem.

[posted 04/27/2000]
Question: Hello. I am a 33 year old female who has was diagnosed with
Irritable Bowel Symdrome nine years ago. Bentyl wasn't helping
much, so my doctor put me on donnatol for spasms as needed about
five years ago. Due to the IBS, I developed slight depression.
I have been taking Effexor, extended release since Nov. of 99.
It has helped my depression immensely, and has also helped
me cope with my IBS symptoms. This along with hypnotherapy has helped
my IBS symptoms subside for the most part. It is an ongoing
battle though and I must watch my diet, exercise and drink plenty
of water each day to keep things in check.
My question to you is: my husband and I have just started trying
to have a baby. What, if any, are the effects these meds
will have on a pregnancy - is there any research on this?
Should I try to come off the effexor now before trying any
further or is it in the same family as Prozac which has shown
some promising results for women to be able to stay on it during
pregnancy? Also, if not donnatol, are there similiar drugs
safe to use during pregnancy?
Any information would be helpful. Thank you for your time.

Answer: There is a lot of information, but no direct studies. That is because it is not ethical to expose children to any drug without their permission(of course impossible to obtain). There have been several studies published on the outcomes of women who were taking Effexor. There is a summary in JAMA in spring of 1999 that would be worth reading. However, no one would recommend taking Effexor for irritable bowel during pregnancy. You and your md will need to determine whethr the depression warrants it. Effexor is a Class C drug, meaning it should be stopped if possible.

[posted 05/1/2000]
Question: I have just started taking Effexor XR for about of couple of months
I am finding that I am getting constipated and have been
gaining weight. Are these side effects of Effexor XR?

Answer: Both are pretty common with this drug.

[posted 04/12/2000]
Question: I just started taking effexorthis morning. what should i be expecting from this drug. how should I feel now. will i feel anything. I was put on this drug because I cannot be on prozac. is this an addictive drug? i smoke marijuana, will this affect the effects the purpose of the drug.

Answer: Effexor is used to treat depression and anxiety. It usually takes 2 or 3 weeks to be effective. It is not a physically addictive drug, but some patients will experience a withdrawal syndrome on cessation(usually after taking it a long period). I am not aware of any interaction with marijuana.

[posted 04/8/2000]
Question: I was wondering if my effexor xr150mgs can cause me to have trouble with my cycle. It has always been unregalur. Now it is up to almost 6mos before i have one. I had trouble before the meds but, can it make it worst?

Answer: 6% of patients on Effexor have difficulty with their period regularity(5%of placebo patients). So, there is a small number about 1% who will have problems, but not a usual problem.

[posted 04/5/2000]
Question: I have been taking Effexor since October, 1999...I have taken myself off of it due to the alarming information I have read about it. I have only stopped taking it two days ago and am experiencing headache, dizziness, nausea and my head is fuzzy. What I need to know is, how long will these withdrawl sysmptoms last and am I in any danger?
Thank you for your time

Marla

Answer: About 10 days to 2 weeks and there is no particular danger, but you will feel crummy.

[posted 03/31/2000]
Question: I am experiencing frequent headaches (daily) and although my blood pressure is normal (118/78), my pulse is consistently high (90 - 100) even though it is taken in a resting state and at home when not under stress. Can the drug Effexor cause this over time? Is there any other reason for a rapid pulse & headaches?

Answer: If it was the Effexor, you should have had them from first taking the drug. Effexor can cause headaches, but usually not after taking it for awhile.

[posted 03/16/2000]
Question: I've just been prescribed effexor for depression. I'm
starting at 37.5 mg. for 1 week and then 75 mg. for the next.
My doctor will evaluate me from there. Is this product
evacuated from the body through the liver or kidneys? I'm
concerned about liver damage. I'm also on neurontin (300mg.)
for headaches. Can I take these 2 together?
these 2 together?

Answer: Neurontin is renally excreted. Effexor is metabolized extensively by the liver. The metabolites and the drug are both excreted by the kidneys. Usually there would not be a major problem combining these two medications.

[posted 03/19/2000]
Question: Hi, I recently went to a second psyc. for 2nd opinion regarding my anxiety and excesive worries. He diagnose me with OCD. He prescribed Klonazepan (.25 x3) a day. Before all this I was taking Paxil 10mg per day for anxiety prescribed by my primary psyc. this work for about 10 months but then I stop taking it. I started taking again with the $\\#%\\#\\# side effects. After a while it started to work again. but about dec 99 I started to feel anxious during one week and good the next 2 weeks (during those days I drank about 2 bottles of wine.) Then I stop taking paxil altogether. That's when I went to the 2nd doctor for 2nd opinion. Now I went back to my primary pscy. and told him that on a second opinion I was diagnose w/OCD. Instead of the Klonazepan he said to use Effexor ER. I have read many bad things about Effexor ER and it effects. Could my problem be a relapse of stoping paxil cold. And is Klonazepan a good choice by the 2nd psch.? or should I go ahead and use Effexor ER?

Thank you for your Help ( if you need moree info let me know ).
Thanks

Answer: Paxil is commonly used for treatment of OCD, but if there is a significant amount of anxiety klonopin(ore equivalent) will also be needed. If there is pressure or anxiety about the obsessiveness then OCD is probably correct. If there is free anxiety, either you have two problems or just simple anxiety. In either case these medications are usually helpful. Effexor has different, but similar side effects to paxil. You will have to take it and see. I have patients who do better on one, others better on the other(in terms of effect vs side effects). But, it sounds like you need to get one md that you have a relationship with and stick with them instead of bouncing back and forth.

[posted 03/10/2000]
Question: I had been taking Effexor up to (150mg) for approx. 2 years. Stopped June 1999. I became pregnant Dec 1999 but miscarriaged. Could this be related to a long term side effect of the Effexor? How long does this drug stay in the body after stopping?

Thks

Answer: I wouldn't think there would be any relationship. The drug would only be biologically active for a few weeks at most. I am not aware of any studies showing problems in this area.

[posted 03/1/2000]
Question: I've been on Effexor for about 4 years. Over the last year, my doctor has tried twice to take me off it and switch to another prescription. Both times I got depressed/anxious and physically shook once I got to one 75mg XR Effexor per day. I've alway put on some serious weight since I've been on this (and prior) Prozac. Are they finding the certain patients have major problems trying to get off Effexor? I am terribly concerned. I have never had a dependant reaction to any of my medications. Will I be able to get off this without being a total wreck?

FYI. I am on Risperdal (low dose 1 mg) for help with anger and fears and that seems to be working fine.

Thank you for your time.

Answer: Go to the regular effoxer, not the xr and decrease the dosage slowly. This is a predictable withdrawal syndrome.

[posted 03/1/2000]
Question: Due to insurance problems, I discontinued taking effexor and synthroid at the same time 2/26/00..
The first two days weren't too bad, however the next several days have been awful. I have been nauseous, unable to stay up for any length of time.
I can still eat, but get very dizzy if I am in an upright position for very long.
My question is.......if I am able to go on the medications again (I get insurance again), should I?
I am wondering which drug (or if both) caused the withdrawal problems, and will it mess my body up to go back on them again?

Answer: The effexor is probably the culprit for the nausea, etc. The synthroid will last in your system 5-6 days before it loses any effect. The effexor starts more rapidly. I would recommend synthroid be continued. It is cheap(generic is available)and will drastically affect your body if you are truly low.

[posted 02/23/2000]
Question: What are Efexors used for? i found some in my kids room and he doesn't have a precription for them, and the label is torn off. Are they dangerous in anyway?

Answer: Effexor is an antidepressant, occasionally used to treat anxiety. Fairly low toxicity, and little addictive potential.

[posted 02/16/2000]
Question: I am in the process of quiting my prescription of Effexor @ 150 MG. I was on this medication for approximately 18 months and feel good and was ready to get off. I have never taken any presciptions like this in the past. I went from one pill per day to every other day for two weeks, to every monday and thursday for two weeks to every wednesday for two weeks. I am on my last wednesday and the feeling of nausea, dizziness, headaches is quite bad. It is at the point I feel like I will start missing work, etc. Will this feeling go away? How long should it last? Did I go off it to slow or fast? Your prompt response is very much appreciated!!! Thank you.

Answer: The usual withdrawal syndrome, best described by most patients as having the flu. Usually lasts 2-3 weeks, although some experience longer. You have tapered correctly, just one of the potential problems with this whole class of drugs.

[posted 02/9/2000]
Question: My doctor has told me that research shows the best dose of Efexor to maintain improvement is 15/18 mths. We are keen for me to try for another baby and as I am quite aged are concerned about the delay. Could you tell me where I can access this research and if there are counter views?

Answer: I'd ask him, news to me. Every patient is different in the time necessary to treat their depression, many are lifetime, others are 6 months or so. Ask him for his reference.

[posted 02/12/2000]
Question: I have been taking the Effexor 1 time daily and recently tried to go off of it since I cannot afford the medication. When I stopped taking it, I became disoriented, with flashes of dizziness to the point of passing out, jittery, and nauseated. Supposedly this medicine is non-habit forming but how do you explain the adverse side effects when I stopped taking it? Also the effects grew worse with time until I went back on it two days afterwards, then in a matter of hours I was fine. Any information you could tell me about this would be greatly appreciated.

Answer: It is not habit forming, that does not mean that you do not have symptoms coming off the medication. Addiction is defined as a physical dependence which this drug does not technically have. It does have the serotonin withdrawal syndrome which you are experiencing-common to this and all the serotonin based antidepressants. It will go away, sometimes it takes two weeks to get over it.

[posted 12/26/1999]
Question: I have been off anafranil for more a yr.---butappetite still voracious---effexor helped for awhile but not anymore-ever heard of this?any suggestions?

Answer: Any of the anti-depressants can affect your appetite. This can be to increase or decrease your appetite. If it worked, increasing the dosage might be an answer-about 20% of patients lose weight on this class of drugs.

[posted 11/14/1999]
Question: I have been on anti-depressants for over 2 years, Effexor for a little less than that 2 years. Do I need to come off this drug, or any other of the anti-depressants, when I become pregnant?

Answer: Best to be off of them if you can. But, some patients simply cannot. There is a risk, seemingly small according to a recent publication, but not zero.

Effexor [posted 1/13/99]
Question: Could I have some information on Effexor?

Answer: Effexor is an antidepressant in a class of its own. Its mechanism is currently unknown, but thought to work through Serotonin receptors in some way. Side effects include nausea, headache, somnolence and constipation.

Effexor [posted 1/11/99]
Question: Regarding the gentleman's question regarding just starting Effexor after Prozac stopped working, I had a similar experience with Prozac as well. It worked at first with the depression, but after a couple of years it stopped working for me. For another year afterwards I was placed on other various anti-depressants with little results. Finally I gave up with my psychiatrist and started using St. John's Wort on my own. It helped somewhat, but the depression came back for longer and longer periods and I was getting desperate. So it was back to another doctor, who promptly put me on Effexor XR 75 mg. My experience over the past 3 months on this medication has been wonderful. Unlike Prozac, I have far less fatigue and feel more "normal" on this medication. I'm also less anxious. My only concern is that this medication may also stop working somewhere down the line, but it buys me time until perhaps someday, there will be a cure for this terrible disease. So to the gentleman who just started using it, I would say hang in there and give this medication a chance. It works. Life feels good again.

Answer: Well, we really don't know the real mechanism of depression. When we do we can give both of you a better answer. Thanks for your input.

After effects of Effexor [posted 1/8/99]
Question: What are the "after effects" when one stops taking effexor?

Answer: Different patients report different problems. Some none, some a 2-3 week feeling of headaches, muscle pain, fatigue, etc.

Getting off Effexor [posted 1/8/99]
Question: I have gained about 50 pounds in the last 18 months while taking Zoloft first, then Effexor to treat depression. I am trying to get off the medications entirely, but it is very difficult because of the dizziness and disorientation I suffer when I reduce the dosage or quit all together. I am also very concerned about having gained so much weight. What is the preferred method of getting off Effexor to minimize the symptoms I described? When I quit taking Effexor, will I loose the weight that I have gained?

Answer: Usually, if you can stop. Some patients have less trouble with weight on St. John's Wort. Although it is somewhat less effective in treating depression it generally has less weight, sexual side effects.

Effexor & Anesthesia [posted 12/02/98]
Question: Is there any research on problems with a person on effexor receiving general anesthesia? Thank you.

Answer: I don't have specifics;but, I'd check with the manufacturer Wyeth-Ayerst 800-934-5556.

Effexor & Prozac [posted 10/29/98]
Question: I took prozac for a little over three weeks with no improvement. The doctor switched me over to a low dose of effexor, 37.5. So I stopped prozac one day and started the effexor the next. I wasn't expecting to notice any change right away, but to my surprise, I noticed a big change within just a few hours after taking the effexor; however, this did not last. It became less and less each day until there was no positive effect at all after the fifth day. I feel that a combination of the two drugs really worked for me since I clearly still had some prozac in my system, but my doctor seemed to think that I just needed a higher dosage of effexor. I am taking 75 now, but it still does not work as well as it first did when I came off the prozac. Can you offer any advise? My doctor has also mentioned wellbutrin.

Answer: A combination using small doses of prozac seems to be the answer. No contraindication that I am aware of.

General Info on Effexor [posted 10/16/98]
Question: Can someone please tell me more about Effexor? Any help would be appreciated.

Answer: Effexor is a relatively new antidepressant. Its mode of action is unknown;but, appears related to sertotonin. It is not in the same class as Prozac(Serotonin Reuptake Inhibitors). It should be started at small doses and gradually increased until effective. It usually takes 10 days to 2 weeks for a change in dosage to have any appreciable effect. Side effects include drowsiness, nausea, dry mouth and decreased sex drive.

Chronic Back Pain and Effexor [posted 8/11/98]
Question: My doctor recently gave me Effexor for back pain. Is this normal? I've read a lot of information about this drug on the internet, none of it too good. Also I take Restoril at night and Hydrocodone. Is it all right to take these medications?

Answer: Effexor is an antidepressant which is in a class of its own. Many physicians employ antidepressants in the treatment of pain (especially chronic) since the antidepressants tend to work in the same type of nerve fiber as responsible for pain. There should not be any problem mixing Effexor and Restoril unless the doses are increased. However, occasional patients will have excessive drowsiness during the day.

Effexor and Depression [posted 8/6/98]
Question: I have suffered from depression since I was a child. (I am now 56 years old) and have tried every avenue of help. I have been prescribed Paxil, Prozac, and over the years, many anti-depressants. I have tried herbal remedies, over the counter herbs, etc. Although I have been to many professional doctors, counselors, Alanon programs, etc., my depression still lingers on - sometimes less and sometimes more. I am really tiring of constantly battling this problem. I have recently been given Effexor. My doctor (pysch) feels that my problem stems from a chemical imbalance, of which I totally agree to. I would like to read of the pros and cons of Effexor.

Answer: Effexor is an antidepressant in a class of its own. The mode of action is not clear. Side effects include: somnolence, insomnia, vertigo, dry mouth, constipation, headache, decreased appetite, sweating, anxiety and blurred vision. This medication seems to work where others have not. Patients generally have marked side effects or almost none.

Effexor [posted 8/4/98]
Question: I am taking effexor for depression and I just stopped taking fluoxetine approximately 2 weeks ago. I was on it for approximately 3 years with great initial success, but it just stopped working for me. Is effexor close in chemistry to fluoxetine? Also, I am reading some good things, but also some horror stories, such as significant weight gain and withdrawal. I am just looking for some facts so when I go see my physician next week, I will be a little prepared to speak with him regarding pros and cons of effexor therapy.

Answer: Effexor is a complete class of its own unrelated to other antidepressants. As to side effects, they tend to be very individual. Some patients lose weight, some gain weight. Withdrawal is a little more than the SRI class of antidepressants in general, but is not severe. Generally, it is a little less tolerated than the SRI, but is an effective medication.

Sexual Dysfunction Side Effects with Effexor [posted 8/4/98]
Question: This medication, Effexor XR, works wonderfully and I am aware personally and through the literature and studies that this is a common problem in males. Is there a remedy or way to minimize or better yet, eliminate these side effects? It is impacting me emotionally and maritally. If there is no remedy (I've yet to hear of one, other than Gynko and hybocine, which are not FDA approved), what might you suggest. Tapered dosages do not help either. Are there any new studies under way to further explore this frustrating and life-impacting side effect?

Answer: Two possibilities. There is one research article that cites using small doses of amphetamines to restore sexual drive when using SRI antidepressants. Effexor isn't a SRI (a complete class of its own), but this might be worth a try. Second, Serzone is one of the better drugs in this class to decrease this problem - worth a try.

Effexor Cardiorespiratory Problems [posted 7/17/98]
Question: I am in the process of coming off Effexor from 200 mg a day down to 105.7 mg. Is there any relation to cardiorespiratory problems and coming off Effexor?

Answer: No.

Effexor
Question: Can Effexor cause the pupils to stay dilated all the time?

Answer: It has a slight anti-cholinergic effect and will dilate the pupils slightly.

Side effect
Question: I have been taking Effexor for about 6 weeks. It's working well, but I have been constipated ever since I started taking it. Will this last as long as I'm taking the drug (150 mg/day) and/or should I ask my physician for a different medication?

Answer: It will last as long as you take it. If it works well, I'd address the constipation with milk of magnesia, stool softeners, and dietary fiber. The other medications similar to this drug will also tend to cause constipation.

Effexor and Depakote
Question: I am a bipolar who is currently taking Effexor and Depakote. Should I avoid prolonged exposure to sunshine and generally hot summertime conditions? That is, more so than a person who is not on these medications?

Answer: Depakote has been implicated in causing discoid lupus. This would involve sun sensitivity. Otherwise neither is a big risk.

Effexor
Question: What are the long term effects of effexor?

Answer: Hard to know since it's only been used a couple of years. So far nothing dramatic. This is based on original studies with follow up and European data.



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