Effexor Day 4: tired and hot
 

Hi,
I am taking one half of a 37.5 mgs capsule (18.75 mgs).

I was very sleepy and hot all day.
I'm going to go to bed soon.


The a/c was out at work and I slept very little last night so I can't know exactly if the Effexor is causing this, but I'm sure it is.
Ugh. I had to leave early from work.

Pdoc told me to take it in the AM because it is activating. ??!

M.

hi.

yes, it is activating. many antidepressants are or can be, but different people react different ways even to ones in the same class. like i CANNOT TOUCH Paxil, but zoloft is fine if approached slowly, and i took celexa before too and that was ok too.

i can say for sure that this time, i had some activation initially with Zoloft, but pretty mild and it did pass after about a week at the same dose.... i actually noticed it more at the beginning, 25mg and then 50mg.... so i think it was very helpful stay low until i was "comfortable" again. now i am taking 150mg of it and did not notice any side effects at all increasing from 100 to 150mg!

the sweating might resolve too. that could be related to the activation. i had that problem with Effexor, but at night more than in the day... now i can't remember when i took it but i'm thinking morning, also. also had other sleep issues with it - maybe i metabolize it more slowly so that it ends up messing with me at night. Anyway Effexor and i did not get along. i hope you do better with it.

~ waves ~

I think you are sleep deprived....and the fact that your ac was out...that too can make you tired.
I am hoping that you can get some good sleep sometime soon.
((((HUGS))))
bizi

Paresthesia
 

Hi,
I took a nap and still feel sleepy and foggy.
Now I also have paresthesia in my face, arms, . . .Pdoc had said that paresthesia (or formication) could be caused by activation / norephedrine.

I might take 1/4 dose tomorrow morning: (9.38 mgs).
After that I will decide tomorrow whether I am going to stop this drug.

I need to be able to function at work.


M.

Dear Mari

indeed with your doc's explanation i was a tad surprised at his wanting to replace the Wellbutrin (acts on norepinephrine, dopamine) with Cymbalta or Effexor (act on norepinephrine, serotonin).

the mechanism is different - Wellbutrin is not a reuptake inhibitor but still... if increasing your NE levels is the problem..... how about we don't take a med whcih does that??? hmmmmm. well i'm sure doc knows something i don't about that. this is yer, non-doc, lay-man's logic sorta thing here. :rolleyes:

Are you still going to ask about the Zoloft? (it only affects serotonin).

if you do, ask him for 25's. seriously. so that you can start at 12.5. it will be slow going but i (who can take it) had unpleasantness last time, starting at 50, which is a common starting dose. even 25 i did notice it, but it was much better.

in your case i'd go up by 12.5mg every week (assuming no problems or problems improve), until you reach 50mg. then 25mg per week.

you can tell him flat out you want to do this. i think by now he has seen you go through enough crap to realize you can react strongly to meds and even if he doesn't "buy it" medically, he can humor you at this point.

what i tell my docs, if i'm "arguing" dosing needs is... "i would be much more comfortable with ...."

his role is to help you be more comfortable, not more uncomfortable.

good luck! :hug::hug::hug:

waves

I'm not taking this anymore: foggy, hot, and stingy pins and needles, . . .
 

Dear Waves,
Yeah I knew the first time he explained that crap to me that he was bs-ing.

Recently I saw this about the action of Effexor at much higher doses than I would be taking:

http://www.crazymeds.us/effexor.html
I told him that I had run across how the brain stuff happens depending on dose. He shrugged.

Pdoc is ok with my starting at baby doses. He gave me very small doses of Wellbutrin. He prescribed baby doses of the Cymbalta that insurance did not approve. He did prescribe baby doses of the Effexor.

Since April, I have been trying to find an anti-depressant. I'm taking a break so I can focus on

1. work (Yesterday I worked through the brain fog but barely functioned. Today I stayed home -- feel just as bad as I did yesterday and I have not taken any Effexor.) Things would really stink if I stayed on this long enough to have to try to discontinue it.

2. all those tests that mdoc wants.

The paresthesia is a serious concern. I wonder if I would have a reaction with most ADs.


At the end of our last appt, I checked with pdoc by saying something about if I am going to have problems with Effexor I will know early and if it helps me I will know in a month or so. He said, "yes." I know that this is not exactly true. My point is that this is the agreement we had when I left the office --- if the med stinks in the beginning, I'm not going to wait out the month.

M.

Mari

You will know is so right. Just give it a little time though please.

Donna:grouphug:

Dear Mari,
You are wise to listen to your body.
I am sorry thta you are having to go thru the medication roller coaster.
It does not sound like fun at all.
I don't understand why the welbutrin worked for years for you but not now?
sorry if you have explained that before.
bizi

Dear Bizi,
I started Wellbutrin around 1993. I started having the paresthesia off and on around 2004. Eventually the side effects got worse so I went off Wellbutrin around 2006 or so.

I had hoped that when I re-started Wellbutrin I might not have the same side effects, but I did.

I'm having the same side effects with the Effexor.
I'm concerned that I cannot take an AD at all.

M.

Mari,

Are you taking the extended release tabs, or regular effexor?
Are you going to be on any AD at all?

I think it's pretty common to have drug sensitivities.
I have a lot of experience with paresthesias and I know uncomfortable it can be. Since you've got a history with this, I really can't blame you for wanting to stop the effexor.

I took zoloft for years and didn't have any side effects until I went to higher doses. Even then, it was stomach issues that were pretty well controlled by prilosec. I love having to take an extra med to control the s/e of another med...

Mari, I hope that you feel better soon, whichever route you choose to take.
:hug:

Dear Kay,
Thank you.
It can be a lot of work to keep track of meds, keep up with docs, loose time to deal with side effects, . . . .

I was on regular release Effexor 37.5 mgs tablets.
I opened them and took half one morning and half the next morning.
After 4 days I stopped.
It's not the right med for me.
I dearly wanted it to work, so I am disappointed.

M.

Mari I understand.

I think stopping is a good call. paresthesia at such a low dose, and with your history of it, does not seem like a promising sign at all.

tests might be a good idea to see if some of these drugs are unmasking some condition.

but even if there is no underlying issue, predisposition to paresthesia can change with age, so what was ok in 1993 for you might not be ok now.

i have to wonder if in some patients effexor CAN have noradrenergic activity even at a low dose. that would be consistent with your doc's suggestion of the cause of the the paresthesia. clinical studies produce statistical ranges that help us predict reactions, but those ranges do not speak for all individuals.

the Zoloft still could be worth trying - paresthesia was not an issue with Lexapro at all, right? that would tell us at least it is not caused by purely serotonergic action.

otherwise, i guess i'd have to consider one of the older ADs...

sorry this didn't work out. :( :hug::hug::hug:

~ waves ~

i am sorry you are going through all of this. I don't have any suggestions because i haven't found an ad that works for me. I am trying vitamin b's. and folic acid which i guess is vitamin b. Jarrow has a B right with all the b's.
i am also trying magnesium. there is something called 5-htp or something like that that i think i am going to try. I don't know what supplements you are on.
bobby

Curr Opin Clin Nutr Metab Care. 2010 Nov;13(6):685-9.

Role of zinc in the development and treatment of mood disorders.
Cope EC, Levenson CW.

Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, Florida, USA.

Abstract
PURPOSE OF REVIEW: The present review is a critical examination of the most recent published work on the role of zinc in the development and treatment of mood disorders.

RECENT FINDINGS: Clinical studies and experimental work using animal models have both revealed a link between zinc status and neuropsychological disorders such as depression and anxiety. Not only has zinc deficiency been shown to induce depression-like and anxiety-like behaviors, supplementation has been used as a treatment for major depression. Zinc administration improves the efficacy of antidepressant drugs in depressed patients and may have a particular role to play in treatment-resistant patients. Recent investigations into the molecular mechanisms responsible for these observations suggest a role for zinc in the regulation of neurotransmitter systems, antioxidant mechanisms, neurotrophic factors, and neuronal precursor cells.

SUMMARY: The data reviewed here not only indicate a role for zinc deficiency in the development of mood disorders, but also show that zinc may also be important in their treatment. Given the prevalence of zinc deficiency in human populations, this work has the potential to influence strategies to prevent and treat these disorders.

"

wow bobby that is really interesting! thanks for posting this.
bizi

Bobby,

Great call!!!

I take vit. B12 because I had a deficiency. That came up before the MS dx. I gave myself IM shots for about a year before I couldn't do them anymore. Now I use jarrow, too... the methyl-cobalamin losenges.
In my case, supplementing didn't help my sensory symptoms because of MS.

Mari, it might be worthwhile to have your level checked...
or you could try taking some on your own. The good thing about B12 is that you can't take too much. Once your body builds it's storage up, it takes what it needs from the supplement, and the excess is excreted into the urine.

Kay

I wonder how much zinc????
I used to encourage my wound care clients to take extra zinc 325mg I think, it had to be special ordered from the pharmacy, still over the counter though. But I remember having to tell them to take it with food because it is hard on your stomach. This is really exciting news about possibly becoming a treatment for depression....WOW!!!!
bizi

work stuff
 

Hello,

I'm crying w/ relief.

One of by work buddies had a conversation with the big boss about me. My buddy will be taking over my visible administrative duties. He and I will still work together behind the scenes.

This is good. I can handle the work as long as I do not deal with mean nasty stupid morons.

M.

That's great news! And a great buddy!:):):)

wow! I am so happy for you!
bizi

I am sending celebration thoughts too you.

I also think that the buddy is finding that you need more than
just a buddy.

He is seeing that you needed a friend and partner at work.

I"m hoping that taking some of the pressure off will help you too.

I know it would me.

Donna:grouphug:

The Natural Medicine Guide to Bipolar Disorder
 

Dear Bobby,

I buy zinc but I don't bother to to take it.
I took some yesterday and again today.

I'm going to get serious with it.
This book, The Natural Medicine Guide to Bipolar Disorder, by Sephanie Marohn explains how the ratio of zinc to copper is off for many bipolars.

I also need to get serious about my fish or krill oil, my vitamin Bs, . . . .

Mari

Zinc / B12
 

Dear Bizi,
I remember that Zinc has to be eaten with food. I've taken it with vit C when I felt a cold coming on and had to take it with food.
My book (see my post to Bobby) says that the amount of Zinc is not important -- only in its relationship to Copper.
Lots of the Zinc supplements come with Copper as well because they sort of fight with each other. Plain Zinc will wash out Copper -- this is a good thing. If you buy Zinc, get the plain kind without Copper. The pills I have at home have 50 mgs Zinc.

We had a poster years ago at the old BT who used to post about this Zinc / Copper info that he found for his bipolar son.

I dug around in google scholar for zinc dose info and did not find anything. Maybe on the weekend I can look some more. I'm guessing that 325 mg is way too much.


Dear Kay,
It is good to be reminded about B12 (methyl-cobalamin. ) I've been taking it off and on for years since an acupuncturist told me to take it. When my internist tested me 12 months ago, my b12 was 1200! I backed off on the dose, but I still take it. I remember that it needs to be taken on an empty stomach.


M.

crummy week -- need to vent
 

Hi,

What a crappy week.

Monday morning was the last time I took the mini dose Effexor. I had brain fog until Thursday afternoon from that horrible med. I have not called pdoc to tell him that I stopped it.

I am anxious about the local elections.
I voted today because I thought I would feel better afterward. It took a lot of mental energy out of my day to go to early voting -- not sure why.

Work stinks. I'm very angry. I hope that no one talks to me. I feel violent. I would take Klonopin to work to stay calm but I am sleep deprived and don't think I should drive with it in my system.

I messed up with the bank again.

Friday night we have an event at school. I hope it goes well -- to make up for the extra long day.

I wish I felt better.
M.

Mari

Sending you some positive vibes. To hopefully help.

Donna:grouphug:

I hope things are beginning to turn for you. I can't imagine the stress you have been under.
I am taking a lot of supplements now since welbutrin isn't helping much. a lot of my depression may be situational.
bobby

I'm nervous about the voting, too... the results, difficulty of getting into polling station, remembering what questions I want to yea and nay. I can't vote until Tuesday. I have an appt. in the city at 11am. I'll probably vote before hand so I'm not as anxious about it driving to Boston.

I'm sorry about your bad week, Mari. Next week has the potential to be much kinder to you!!!:hug:

sending good thoughts to help you thru this day.
rest this weekend...rest/sleep when ever you can.
((((HUGS))))
bizi

i am sorry about the crappy week... :(:hug::hug::hug:

great about your work buddy stepping in to help you though!

i hope today/this evening's event went well.

TGIF again. i hope you feel better soon.

waves

Dear Kay,
 

When I went to vote and handed the poll worker my drivers license, she asked me my address. I said my memory is not good and I don't know my address -- never bothered to learn it after a move 16 months ago. Then she held up my license and asked me to read it aloud to her. I did know exactly whom to vote for -- no memory issues with that.

The paper ballot was long and in three languages with lots of state amendments, county proposals, school board races, city commissioner races, judges, . . .
I had checked with my local news paper and printed out most of the stuff ahead of time but not all of it.

Basically, I voted for the folks I wanted at the top of the ballot, voted against the against the bad state amendments, left the rest of it blank, and came home. It took a lot out of my day -- not sure why.

I hope the whole thing goes easily for you.
I also hope that after Tuesday we can relax for a while about politics.
M.

Spoken Word on Friday night
 

Hi,

My buddy brought a local group to campus.
The work behind the scenes took months to put together - - - - but it was seamless for the audience.
The students were surprised that they liked it because we pushed them to show up.
I was happy for my buddy and the students.

=-=-
This success tells me that my buddy will be feeling ok about taking over some of my administrative roles. He and I had two successes this last week. (His show and his taking over some of my job) Thank goodness!


M.

Dear Mari

i am glad the week ended on a positive note. also it sounds like there was major progress in terms of your relationship with work and role at work. i am happy for you. :)

~ waves ~

Mari,

As far as voting, I also have to deal with incompetent old biddies (I have nothing against seniors BTW). I confuse my new address with old ones, too. The fact that they can't remember it for 5 seconds doesn't help.

They stare at me, d/t the cane, and talk about me in the "Irish whisper."
I hate it. Hopefully this time the polling station is busier, so they'll have less time to be so nosy.

I just want to get it over with.

Kay

Pdoc called me: REMERON
 

Hi,

Pdoc returned my call.


He is going to call in 3 pills of 15 mgs Remeron. I am supposed to call him back before Friday because he is going out of town on Friday. If Remeron is ok he will call in more.
I tried to look up generic while he was on the phone. He said it is in a generic.

Mari

=-=

I looked it up. I'm not familiar with the Tetracyclics.
He said it is sedating and to take it at night.
BS to taking this drug during the work week!!

I will wait until the weekend to try something new.
Last time I started the Effexor on a Friday and did not feel bad about brain fog and sweating until the fourth day (MONDAY!!!). I can't remember when I started the paresthesia -- will have to read what I wrote --- need to go to work.

M.

Dear Mari,

please call him back before he leaves, and find out when he will be back. i would suggest you not start the med until he gets back or within a day or two of. not just so you don't run out. in case, you know, any weird stuff... :o

(((hugs)))

~ waves ~

So are you going to take it before you sleep, during the day?
bizi

Hi,

I got off the phone before the pdoc and his office could confirm the pharmacy's phone number.

When I got home a few minutes ago I had a message from the office.

No Remeron tonight.

I will call Tuesday.
I will also verify that pdoc will be in town when I start taking the med.

Dear Bizi,
That is a good question.
Normally I take my night meds between 1 to 3 am.

BUT:
I am anxious about this med.
The first time I take it will be at home when I am awake (normal wake time when I am home is around noon.)

I want to be alert for the first dose or two.

M.

Hi,

The woman and the pdoc's office really thought it was important for me to start the Remeron today / Tuesday.
I told her I really really was not going to do that. :icon_neutral: I'll decide to take it whenever I freeking want.

I messed up my sleep clock more than usual. Now I am in a major grouchy mood. I think I need to stay home from work. I feel that if I go to work tomorrow / Wednesday I might be angry and inappropriate.


M.

I need to go to bed
 

I planned on staying relatively calm about the election.

Instead, I have not slept in bed since Sunday night when I had 4 hours of sleep.

I crashed on the couch with the tv loud and got in an hour here or there.

I need to be more careful.
I also need to allow myself to go to bed tonight.
M.

Mari :hug::hug::hug:

i am sorry the pdoc's office lady was trying to put pressure on you. she can go stuff herself. you know best how to manage your meds, especially new meds.

i hope you do manage to get some good sleep. sorry the elections had you so upset. that's two stressors... politics and the med. yuck.

feel better. sending good vibes http://www.thesmilies.com/smilies/happy/goodvibes.gif, soothing thoughts http://www.thesmilies.com/smilies/happy/angel.gif and hugs :hug::hug::hug:

~ waves ~

very confused
 

Dear Waves,
The pdoc only called in three pills.
She wants me to start the pills so that three days later I can call the pdoc to let him call in more pills. She wants that third day to be during the week so that he is in town.

Three pills? :confused:
Really???


-->>She and pdoc want me to
~call them on the morning of the third day
~pick the refill on this third day
~and take the fourth pill on this third day --- all of this has to happen on the same day. This cannot be on a Friday, Saturday, or Sunday. I feel boxed in.

This takes too much planning.
It also requires the pdoc, the pharmacy, and me to be available in the third day. On the same day I have to both call the pdoc and deal with the pharmacy. I often want to space things out if I can.

I'm not sure what to do.
Which day do I start them?
How do I work around work?
Do I take them daytime or night time (during times of anxiety I need to take them when I wake up -- not when I am going to bed.

I'm very confused.
This is waaaaaaaaay to much pressure on me.
I prefer not to deal with any of it.

He could have given me a week's worth and let me call on the 5th day. This is stupid. I need more flexibility.

One important thing I am reminding myself is that I can take the three and stop and start again. It is not optimal but it is not a big deal. -- Yet, somehow it is.
Three pills. These are cheap Remeron -- been on the market since 1996. Why do I feel that I am being harassed?

Today is not looking like a good day.
I need to find one of my old Jane Austin books so I can stay away from the computer, radio, and tv the whole day
. . . maybe look for some cds to find where I put them.
M.