I want to specifically address this antidepressant for three reasons: 1- the difference between Effexor and other antidepressants; 2- the generic is not equivalent for Effexor XR; 3- a caution about certain people’s response to reducing their dose and/or stopping the medication 1-Many of the well known antidepressants are of the type known as selective serotonin reuptake inhibitors (SSRIs) ; these include Paxil, Prozac and Zoloft. In basic terms, SSRI’s work by increasing the levels of a brain chemical called serotonin. The body naturally produces serotonin and keeps it at a certain level, but SSRIs can increase that level by blocking (inhibiting) the re-absorption (reuptake) of serotonin. Effexor is a serotonin-norepineephrine reuptake inhibitor (SNRI). Similar to SSRIs, SNRIs block the reabsorption of serotonin. But unlike SSRIs, SNRIs also block the hormone norepineephrine. By doing so, brain cells seem to communicate better. This boosts a person’s mood. Doctors prescribe SNRIs to adults to treat major depressive disorder, generalized anxiety disorder, social phobia and panic disorders. 2- There is a generic version of venlafaxine XR (the active ingredient in Effexor XR) that comes in tablet form, compared with the capsule form of Effexor XR. However, they are not AB-rated (one of the Food and Drug Administration’s codes for bioequivalency) because of the difference in tablet and capsule. This basically means that one cannot be substituted for the other. Doctors needs to specify venlafaxine XR tablets on the prescription, if they want to prescribe the generic form. However, the tablets are not FDA-approved for the treatment of panic disorder or generalized anxiety disorder, which Effexor XR capsules are. Like Effexor XR capsules, venlafaxine XR tablets are FDA-approved for major depressive disorder and social anxiety disorder. http://www.everydayhealth.com/drugs/effexor 3- Over the years I have been prescribed a number of antidepressants and stopped them for various reasons. Imipramine, Paxil, Celexa, Prozac, Wellbutrin, Effexor XR and Abilify. I suspect there may be more, but these are ones I recall. Most were either stopped because they did not seem to be addressing my depression well enough or the side-effects were too uncomfortable. (As an aside, I seemed to do well on Wellbutrin, but after being on it for a week or so, I made a pan of brownies, ate the entire pan in one sitting and could have eaten a second. My food intake has always been regulated by a sick feeling when I overeat. That regulator seemed to have gone missing. I called my doctor and said, this isn’t going to work out. The brownie incident still makes me a chuckle). I am not exactly sure when I was prescribed Effexor, but it would have been not more than a year before I started being treated for bipolar. It seemed to work well and so I remained on it as we worked through finding mood stabilizers. At that time, psychiatrists did not have concerns about patients with bipolar being on an antidepressant, in fact, I would venture to say it was rather typical. As my psychiatrist and I were starting to settle in on the mood medications, I must have had some depression issues. A new antidepressant, Abilify, had recently come to market and so my doctor suggested I give it a try. I tapered off the Effexor while starting the Abilify. After two days on the Abilify, I checked myself into the hospital for suicidal thoughts. I had never had any thoughts of suicide previously; I knew it must be the Abilify, as most antidepressants list suicidal thoughts as a potential side effect. The hospital and my doctor worked together; I told them, you need to get me off the Abilify and back on the Effexor. I spent four interesting days in the hospital while they tapered me off Abilify and back onto Effexor. I was fine after that. Until last year, I believed Abilify was the culprit. However, I now suspect that may not be true. As noted in my previous post, the psychiatric community has recognized the problems antidepressants can potentially cause for people with bipolar. Essentially, the two psychiatrists who failed to treat me correctly, believed I should taper off Effexor XR (the XR refers to extended relief). I take two separate capsules per day, a 75mg and a 150mg. So, I stopped the 75mg capsule. I was already doing poorly, but after about a week, I went back on- the results had been awful. I was seeing my psychologist on a regular basis; after hearing my response to the reduced dose he explained that reducing or discontinuing Effexor had to be done very slowly. As many of his patients are on medications, he knew that many of them had to open the capsule and remove one bead at a time. So, I started that method; my psychiatrist thought this very slow method was ridiculous, but I didn’t trust her much so I continued. I was still having so many issues, including continued cognitive and memory problems. My anxiety and social anxiety were ever increasing and I noticed I was starting to feel like I was going to have panic attacks. I also began having frequent and severe headaches. Between my poor memory, social anxiety and illness, I did not see my psychologist for a few months. When I was finally able to see him, he asked me if I was still reducing the Effexor and if so, how quickly. I said, I am removing one new bead from the capsule daily. He explained that this was much too fast and that removing one additional one per week was a better pace. As noted in my previous post, I eventually decided to just go back to my normal dose that I had been on for years. About two days after resuming that dose, I recall standing in the middle of my kitchen and having a thought. As my mind completed the thought, it occurred to me that my normal thought process was returning. I knew that I was struggling cognitively, but it was interesting to feel like, “hey, I recognize that way of thinking, that is how I used to think”. It was a much overdue breakthrough. About a month after I started to feel like I might be able to accomplish more than grocery shopping and laundry, in my life, I got sick. I also began having increasing headaches, which were then diagnosed as migraines. It seemed that my sensitivity to light was growing each day. I has always loved light, I keep my blinds open until the last bit of sunset is gone. I go in the room with the most sunlight during the day. Light has always made me feel happy; now I was having to close all my blinds, keep the lights off, I even started to wear dark glasses while watching TV. Photophobia, which is a term used to describe the type of sensitivity to light that I was experiencing is a side-effect of Effexor. It just occurred to me today that perhaps my body is responding to the Effexor as if I had just started it and these are side effects that won’t last. Or is this a side effect I have developed because I tried to decrease the dose. The good news is that my anxiety, social anxiety and panic attacks have been significantly reduced. I know that some people do not want to be tied to a medication for their entire life. Sure, I understand that, but I am not that person. I tried to live the first half of my life trying to will my way through my disease. Waking each day and wanting to live and not hoping to get hit by a bus and die, that is worth taking medication for my entire life. You may also look at my experience with Effexor and tell me that it is incredibly addicting and that I should get off of it. I would disagree, I have suffered from severe anxiety and social anxiety since I was very young. This particular medication is specifically designed to address all those issues along with my depression. I don’t have a doubt in my mind that my brain has some glitches, I did not make them, it came that way. I can choose to live miserably or I can choose to use all the resources available to me and live as fully as possible. I choose to live as fully as possible; life has good and bad. I have had good psychiatrists who helped me find the correct diagnosis that was life changing for me. I have also had psychiatrists who really messed things up for me. I have a medication that has blessed my life, it has also caused me a lot of trouble. I won’t ever write off either, I believe both are essential to keeping myself as emotionally and mentally healthy as possible. Lots of people have a resume and education that represents their hard work and strengths. I recently realized that I can’t put my more than 30 years of experience living with mental illnesses and the resulting strengths and growth on a resume. However, what I have accomplished and the progress that I have made is just as valid as someone who has honed their expertise for 30 years. There is always hope, it might be barely recognizable or seem to be just out of reach each time you think you have almost grasped it, but it is there.
2 Comments
lori
5/27/2016 02:15:35 pm
I have read each and every one of your blog posts. I want to tell how brave you are!!! Thank you for sharing your experience. It is so challenging to achieve mental health ... and SO worth it! God be with you.
Reply
sally
5/27/2016 08:58:55 pm
Lori, Thank you very much for your compliment, it has taken courage and some posts feel like they take more than others. Achieving good mental health is very worth it. Thank you for reading my blog, it means a great deal to me.
Reply
Your comment will be posted after it is approved.
Leave a Reply. |
|