Sunday, January 07, 2007

A plea for anecdotal evidence...

And yes, I know the plural of "anecdote" is not "data." Let me explain:

Those of you who've read this blog for a while know that I've been dealing with changes in my brain chemistry. This is known technically as Being a Nutjob, of which I am proud. It's a long tradition in my family.

Trouble is that I'm experiencing some pain-in-the-arse side effects from Effexor. I'm not taking a huge dose of it, as doses go--150 milligrams of the extended-release stuff a day--but I'm still bugged by what's been happening.

What's been happening is, to wit:

1. Excessive daytime sleepiness. I've taken two three-hour naps today and could easily lie down again. I'll probably go to bed at about 8 tonight.

2. Body fat that will not go away, no matter how carefully I eat or how much I exercise. Note that I don't say weight gain; this is body fat distributed in places where it's never been before.

3. Massive, horrible side effects if I miss a dose by even a few hours.

4. Being posessed by the Hunger Monster at odd times of day. Like all day long, basically. I am never not hungry. Since I read that Effexor has an off-label use for treating eating disorders, this begins to make sense.

I have to visit the Brain Doctor sooner rather than later, so I figured I'd talk to him about making the change. Wellbutrin seems like a pretty good choice, even though the discontinuation syndrome is just as bad as it is with Effexor. At least the stuff I've read doesn't talk about increased appetite and trouble waking up, which are my two big bugaboos.

Or perhaps Lexapro, I dunno. From what I understand it's not all that different from Celexa, which again seems to have a side-effect profile I could deal with, except for those darn "sexual side effects".

So, people, what are you taking, if you're a nutjob like me? What have you tried in the past, and what did you like or not like about it? How was switching from one crazy med to another for you?

Just for reference, I was dealing with anxiety and moderate depression as well as some weird obsessive stuff before I started Effexor. All those symptoms are going away...but I'm going to get depressed again if I end up sleeping my life away.

23 comments:

Vermont RN said...

My guess would be your seratonin/norepinephrine balance is out of whack. Effexor is supposed to work on both of these neurotransmitter, but of course it all depends on what your brain makes on its own as a baseline. I've experience the side effects you describe, and my NP presribed Ritalin to give me more norepinephrine. It solved the problem very quickly. I take 0.5 mg ritalin three times a day. Give it a try.

Lioness said...

Oh, bloody hell, wish I could help but I can't. No idea at all. Hope you find a solution, it sounds terrible.

Jo said...

Lioness, it's not terrible in the least. It's a case of things going so well psychologically that I can afford to worry about physical side effects.

Yeah, it would be nice not to have to sleep all the time, and to have something that doesn't make me nutso if I miss a dose, but you know what? I feel good right now. If the brain doc says that Effexor is it, that any other drug won't work as well, I'll be fine with that.

Jo said...

Vermont RN, do you have any odd side effects from the Ritalin? I've never heard of that being prescribed in conjunction with antidepressants, but then, I deal with brain tumors. This is interesting and something I'll look into. Thanks!

Cherry Ames said...

Cipralex. Works in 2 weeks, weight negative, sleepy for the first two weeks then back to pre-med normal. Minimal side effects and it works on both anxiety and depression. Down side? Not covered by many plans unless documented lack of success with other meds (think you might qualify for that...)

Kaliki said...

Wellbutrin 300 mg QD and Lamictal 100mg QD, without discernable side effects. I have sleep apnea, and take Trazodone 100 mg QHS, which has worked great for me for years. I have been a nut job for many, many years and actually went to nursing school during major depression! Dumb, huh? The Lamictal is to prevent constant dips, but I haven't taken it long.. I love your blog, Jo, keep it coming. And thank God we have this stuff. Our brains will probably eventually say, "I've had it with serotonin and norepinephrine, give me chocolate."

Anonymous said...

Wellbutrin is generally not recommended for anxiety - partly I think because it makes one somewhat revved up. The first time I was on it I had no problem with side effects and had no trouble getting off it. Tried again recently and absolutely couldn't tolerate it - but had no trouble stopping. Brain drugs are weird things. Hope you can find something that does the trick without too much misery along the side.

anne said...

I've been on Wellbutrin in the past - the only two side effects I had were too much wakefulness (so I took my dose in the morning instead of evening), and it made me somewhat lightheaded/dizzy for the first 7 to 10 days or so. I had no trouble at all when I stopped taking it - no aftereffects. I'm going to start taking it again, as I am once again heading into NutJobLand - so I wish us both the best!

Anonymous said...

Wife has experience with the brain drugs, and here is what I've learned from her...

She liked Wellbutrin, but it caused hives so she had to get off of it. Gave her a very peppy feeling, which staved off the depression and got her moving.

This is her second time on Lexapro, and the main side effect is the 'zaps' if she misses a dose. First time she took Lexapro she had some wierd visual effects at first, and also had the typical sexual side effects. Now that she's been on it for about three months that is finally going away.

Engranon said...

Effexor left me sleepy, but did nothing for my nutjob symptoms. Celexa turned me into a raving lunatic. I absolutely could not stop moving/talking/bouncing and couldn't stand a second dose of it. I've never tried Wellbutrin.

My med of choice for some time has been Luvox. Since I also have many OCD tendancies, this makes sense. I did have to up the dose considerably about a year ago and occasionally find that a small bit of Xanax will bring me off the ceiling during that one week of hell a month.

Anonymous said...

Getting off the XR and back to "normal" (and now generic) Effexor is also worth a try, likely a fairly risk-free trial, as you won't be taking your dose down. Run it by your Braindoc- this might sort out the sleepiness nicely. May also be good for the wallet.

GingerJar said...

Paxil gave me weight gain...Effexor XL sleepiness...Lexapro...ditto along with sexual side effects. My choice....divorce the guy, drank margarita's and stayed sane. Oh, and I lost that pesky weight and the other side effects.

Sarah said...

Paxil made me consider driving my car into the river except that I couldn't get out of bed.

Imipramine helped but does make you a little tired right after you take it so I took it at bedtime.

Nic Bunny said...

Wellbutrin XL (300mg/day) has been working fine for me for about six months now. Initial ramp-up was a bit tough - I was biting people's heads off right and left - but other than that it has been fine. I've been as much as 12 hrs late on a dose with only a slight headache for a consequence. I will say that you should pay attention to the warnings about not drinking alcohol. Anything beyond one beer makes the following day a living hell. And I mean that in the full pitchfork kind of way.

I hope you find something that works for you.

DisappearingJohn said...

Lexapro is the one that works for me... After the first 6 weeks, the "sexual side effects" went away, and I really didn't notice too many other side effects. Just like any of those meds, getting off of them is always a walk through homicidal tendancies land for me. I have taken Paxil, but I gained a bunch of weight. Haven't had that issue with Lexapro

hannah said...

If you do end up tapering off effexor, ask your psych about rxing a small amount of prozac to help wean you.

Cymbalta is very similar to effexor, but works more on the norep than effexor does. I was on effexor for years before I developed a prolonged qt, but I've been doing pretty well on 90 mg of cymbalta.

Good luck. I hope you find the right combination that works for you.

scalpel said...

One of the Zoloft reps once told me they call it "side-Effexor."

LOL.

shrimplate said...

Lexapro makes me care a little less about the stress of life and I still f%ck like a happy little bunny. A very happy one, actually. Twice since Friday. Not like I'm proud. Just sayin'.

Better Living Through Chemistry.

Have you ever really looked at your hand? It's wierd.

Vermont RN said...

Re: your question, the only side effect I've had from Ritalin is taking off the 15 pounds I put on in nursing school--not a bad effect! just not the reason I take the med. I also do other things to handle my own nuttiness--lots of exercise, Reiki on myself and others, gratitude that I'm sane enough to enjoy a great life (finally). Best wishes to you!

Angry Aine said...

Cymbalta 60mg/day. Arrived at this magic formula after Prozac, titrated upward to 80mg/day,which helped anxiety but not depression; Paxil, which made me gain weight and lose all interest in sex; Serzone, which did nothing; lithium, which made depression MUCH worse; Wellbutrin, which helped depression but made anxiety worse; and Effexor, which worked but only at doses (300mg/day) that caused hypertension. Also tried Lamictal, which brought on Stevens-Johnson ("scalded skin") syndrome, apparently not an uncommon side effect.

Only problem with Cymbalta is h/a and weird, electric dizziness - similar to "spinners" when you're drunk - if I miss a dose for more than 48hrs.

Did have sleepiness with Effexor, in fact the opposite - both it and Cymbalta cause insomnia if taken too late in the day. However, good friend takes Effexor as well as Thyroxine (thyroid replacement); her doc combats the resulting insomnia with Neurontin 30 min before bedtime.

Good luck and happy hunting; it took me 6 years to find a good solution!

PerpetualBeginner said...

The only brain drug I've been on so far is Paroxetine (for anxiety & depression), and it did a lovely job for me.

fjones23 said...

Saw that you had a sentence on Celexa/Lexapro.

In a way, they are the same thing. Lexapro (escitalopram) is just the active enantiomer of Celexa (citalopram). Some drugs have been found, that you would isolate the more "active" enantiomer that the drug works "better." This seems to be the case here where Lexapro is more selective for the 5HT receptor than Celexa. (Just FYI - not all drugs that have isolated enantiomers prove to be better, example: albuterol vs levalbuterol [Xopenex])I took Lexapro myself, mainly due to it being said to having less risk of weight gain. Didn't work, and I gained around 20 pounds. Paxil has the strongest background of causing weight gain.

If you switch to anything from Effexor, make sure you are titrated off. Don't just stop taking it. Effexor has a nasty history with people just D/C it.

Good luck...

Anonymous said...

I AM HAVING THE SAME PROBLEM ON EFFEXOR 150 XL. I HAVE BEEN VERY SLEEPY IN THE LAST WEEK SINCE THE DOSE WAS INCREASED FROM 75 MG. BUT TODAY I COULD NOT KEEP MY EYES OPEN AND NOW AT 7 PM WHEN IT STARTS WEARING DOWN I AM MORE AWAKE. THIS REACTION SCARES ME AS I WORK. I HAVE READ THAT ADDING WELLBUTRIN TO THE EFFEXOR AT 150 MG COUNTERACTS THIS EFFECT. I HAD TO GET OFF LEXAPRO OR SIPRALEX AS IT IS CALLED HERE DUE TO TERRIOBLE LEG CRAMPS. IT HAD WORKED WILL. AND IN COMBO WITH A TRICYCLIC AT NITE TO HELP SLEEP. ANYWONE ON WELLBUTRIN AND EFFEXOR?