Question:

I know that not gargling after taking inhaled steroids can lead to problems. I was just wondering if taking inhaled steroids and having oral sex could cause a problems too. Would there be an increased chance of getting an infection? Thanks

Response:

I was just wondering if taking inhaled steroids and having oral sex could cause a problems too. Would there be an increased chance of getting an infection?

What kind of infection are you referring to?? Ash http://www.angelfire.com/tn/Ashleigh1976/index.html

Response:

I’m really not sure what kind of infection, I just know that my throat doesn’t feel right and my Asthma gets worse. The doctor says it looks really red and that I could have an infection or just allergies. They usually just give me antibiotics, I don’t think they’ve ever taken a culture.  I asked the question only because the problem seems to occur around the same time I’ve had this kind of activity and I wanted to know if there could be a connection.  Maybe next time I’ll insist that the doctor take a throat culture.

– Hide quoted text — Show quoted text – I was just wondering if taking inhaled steroids and having oral sex could cause a problems too. Would there be an increased chance of getting an infection? What kind of infection are you referring to?? Ash http://www.angelfire.com/tn/Ashleigh1976/index.html

Response:

Thrush? Now there’s something for the weekend sir!! OUCH OUCH OUCH OUCH OUCH OUCH OUCH OUCH OUCH OUCH OUCH OUCH OUCH OUCH !!!!!!!

– Hide quoted text — Show quoted text – I was just wondering if taking inhaled steroids and having oral sex could cause a problems too. Would there be an increased chance of getting an infection? What kind of infection are you referring to?? Ash http://www.angelfire.com/tn/Ashleigh1976/index.html

Response:

I’m really not sure what kind of infection, I just know that my throat doesn’t feel right and my Asthma gets worse. The doctor says it looks really red and that I could have an infection or just allergies. They usually just give me antibiotics, I don’t think they’ve ever taken a culture.  I asked the question only because the problem seems to occur around the same time I’ve had this kind of activity and I wanted to know if there could be a connection.  Maybe next time I’ll insist that the doctor take a throat culture.

    Well, the, uh, feminine area is lined with a mucous membrane, just like the throat.  So if you’ve a sore throat, it could be, uh, spread to your paramour.  The other possibility is that your paramour might have a relatively benign infection and be spreading it to you.  Exercise your judgment.

Response:

culture.    Well, the, uh, feminine area is lined with a mucous membrane, just like the throat.  So if you’ve a sore throat, it could be, uh, spread to your paramour.  The other possibility is that your paramour might have a relatively benign infection and be spreading it to you.  Exercise your judgment.

Light Soor is not uncommon for the Vagina, but makes normally no problems May be, there was a transfer, but I thing, this is not a problem of your sex praxis. Fungus is ubiquit

Question:

It could be the propellant you are having a problem with or the medication myself.  I had problems with aerobid inhaler, it made me feel worse.  My doctor switched me to azmacort and I am free sailing now.  

Response:

Actually, to me the Steroid works best out of my three different types of medications, keeping my asthma at the minimal attacks. — Aaron Kennell – Hide quoted text — Show quoted text –

Response:

It could be the propellant you are having a problem with or the medication myself.  I had problems with aerobid inhaler, it made me feel worse.  My doctor switched me to azmacort and I am free sailing now.  

A few years ago, my pulmonologist put me on Becloforte. After a few months, trying to inhale it was making me caugh with the result that I was not inhaling it at all or almost. He then switched me to Pulmicort and I had no problem. I had maybe, he said, become allergic to the gas propellant… Yves Dussault

Response:

Actually, to me the Steroid works best out of my three different types of medications, keeping my asthma at the minimal attacks.

If you had tried breathing thechniques you would also have less steroids, and perhaps no asthma attacks.. |-| /- |-< |-< ||| – Hide quoted text — Show quoted text – — Aaron Kennell

Response:

Question:

Has anybody out there had any experience with Effexor?  What were the side effects compared to say, Zoloft or Paxil?  I know all SSRI’s are different with everybody, but would just appreciate any info or experiences anybody’s had with Effexor.  Thanks! Sara

Hi Sara: I have been taking Effexor XR, 75mg, plus Topomax and klonipin, but the most I can are the side effects from the Effexor. At first, I had some problems with inomnia, but that lasted little. No problems with sexual side effects either. You might have to try taking it in the morning or evening, because it stimulates some, and keeps others awake. You might want to make sure you get a small dose of a benzo (klonipin) to help with any anxiety or sleeplessness you get at first. To be honest, physically, it doesn’t give me that same "depersonalization" like Zoloft, Prozac, or Paxil does. It’s also nowhere NEAR as stimulating to me as Welbutrin, which really made me anxious, grumpy, and I could never sleep. I have been reading in alot of Psychiatric Journals that 37.5mg of Effexor XR is a good dose to start off at, say for a week or so, as side effects then are almost nill. As I said, it’s really only any of the a.d.’s I can take that doesn’t cause really weird side effects. Like, I still feel like "me" on it, just helps keep up some of the energy, and keep my cool when needed. Just be careful with dose…starting at 75mg’s XR a day may be a little "too" stimulating. As I said, a benzo helps too with taking some of the edge off. Good luck… James — Outside of the killings, Washington has one of the lowest crime rates in the country.     —Mayor Marion Barry, Washington, D.C.

Response:

have lessened my depression and reduced my tendencies to anxiety attacks. It’s hard to know if it’s the drugs, therapy or what though. DOug

Response:

I believe Effexor XR is Effexor Extended Release..Anyways please don’t take my experience with Effexor XR as how it many effect you..It may help you out..Effexor XR within an hour of taking my very first dose of it I KNEW I was on a medication/drug..This has not happened before with me trying new Antidepressants..From there I was only able to sleep in 2 to 3 hour increments for a few weeks and then the next 2 weeks I had pure insomnia, which I think was hypomania..Needless to say I went off that med! Religion is for those who fear going to Hell and Spirituality is for those of us who have already been there!

Response:

Hi Sara… I just started Effexor XR yesterday. (I’m taking 37.5 mg in the morning for a week, then 75 mg in the morning thereafter.) I have previously taken Prozac, Paxil, Zoloft and Serzone, but always had side effects that caused me to discontinue them. In a couple weeks, I’ll probably be able to give you more information. The most common side effect I hear about Effexor is nausea, along with some nervousness and sexual problems. If anyone would care to compare notes on Effexor, just e-mail me! Ron in St. Louis – Hide quoted text — Show quoted text – Newsgroups: alt.support.anxiety-panic Lines: 6 NNTP-Posting-Host: ladder03.news.aol.com Organization: AOL http://www.aol.com Has anybody out there had any experience with Effexor?  What were the side effects compared to say, Zoloft or Paxil?  I know all SSRI’s are different with everybody, but would just appreciate any info or experiences anybody’s had with Effexor.  Thanks! Sara

Response:

Has anybody out there had any experience with Effexor?  What were the side effects compared to say, Zoloft or Paxil?  I know all SSRI’s are different with everybody, but would just appreciate any info or experiences anybody’s had with Effexor.  Thanks! Sara

Response:

Hi,      First I wanted to say,thanks for the help with my throat problem.I though there was something seriously wrong with me.Thanks for the support.Now,I have something to ask,and something to complain about.I went to see my psych today for the first time.First,she put me on Effexor XR,37mgs to start,then 75 and then 150.I wanted to know has anyone been on this before and was it helpful?Also,I took the MMPI test for the psych and she had the results today.She told me she feels as though I am exxagerating my situation.That it is nowhere near as bad as I claim it to be.Now,I thought going to a psych would help me and it took me a long time to get up the nerve to finally go out of my house and see one.I can’t believe that is the response I received.I am also applying for SSI disability because of this and she told me there is no way that she will help me with this case,and she doesn’t help any of her other patients with it either.She doesn’t feel as though it is a disability.What should I do??Has anyone gone through this with a psych before???Sorry about the length,but I am at my wits end,and I am only 22.

Response:

As far as the Effexor XR is concerned, I’ve been taking 300mg for several months and it has been the best AD for me personally.  Now, keep in mind the individuality of AD’s is huge, and it’s quite normal to go through a process of changing meds/dosages until you find the one that works.  It can seem tedious, but it’s worth it.  I hope Effexor works for you as well as it does for me, I found it does take the full 4-6 weeks to really help. Best, -Alan ps – I think everyone with PD feels worse then perhaps in reality they are, that they are more pathetic in dealing with things then they is true.  But it’s also important to remember that’s part of the territory, and how we see ourselves plays a lot on how we feel, consciously and subconsciously.  It’s something that can be helped a lot with therapy.  Also, don’t take the results of the MMPI to seriously, and your pdoc shouldn’t either.  She may also be rigid about not helping you with disability because many feel that this is in fact going to counter condition you, to hurt progress and therapy – that sense of increasing security and self-confidence.  I’m sure if you really wanted the disability, there would be other docs that would help, it’s a matter of their preference in approaching the condition. BTW – I am only 21 myself…hang in there, it does get better, even when it seems it never can  :)

– Hide quoted text — Show quoted text – Hi,      First I wanted to say,thanks for the help with my throat problem.I though there was something seriously wrong with me.Thanks for the support.Now,I have something to ask,and something to complain about.I went to see my psych today for the first time.First,she put me on Effexor XR,37mgs to start,then 75 and then 150.I wanted to know has anyone been on this before and was it helpful?Also,I took the MMPI test for the psych and she had the results today.She told me she feels as though I am exxagerating my situation.That it is nowhere near as bad as I claim it to be.Now,I thought going to a psych would help me and it took me a long time to get up the nerve to finally go out of my house and see one.I can’t believe that is the response I received.I am also applying for SSI disability because of this and she told me there is no way that she will help me with this case,and she doesn’t help any of her other patients with it either.She doesn’t feel as though it is a disability.What should I do??Has anyone gone through this with a psych before???Sorry about the length,but I am at my wits end,and I am only 22.

Response:

Sorry to hear that your psychiatrist wasn’t a little more compassionate in the way she delivered the information to you, but I think in many ways she probably has the correct idea.  First, as someone else mentioned, you probably are experiencing things as worse than they really are (this is sort of what panic disorder is all about – we perceive uncomfortable body sensations as dangerous when they are not). Second, as for the disability issue, as a psychiatry (and medicine) resident, I am always reluctant to recommend someone for disability. Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there. I also think effexor is a reasonable choice for a medicine and she is dosing it appropriately.  The specific medicine was probably chosen based on your specific descriptions to her, as well as her experience with various medications. Good luck, Rick http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety Links – view them, rate them, add your own! Before you buy.

Response:

I am always reluctant to recommend someone for disability.

and if they cannot work how will they pay for your services let alone food-these things as necessary as they are are still lack the motivational impact as one would think-if one is backed into a corner has no out no way to have any gainful productive existance then their suicidal tendencies go through the roof-no more patient no more ssdi recipient no more anxiety no more problem-the judgement call for collecting assistance isn’t dependent on the values of the shrink but of the patient-if anxiety were but a mere exageration then this is tantemount to saying snap out of it it’s all in your head. – Hide quoted text — Show quoted text -Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there. I also think effexor is a reasonable choice for a medicine and she is dosing it appropriately.  The specific medicine was probably chosen based on your specific descriptions to her, as well as her experience with various medications. Good luck, Rick http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety Links – view them, rate them, add your own! Before you buy.

I don’t know where you get your studies frm but this is the same logic that our great fathers in washington have used to get the malingerers off the role call-what has happened is we have a false set of economic indicators and psychiatricaly impaired homeless people in a state of limbo with no place to go-who’s responsibility is it-the impaired patient or the welfare system of a fair goverment. I disagree with you and this posters shrink-if she is incapable of work and chooses to approach assistance then I would support her and her choice-when she has established the criterea of our jointly reached goals in therapy she can resume her own financial responsibility and she no doubt will LM

Response:

– Hide quoted text — Show quoted text – Hi,     First I wanted to say,thanks for the help with my throat problem.I though there was something seriously wrong with me.Thanks for the support.Now,I have something to ask,and something to complain about.I went to see my psych today for the first time.First,she put me on Effexor XR,37mgs to start,then 75 and then 150.I wanted to know has anyone been on this before and was it helpful?Also,I took the MMPI test for the psych and she had the results today.She told me she feels as though I am exxagerating my situation.That it is nowhere near as bad as I claim it to be.Now,I thought going to a psych would help me and it took me a long time to get up the nerve to finally go out of my house and see one.I can’t believe that is the response I received.I am also applying for SSI disability because of this and she told me there is no way that she will help me with this case,and she doesn’t help any of her other patients with it either.She doesn’t feel as though it is a disability.What should I do??Has anyone gone through this with a psych before???Sorry about the length,but I am at my wits end,and I am only 22.

Hi! I’m sorry she put you through that.  I haven’t been in that situation, but I’d say get a new pDoc!  She sounds very insensitive and you don’t need that right now.  You’re young and you can beat this thing, but with help from a pDoc.  Not criticism from one.  Please let us know how you’re doing and if you find another doctor.  You’ll be in my thoughts. Di

Response:

Sorry to hear that your psychiatrist wasn’t a little more compassionate in the way she delivered the information to you, but I think in many ways she probably has the correct idea.  First, as someone else mentioned, you probably are experiencing things as worse than they really are (this is sort of what panic disorder is all about – we perceive uncomfortable body sensations as dangerous when they are not).

Sure. But that *is* our problem, that is what is *bad* about it. It’s called Panic Disorder and it is as bad as the sufferer feels it is. And for those symptoms we need meds and therapy and it can be so debilitating that people can lose their marriages, their jobs, their friends and their freedom to move around outside their house. Is that bad enough? Even if all it is is *cognitve distortion* then that can be *terrible*. You sound like those people saying: "Get over it, your fear is irrational." Yes, we know that. That is what the probem is…. Second, as for the disability issue, as a psychiatry (and medicine) resident, I am always reluctant to recommend someone for disability. Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there.

I can’t judge from here whether the original poster should be put on disability or not but neither can you. As a psychiatry resident you might try to not patronize people or you will make as bad a psychiatrist as the total idiot we’re talking about here. Actually I find this post not in keeping with your earlier posts here which I liked. Bad day? Philip – Hide quoted text — Show quoted text – http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety Links – view them, rate them, add your own! Before you buy.

Response:

I did not mean to sound unsympathetic, but it appears I did. Disability is a controversial subject, and I may disagree with some people on this one – and my opinions may change over time as we have better evidence about the pros and cons of placing someone on permanent disability.  I in no way mean to imply that people are not severely impaired by anxiety disorders or other mental illness.  The question is whether they are unable to have employment of any type. the judgement call for collecting assistance isn’t dependent on the values of the shrink but of the patient-if anxiety were but a mere exageration then this is tantemount to saying snap out of it it’s all in your

head. I did not mean to imply that anxiety is a mere exageration or that someone can just snap out of it, because I know and understand that the suffering is very real and often very difficult to overcome.  We are obviously dealing with a very touchy subject here between doctors and sufferers, and I want to help resolve this problem, not make it worse. I also don’t believe that disability should be determined by a patient –  there are too many people who would take advantage of the system (I am not saying that people with panic disorder try to take advantage).  I also am firmly convinced that permanent disability is not appropriate for a young person with a relatively short duration of panic disorder. I do take care of people with anxiety disorders that I have on disability, but it is only after they have failed usual treatments. Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there. I don’t know where you get your studies frm

Rather than get into a debate about studies, as I know very well that people can get studies to say just about anything, I am assigning myself the project of reviewing this data.  I will try to offer as unbiased as possible of a summary on this, including references and abstracts, and then post it on my site.  As I am fairly busy, this may take me some time, but I think it is an important issue for me to understand better.  Hopefully other people will benefit as well to better understand why some doctors are reluctant to place someone on disability. I disagree with you and this posters shrink-if she is incapable of work and chooses to approach assistance then I would support her and her choice-when she has established the criterea of our jointly reached goals in therapy she can resume her own financial responsibility

The problems I have had is that as people are close to reaching their goals, the talk of returning to work often sends them into a downward spiral.  The whole idea of CBT is that you need exposure in order to overcome fears.  Placing someone on disability often reinforces avoidance behavior.  It takes very careful judgment to determine when disability is approriate or not, as the action of offering someone disability has large ramifications on illness behavior. I really don’t want to get into an argument over this, as I have an extreme amount of respect for your knowledge.  I genuinely want to better understand this issue. As a medicine and psychiatry residenct I have seen many instances where I don’t know whether an illness justifies placing someone on disability.  The usual illness I see this with is fibromyalgia.  The most interesting case I saw was a guy with severe antisocial personality disorder.  His girlfriend could not understand why he did not qualify for disability, since part of his "illness" is that he can not maintain employment (this is actually one of the DSM IV criteria for ASPD).  Should all sociopaths get SSDI?  No way in my mind, but if you want to view ASPD as an illness, then they should all get it. Again, I am not trying to compare ASPD to panic disorder, I am just trying to demonstrate that disability issues are something very unclear in my mind, despite my attempts at trying to clarify this issue in the past. The bottom line is, this discussion is only tangently relevant to the original posters issue of the doctor not wanting to place her on disability.  I think what is more important is for the original poster to have a better dialogue with her physician, and if the doctor can not do that, she should consider another doctor. Hopefully I won’t upset too many more people, as it seems I struck a nerve (no pun intended) Rick http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety links – view them, rate them, add your own Before you buy.

Response:

–

Sorry to hear that your psychiatrist wasn’t a little more compassionate in the way she delivered the information to you, but I think in many ways she probably has the correct idea.  First, as someone else mentioned, you probably are experiencing things as worse than they really are (this is sort of what panic disorder is all about – we perceive uncomfortable body sensations as dangerous when they are not).

Well isn’t that the part of the big problem with P/A?  IMO this Pdoc is an ass. Second, as for the disability issue, as a psychiatry (and medicine) resident, I am always reluctant to recommend someone for disability. Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there.

This is rediculous.  Maybe people who receive SSD don’t recover as well because they are the more severe cases.  SSD is a way to help you get a small (and I emphasize "small") bit of income and a way to feed yourself and feel as if you are contributing to the household.  If you feel you are able to work then there are ways to keep SSD while on a trying to get employed again. – Hide quoted text — Show quoted text – I also think effexor is a reasonable choice for a medicine and she is dosing it appropriately.  The specific medicine was probably chosen based on your specific descriptions to her, as well as her experience with various medications. Good luck, Rick http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety Links – view them, rate them, add your own! Before you buy.

Love Cathy P.H.O.B.I.A. People Helping Others Become Independent Again Off-line Self Help Support Group, NJ http://community.nj.com/cc/phobia Anxiety Treatment Options http://www.members.tripod.com/~PhobiaGroup/index.html

Response:

First off Prince, I would find another doctor asap.  She obviously not only doesn’t know what she’s talking about but she doesn’t have a heart either.  Sounds like she has a "goddess" complex.  Secondly, EffexorXR is an excellent med for panic and anxiety.  I started off with the same low dose and weaned up to 150mg. which I’ve been on for over 8 months now.  It has changed my life.  I honestly cannot believe she said this was not a disability.  May she have one hugh panic attack that lasts all day and then we’ll see her change her evaluation real fast.  I know it’s discouraging and a pain to have to go through seeing another doctor, but you deserve the best.  I had to see 9 before I found the right one.  And it cost me a bundle, but it was well worth it in the end.  BTW, Effexor XR works pretty fast, so you should be seeing good results pretty soon. Take care and let us know how you are feeling.  If you need to e-mail me with any questions about the Effexor, please feel free to do so any time. Love, Rita  :) Hi,      First I wanted to say,thanks for the help with my throat problem.I though there was something seriously wrong with me.Thanks for the support.Now,I have something to ask,and something to complain about.I went to see my psych today for the first time.First,she put me on Effexor XR,37mgs to start,then 75 and then 150.I wanted to know has anyone been on this before and was it helpful?Also,I took the MMPI test for the psych and she had the results today.She told me she feels as though I am exxagerating my

situation.That it is – Hide quoted text — Show quoted text – nowhere near as bad as I claim it to be.Now,I thought going to a psych would help me and it took me a long time to get up the nerve to finally go out of my house and see one.I can’t believe that is the response I received.I am also applying for SSI disability because of this and she told me there is no way that she will help me with this case,and she doesn’t help any of her other patients with it either.She doesn’t feel as though it is a disability.What should I do??Has anyone gone through this with a psych before???Sorry about the length,but I am at my wits end,and I am only 22.

Before you buy.

Response:

Thank you Margrove. Love, Rita – Hide quoted text — Show quoted text – I am always reluctant to recommend someone for disability. and if they cannot work how will they pay for your services let alone food-these things as necessary as they are are still lack the motivational impact as one would think-if one is backed into a corner has no out no way to have any gainful productive existance then their suicidal tendencies go through the roof-no more patient no more ssdi recipient no more anxiety no more problem-the judgement call for collecting assistance isn’t dependent on the values of the shrink but of the patient-if anxiety were but a mere exageration then this is tantemount to saying snap out of it it’s all in your head. Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there. I also think effexor is a reasonable choice for a medicine and she is dosing it appropriately.  The specific medicine was probably chosen based on your specific descriptions to her, as well as her experience with various medications. Good luck, Rick http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety Links – view them, rate them, add your own! Before you buy. I don’t know where you get your studies frm but this is the same logic that our great fathers in washington have used to get the malingerers off the role call-what has happened is we have a false set of economic indicators and psychiatricaly impaired homeless people in a state of limbo with no place to go-who’s responsibility is it-the impaired patient or the welfare system of a fair goverment. I disagree with you and this posters shrink-if she is incapable of work and chooses to approach assistance then I would support her and her choice-when she has established the criterea of our jointly reached goals in therapy she can resume her own financial responsibility and she no doubt will LM

Before you buy.

Response:

Is a secret agent who is frightened of jumping out of an airplane at night over enemy territory suffering from ‘panic disorder’?  (Or, as a former paratrooper told me, suffering from ‘being sensible’?) See: http://www.offmsg.connectfree.co.uk/psychiatry/shrink1.htm I nominate the author of this (genuine) report for Total Idiot Psychiatrist of the 20th Century.  All I need is his (or her) name. Mingus. – Hide quoted text — Show quoted text – Sorry to hear that your psychiatrist wasn’t a little more compassionate in the way she delivered the information to you, but I think in many ways she probably has the correct idea.  First, as someone else mentioned, you probably are experiencing things as worse than they really are (this is sort of what panic disorder is all about – we perceive uncomfortable body sensations as dangerous when they are not). Sure. But that *is* our problem, that is what is *bad* about it. It’s called Panic Disorder and it is as bad as the sufferer feels it is. And for those symptoms we need meds and therapy and it can be so debilitating that people can lose their marriages, their jobs, their friends and their freedom to move around outside their house. Is that bad enough? Even if all it is is *cognitve distortion* then that can be *terrible*. You sound like those people saying: "Get over it, your fear is irrational." Yes, we know that. That is what the probem is…. Second, as for the disability issue, as a psychiatry (and medicine) resident, I am always reluctant to recommend someone for disability. Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there. I can’t judge from here whether the original poster should be put on disability or not but neither can you. As a psychiatry resident you might try to not patronize people or you will make as bad a psychiatrist as the total idiot we’re talking about here. Actually I find this post not in keeping with your earlier posts here which I liked. Bad day? Philip http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety Links – view them, rate them, add your own! Before you buy.

Before you buy.

Response:

Is a secret agent who is frightened of jumping out of an airplane at night over enemy territory suffering from ‘panic disorder’?  (Or, as a former paratrooper told me, suffering from ‘being sensible’?)

Anyone who is not frightened in such a situation is crazy ) Anxiety is a natural warning sign, we need it to warn us that danger is coming our way and to react adequately. An anxiety disorder means having anxiety without any danger being around. It’s inappropriate fight-or-flight response, the CNS out fo whack, neurons firing randomly…. Philip – Hide quoted text — Show quoted text – Sorry to hear that your psychiatrist wasn’t a little more compassionate in the way she delivered the information to you, but I think in many ways she probably has the correct idea.  First, as someone else mentioned, you probably are experiencing things as worse than they really are (this is sort of what panic disorder is all about – we perceive uncomfortable body sensations as dangerous when they are not). Sure. But that *is* our problem, that is what is *bad* about it. It’s called Panic Disorder and it is as bad as the sufferer feels it is. And for those symptoms we need meds and therapy and it can be so debilitating that people can lose their marriages, their jobs, their friends and their freedom to move around outside their house. Is that bad enough? Even if all it is is *cognitve distortion* then that can be *terrible*. You sound like those people saying: "Get over it, your fear is irrational." Yes, we know that. That is what the probem is…. Second, as for the disability issue, as a psychiatry (and medicine) resident, I am always reluctant to recommend someone for disability. Studies suggest that people have less motivation to recover once they receive disability.  Also, people who are seeking disability usually don’t recover as well.  You are young and have an excellent chance of recovery from your problems – hang in there. I can’t judge from here whether the original poster should be put on disability or not but neither can you. As a psychiatry resident you might try to not patronize people or you will make as bad a psychiatrist as the total idiot we’re talking about here. Actually I find this post not in keeping with your earlier posts here which I liked. Bad day? Philip http://www.med-psych.net/links/Illnesses/Anxiety_Disorders/ Anxiety Links – view them, rate them, add your own! Before you buy. Before you buy.

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Hi,      First I wanted to say,thanks for the help with my throat problem.I though there was something seriously wrong with me.Thanks for the support.Now,I have something to ask,and something to complain about.I went to see my psych today for the first time.First,she put me on Effexor XR,37mgs to start,then 75 and then 150.I wanted to know has anyone been on this before and was it helpful?Also,I took the MMPI test for the psych and she had the results today.She told me she feels as though I am exxagerating my

situation.That it is – Hide quoted text — Show quoted text – nowhere near as bad as I claim it to be.Now,I thought going to a psych would help me and it took me a long time to get up the nerve to finally go out of my house and see one.I can’t believe that is the response I received.I am also applying for SSI disability because of this and she told me there is no way that she will help me with this case,and she doesn’t help any of her other patients with it either.She doesn’t feel as though it is a disability.What should I do??Has anyone gone through this with a psych before???Sorry about the length,but I am at my wits end,and I am only 22.

Prince, I am so sorry to hear of your Dr.s apparent lack of compassion.  My husband had one like that and we promptly FIRED HIM and found a MUCH better Dr. I am on Effexor XR and my current dosage is 225 mg/day.  It has done wonders for me. (((((((((((((HUGS))))))))))))) and keep your chin up!!!!  Let us know how you are doing!!!!!! Kindest Regards, Kkkkkkkkatie — "A word to the wise ain’t necessary.  It’s the stupid who need the advice." —Will Rogers Before you buy.

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Hi Hadley! Personally, effexor did wonders for my anxiety!  I had a few side effects to begin with (increased nervousness, upset stomach), but as the past posts have stated, they do tend to go away…. good luck! Janine

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I am wondering what if any effect this AD has on anxiety. I am not familiar with SNRI’s, wether or not they have any impact on panic disorder and anxiety disorder. TIA

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:I am wondering what if any effect this AD has on anxiety. I am not familiar :with SNRI’s, wether or not they have any impact on panic disorder and :anxiety disorder. TIA Dear Hadley, All antidepressants have the potential to "temporarily" increase anxiety during the weaning process. The way to minimize this is by starting at a low dose like 37.5mgs and to increase the dose slowly, every week or so or at a pace that is comfortable to you. It also helps to use a benzo such as xanax to tame any side-effects and/or increased anxiety you "may" experience.  Take care and good luck!~ Jackie ~*~Forget not that the earth delights to feel your bare feet and the winds long to play with your hair~*~     ~Kahlil Gibran~

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I am wondering what if any effect this AD has on anxiety. I am not familiar with SNRI’s, wether or not they have any impact on panic disorder and anxiety disorder. TIA

Can be very effective if started at 37.5 mg and raised to 75 mg after a week etc. Potential side effects are much like Paxil’s but YMMV. Philip – Hide quoted text — Show quoted text –

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Hi, my Dr. is having me try Effexor XR for depression but I also suffer from anxiety.  Curious if any of you had any experiences with this drug.  I see anxiety is a possible side affect, that’s why I am asking. Thanks, Tono

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Hi, my Dr. is having me try Effexor XR for depression but I also suffer from anxiety.  Curious if any of you had any experiences with this drug.  I see anxiety is a possible side affect, that’s why I am asking. Thanks, Tono

I agree with Dan 100%.   I’ve been on Effexor XR 150 mg., plus XanaxXR, for over two years and it has completely changed my life for the best.  But IMO, going on slowly with a benzo added is the way to go.   I started with 37.5mg. for a week or so (I don’t remember how long, but I know we took our time).   To be honest, it didn’t work overnight, but each week was a little better than the last until I hit my top dose and stayed on that for awhile. Then the transformation was incredible. Other p-docs only gave me an anti-depressant alone and I had terrible side-effects, my anxiety never really went away.   The combination of the two was the wonder combo for me.  I expect to be on this for the rest of my life, God willing. xxoo Rita

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Hi, I’m new here and apoligize if this has already been covered. I suffer from major depression and have an overwhelming since of hoplessness. I’ve been taking Effexor XR 75mg 1x day for about a year. This seems to help, but only slightly. I have major dfficulty with sleep. Any suggestions on the best time to take this medication would be appreciated. Thanks, Jeff

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I am new here too, Jeff so I do not know if it has been covered but I will gladly share my own experience. First, tell your doctor. I take 3 75mg pills a day. Your doc might have to up your dosage. I had the the same trouble of not sleeping. My body would get tired but my brain would not shut off. I was told to take the Effexor early in the morning as soon as I woke up. That helps some. My doctor also placed me Trazadone at night and that combination does the trick. I can sleep like a log. Trazadone is not habit forming. I hope that helps, and welcome to the group. – Hide quoted text — Show quoted text – Hi, I’m new here and apoligize if this has already been covered. I suffer from major depression and have an overwhelming since of hoplessness. I’ve been taking Effexor XR 75mg 1x day for about a year. This seems to help, but only slightly. I have major dfficulty with sleep. Any suggestions on the best time to take this medication would be appreciated. Thanks, Jeff

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-I am new here too, Jeff so I do not know if it has been covered but I -will gladly share my own experience. First, tell your doctor. I take 3 -75mg pills a day. Your doc might have to up your dosage. I had the the -same trouble of not sleeping. My body would get tired but my brain -would not shut off. I was told to take the Effexor early in the -morning as soon as I woke up. That helps some. My doctor also placed -me Trazadone at night and that combination does the trick. I can sleep -like a log. Trazadone is not habit forming. I hope that helps, and -welcome to the group. What’s the max dosage?

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My, aren’t you a great help to someone in need. I’d hate to know someone like yourself in real life. Imogen

– Hide quoted text — Show quoted text – sugar pills or better yet exercise Hi, I’m new here and apoligize if this has already been covered. I suffer from major depression and have an overwhelming since of hoplessness. I’ve been taking Effexor XR 75mg 1x day for about a year. This seems to help, but only slightly. I have major dfficulty with sleep. Any suggestions on the best time to take this medication would be appreciated. Thanks, Jeff

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Study after study shows that anti depressants work no better and sugar pills.

Idiot. — Regards, .

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Hi JJ, I am taking 150MG 1x a day (Effexor XR) and also taking Risperdal 2mg at night for sleep.  I sleep like a log. — John T. May Don’t sweat the small stuff…

– Hide quoted text — Show quoted text – Hi, I’m new here and apoligize if this has already been covered. I suffer from major depression and have an overwhelming since of hoplessness. I’ve been taking Effexor XR 75mg 1x day for about a year. This seems to help, but only slightly. I have major dfficulty with sleep. Any suggestions on the best time to take this medication would be appreciated. Thanks, Jeff

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What does anybody think about this drug; has anybody had any good luck with drug?

I have been taking 75mg Effexor XR since January for anxiety/depression.  It is important to give the medication 4-6 weeks to take effect and for me the side effects of dry mouth, sleep pattern disturbance, light-headedness and elevated blood pressure took even longer to subside. After stabilizing on the Effexor, I have decided to stay on it because of its effectiveness in treating the anxiety.  The nice thing about the Effexor is that you don’t notice that you are on it other than the alleviation of the anxiety and depression. I only write to encourage those starting the medication to continue with it despite what feels like a worsening of the anxiety initially. Many discontinue because of the bad initial side effects. I still get the vivid dreams….they’re OK. Andrew R. Before you buy.

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Thanks your all your input!!!!   W & C

– Hide quoted text — Show quoted text – What does anybody think about this drug; has anybody had any good luck with drug?                             Also I’ve got my Zanax back 2 fives a day!! Wild & Crazy Hi Wild!  I have been on Effexor for 5 months at 300mg and am not complaining.  You can see mine and many other peoples responses to this same question in the recent thread ‘Effexor’ as well…a lot of people asking it these days Best, -Alan — Alan Derrick Before you buy.

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Hi Wild, I’ve been on EffexorXR since January and it literally changed my life.  First AD that I had no side effects from, which is a miracle in itself. And it worked pretty fast for me.  I also take XanaxXR twice daily…just a small amount.  The combination of meds is working so well, I don’t want to ever stop taking them.  And I used to be phobic about taking meds, but no more. Hope Effexor works as well for you. Love, Rita What does anybody think about this drug; has anybody had any good luck with drug?                             Also I’ve got my Zanax back 2 fives a day!! Wild & Crazy

Before you buy.

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What does anybody think about this drug; has anybody had any good luck with drug?                             Also I’ve got my Zanax back 2 fives a day!! Wild & Crazy

Hi wild and crazy ! I am on Effexor XR(time release) since September of 1999. I started with the sampler pack-one week at 37.5 and one week at 75mg. I was put on 150 after those 2 weeks and about 4 weeks into it I notice a positive change with me. But I wasn’t comfortable where I was at. I was still having break through anxiety and depression. In December, my gp raised my Effexor to 300mg. Within the week I started I improved my emotional outlook and well being tremendously. I am still on the 300-that is 2-150mg capsules per day. I take mine in the morning with breakfast. Do not take on an empty stomach. My only side effects were dry mouth, vivid dreams(whoppers) and head pressure. They eventual went away. I have Ativan as per needed now and I haven’t taken any for about 4 -5 weeks now. I will take it if I need it but I also have my coping skills that I learned, to help me get through my anxiety and panic times. Not my everyday stresses but my actual panic. I would tell people that it is worth a try and to stay on it for at least 4 weeks to see any benefit from the Effexor. Xanax is good too and only .5 twice a day is a small amount so do not worry about getting hooked on it-you won’t. YOu do the best you can with what you have. Take the meds, even if you have to for a long time.So what? You have to take care of you. And you comes first!!! good luck and email me with any questions.Julie Before you buy.

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What does anybody think about this drug; has anybody had any good luck with drug?                             Also I’ve got my Zanax back 2 fives a day!! Wild & Crazy

I have had anxiety/depression my whole life, and tried almost all the ADs around except for some of the newer ones.  But I have been on Effexor for a year now.  It is the best AD I have ever used.  I think it is so effective because it works on two major chemicals (Seretonin and norephenephrine) and alittle on dopamine.  Anyway I was really depressed about a year ago and started taking it.  Around the middle of the third week, all of a sudden I started to feel this sense of calm and the depression just kind of lifted. It was the most peculiar thing.  Anyway, I think it is the best that I have tried by a long shot. Hope it works for you. John

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What does anybody think about this drug; has anybody had any good luck with drug?                             Also I’ve got my Zanax back 2 fives a day!! Wild & Crazy

Hi Wild!  I have been on Effexor for 5 months at 300mg and am not complaining.  You can see mine and many other peoples responses to this same question in the recent thread ‘Effexor’ as well…a lot of people asking it these days Best, -Alan — Alan Derrick Before you buy.

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What does anybody think about this drug; has anybody had any good luck with drug?                             Also I’ve got my Zanax back 2 fives a day!! Wild & Crazy

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What does anybody think about this drug; has anybody had any good luck with drug?                            Also I’ve got my Zanax back 2 fives a day!! Wild & Crazy

Hi Wild, From what I have seen of posters on Effexor, it seems like a really decent med for anxiety and depression. It can`t hurt to try, and I hope it helps you!! Good for you in getting your Xanax back, I know that med helped you alot. Take care and feel better soon!!!! Jackie

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The Dr. just put my husband on this today, can anyone tell me ANYTHING about it?? How effective it is?  (He has depression and general anxiety)  Side effects?  Alcohol yes/no??? I appreciate ANY information!!!!! Thanks much!!!!

Here’s the web site:  http://www.effexorxr.com Don’t go searching the internet to put false ideas in your head. Take it one day at a time and report any side effects to the prescribing doctor. It is an antidepressant so it should help with the depression once he reaches a therapeutic dose. The doc usually starts you out on a low dose so you can gradually adjust to the med with minimal sensations that can lead to anxious thoughts and then anxiety. I personally think benzodiazepines, CNS depressants, are the best immediate treatment for people who have anxiety disorders.  A good therapist can also help a person analyze their anxious thoughts and give them a new perspective on how to view the world.  A lot of anxious thoughts are purely irrational and can be looked at and tossed away by a rational mind.  Get a copy of the book – "The Guide To Rational Living" by Albert Ellis.  www.rebt.org Don’t Worry, Be Happy  :  ) Tony

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Yeah, I’m thinking I’ll ask a dr. and maybe even call a different pharmacy just to see if they say the same thing……

i suggest calling around til ya get the answer you like.. that’s always my MO. xoxoxo ~tanya

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– Hide quoted text — Show quoted text – Effexor XR worked very well for me for years. I have depression and Panic Disorder. http://www.rxlist.com/cgi/generic/venlafax_ids.htm It can be difficult tapering onto SNRIs. My anxiety symptoms worsened initially.I increased my Xanax to help counteract these side effects. Meryl i’ve been taking effexor xr for a while. now my pdoc has prescribed a higher dose. it’s only been a few days since i increased the dose, and i’m definitely feeling more anxious right now. i hope i’ll feel better in a week or two. And I know any doc is going to say "don’t drink!!!", but that’s not realistic for him.  We go out to dinner a couple times per week and he has a couple of drinks, he doesn’t get drunk, but has 2-3 (he’s a pretty decent sized guy).  BUT there are occassion he has WAY too much, New Years, Stag’s, etc. we went on a camping trip a month ago and he got totally sh-tfaced, etc.  I want to know he won’t die on those occassions.  I called a pharmacist last night just to see what they’d say, she scared the crap out of me, she said he shouldn’t drink AT ALL and that too much alcohol would repress his heart to the point it would stop beating.  She flat out said "he’ll die if he drinks too much". Now I’m freaking out!!!!???

From the link I have given. *Alcohol Although Effexor has not been shown to increase the impairment of mental and motor skills caused by alcohol, patients should be advised to avoid alcohol while taking Effexor.* I still enjoyed my wine and I am still here. JMO Meryl

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- Hide quoted text — Show quoted text – And I know any doc is going to say "don’t drink!!!", but that’s not realistic for him.  We go out to dinner a couple times per week and he has a couple of drinks, he doesn’t get drunk, but has 2-3 (he’s a pretty decent sized guy).  BUT there are occassion he has WAY too much, New Years, Stag’s, etc. we went on a camping trip a month ago and he got totally sh-tfaced, etc.  I want to know he won’t die on those occassions.  I called a pharmacist last night just to see what they’d say, she scared the crap out of me, she said he shouldn’t drink AT ALL and that too much alcohol would repress his heart to the point it would stop beating.  She flat out said "he’ll die if he drinks too much". Now I’m freaking out!!!!??? since a pharmacist said it, i’d believe it. you could talk to a doctor for a second opinion. i’d better watch my own drinking now, i guess.

Yeah, I’m thinking I’ll ask a dr. and maybe even call a different pharmacy just to see if they say the same thing……

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Thanks for the input.  I guess I must not be as "computer savvy" as I like to think, how did all of these old posts get hooked onto the original message I posted????

Took me a few minutes to figure out why you’re puzzled, because all I see is your original post plus Meryl’s reply.  Then I noticed that you’re using Google to post. Google sorts by subject line.  All posts with with specific subject "Effexor XR" are going to be grouped together, as if it was a single thread.  So when you read the thread in Google Groups, it looks like it started by in 1999 because someone else used the same topic line. Maybe someone else knows a way around this.  A regular newreader would be better, though. Fig

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And I know any doc is going to say "don’t drink!!!", but that’s not realistic for him.  We go out to dinner a couple times per week and he has a couple of drinks, he doesn’t get drunk, but has 2-3 (he’s a pretty decent sized guy).  BUT there are occassion he has WAY too much, New Years, Stag’s, etc. we went on a camping trip a month ago and he got totally sh-tfaced, etc.  I want to know he won’t die on those occassions.  I called a pharmacist last night just to see what they’d say, she scared the crap out of me, she said he shouldn’t drink AT ALL and that too much alcohol would repress his heart to the point it would stop beating.  She flat out said "he’ll die if he drinks too much". Now I’m freaking out!!!!???

since a pharmacist said it, i’d believe it. you could talk to a doctor for a second opinion. i’d better watch my own drinking now, i guess.

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she said he shouldn’t drink AT ALL and that too much alcohol would repress his heart to the point it would stop beating.  She flat out said "he’ll die if he drinks too much".

i’m no doctor but i do believe when your heart stops beating that death is a common side effect.  so maybe she’s right. Now I’m freaking out!!!!???

why?  you can’t control what he does, if it gives ya the heebie jeebies, and he’s bound and determined to continue behavior that freaks you out, well…. my concluson would be "dude doesn’t care a holy fuck about me to put me in a position of freakin out for a few drinks".. and i’d be out the door in about 3 hours… or however long it took me ta pack my shit, or go thru the aggravation of gettin him out.. (which is more difficult cuz then ya gotta get the police involved and crap.. and i say take the easy way out) .  you gotta choice, deal with it and stay freaked out cuz you "LOVVVVE HIMMMMM" or hit the proverbial road.   i find it easy as hell to leave people that have intolerable behavior, no matter how close i am to em, i guess i’m justah cold cold bitch.. but that’s my advice.. and i kinda like it.  nobody else will, but i couldn’t give a good goddam. xoxoxoxoxo ~tanya

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Effexor XR worked very well for me for years. I have depression and Panic Disorder. http://www.rxlist.com/cgi/generic/venlafax_ids.htm It can be difficult tapering onto SNRIs. My anxiety symptoms worsened initially.I increased my Xanax to help counteract these side effects. Meryl i’ve been taking effexor xr for a while. now my pdoc has prescribed a higher dose. it’s only been a few days since i increased the dose, and i’m definitely feeling more anxious right now. i hope i’ll feel better in a week or two.

And I know any doc is going to say "don’t drink!!!", but that’s not realistic for him.  We go out to dinner a couple times per week and he has a couple of drinks, he doesn’t get drunk, but has 2-3 (he’s a pretty decent sized guy).  BUT there are occassion he has WAY too much, New Years, Stag’s, etc. we went on a camping trip a month ago and he got totally sh-tfaced, etc.  I want to know he won’t die on those occassions.  I called a pharmacist last night just to see what they’d say, she scared the crap out of me, she said he shouldn’t drink AT ALL and that too much alcohol would repress his heart to the point it would stop beating.  She flat out said "he’ll die if he drinks too much". Now I’m freaking out!!!!???

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Effexor XR worked very well for me for years. I have depression and Panic Disorder. http://www.rxlist.com/cgi/generic/venlafax_ids.htm It can be difficult tapering onto SNRIs. My anxiety symptoms worsened initially.I increased my Xanax to help counteract these side effects. Meryl

i’ve been taking effexor xr for a while. now my pdoc has prescribed a higher dose. it’s only been a few days since i increased the dose, and i’m definitely feeling more anxious right now. i hope i’ll feel better in a week or two.

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The Dr. just put my husband on this today, can anyone tell me ANYTHING about it?? How effective it is?  (He has depression and general anxiety)  Side effects?  Alcohol yes/no??? I appreciate ANY information!!!!! Thanks much!!!!

Effexor XR worked very well for me for years. I have depression and Panic Disorder. http://www.rxlist.com/cgi/generic/venlafax_ids.htm It can be difficult tapering onto SNRIs. My anxiety symptoms worsened initially.I increased my Xanax to help counteract these side effects. Meryl

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- Hide quoted text — Show quoted text – The Dr. just put my husband on this today, can anyone tell me ANYTHING about it?? How effective it is?  (He has depression and general anxiety)  Side effects?  Alcohol yes/no??? I appreciate ANY information!!!!! Thanks much!!!! Effexor XR worked very well for me for years. I have depression and Panic Disorder. http://www.rxlist.com/cgi/generic/venlafax_ids.htm It can be difficult tapering onto SNRIs. My anxiety symptoms worsened initially.I increased my Xanax to help counteract these side effects. Meryl

Thanks for the input.  I guess I must not be as "computer savvy" as I like to think, how did all of these old posts get hooked onto the original message I posted????

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I do efexor, buspar & valium, i do drink & it’s a problem for me!, maybe it’s the alcohol or the efexor or both, i dunno.   Nightsweats happened with me on 225mg, also mind zapps, disorientation, confusion & vivid dreams, but hey, that could be the alcohol also. Just your better off avoiding alcohol as it’s a depressant, but who the hell am i to say that.!!

– Hide quoted text — Show quoted text – The Dr. just put my husband on this today, can anyone tell me ANYTHING about it?? How effective it is?  (He has depression and general anxiety)  Side effects?  Alcohol yes/no??? I appreciate ANY information!!!!! Thanks much!!!! Effexor XR worked very well for me for years. I have depression and Panic Disorder. http://www.rxlist.com/cgi/generic/venlafax_ids.htm It can be difficult tapering onto SNRIs. My anxiety symptoms worsened initially.I increased my Xanax to help counteract these side effects. Meryl Thanks for the input.  I guess I must not be as "computer savvy" as I like to think, how did all of these old posts get hooked onto the original message I posted????

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The Dr. just put my husband on this today, can anyone tell me ANYTHING about it?? How effective it is?  (He has depression and general anxiety)  Side effects?  Alcohol yes/no??? I appreciate ANY information!!!!! Thanks much!!!!

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The Dr. just put my husband on this today, can anyone tell me ANYTHING about it??

First thing take the meds for a minimum of 6-12 weeks before trying to observe positive effects and do not discontinue (let me repeat that DO NOT DISCONTINUE cold turkey) except under supervision or by slow taper. However if someone has a penchant to mild hullucinations, severe insomnia and a knife edge metal state … it’s highly recommened. See http://www.crazymeds.org/ Look for the link named Effexor/Venlafaxine See http://www.mentalhealth.com/ Select Medication and then select Venlafaxine How effective it is?  (He has depression and general anxiety)  Side effects?  Alcohol yes/no???

Some say very effective others not (Wasn’t good for me but then I think I didn’t have the right information at the time thought it would be a miracle cure … not so). Wide and varied side effects. Decreased libido, increased anxiety (initially), sweating, insomnia, sensitivity to light (dilated pupils) etc I had no personal side effects when taken with large quantities of alcohol however that doesn’t mean I’ll not need a liver transplant in a few years I appreciate ANY information!!!!!

Please do some research and never accept info in this forum as given … a few nutters lurk in this fine newsgroup. – Hide quoted text — Show quoted text – Thanks much!!!!

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Good on ya Tyr. Have a great day. Bren — http://www.searchtimes.com/brouchers/newyear/index.php?AID=1431&src=n…

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Super dude! Isn’t it a wonder when it works?! Things do change- and often for the better. Guess that is one of the things that keeps me going when I’m down. Best wishes for you both. -Dan

– Hide quoted text — Show quoted text – Soon after I wrote that, my girlfriend called me on the phone and after about thirty seconds she told me that she was on her way over. I had felt that it was just a hum-drum day at that point, but she said I sounded so down over the phone that she’d spring for the Wellbutrin because she didn’t think I should try to wait until payday. (Which was today, 2/15) So, I’ve taken it…what…4 or 5 times now, and although the insert from the pharmacy said not to expect any major change for three to four weeks, today was the first day in months that I felt halfway human, again. I started taking the XL version tonight, since that’s the only thing that my prescription service has on their list, so I’m getting kind of excited about what it can do for me. I actually feel like getting out and doing! Maybe I can take off some of this "winter weight". -Tyr

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Hey…New to Group, but VERY familiar with Effexor XR.  I have been on it for almost 2 years now.  For 10 or more years NOTHING had worked until the effexor in combo with Clonopin and Trazadone.  The initial level for me was the 150.  About 4 months ago I was slowly elevated to 350.  Back in action again.  Keep in mind that I do have fairly serious PTSD as well as chemical imbalances present.  But I am Just so thankful to be down from 30+ pills a day to only 6.  LadyJ

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Soon after I wrote that, my girlfriend called me on the phone and after about thirty seconds she told me that she was on her way over. I had felt that it was just a hum-drum day at that point, but she said I sounded so down over the phone that she’d spring for the Wellbutrin because she didn’t think I should try to wait until payday. (Which was today, 2/15) So, I’ve taken it…what…4 or 5 times now, and although the insert from the pharmacy said not to expect any major change for three to four weeks, today was the first day in months that I felt halfway human, again. I started taking the XL version tonight, since that’s the only thing that my prescription service has on their list, so I’m getting kind of excited about what it can do for me. I actually feel like getting out and doing! Maybe I can take off some of this "winter weight". -Tyr – Hide quoted text — Show quoted text – Of course everyone is different- with their own unique responses to various drugs. Also samples of one (anecdotes) are notoriously unreliable. That said- I had same problem with Effexor. At least it led to exploration of non-orgasmic intimacy- a widely overlooked pleasure if one can get around expectations and relax. If you have same response as I- the Wellbutrin will present practically no side effects whatsoever. Good luck. -Dan snippage<<

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I took Effexor at the 75mg level and stayed there for a few months. It worked great for a short time, but towards the end, I was starting to slide back down into depression. My side effects were a bit…um…different. While I still had orgasm issues, my sex drive went through the roof! Don’t think that wasn’t frustrating. That’s the primary reason I stopped taking it. My doc prescribed Wellbutrin, but I haven’t had the funds to get it filled yet. Hopefully, the way Wellbutrin works will be more appropriate for me, since my problem my be compounded, situationally speaking, but at the root it is just a chemical imbalance.

Response:

Of course everyone is different- with their own unique responses to various drugs. Also samples of one (anecdotes) are notoriously unreliable. That said- I had same problem with Effexor. At least it led to exploration of non-orgasmic intimacy- a widely overlooked pleasure if one can get around expectations and relax. If you have same response as I- the Wellbutrin will present practically no side effects whatsoever. Good luck. -Dan

– Hide quoted text — Show quoted text -I took Effexor at the 75mg level and stayed there for a few months. It worked great for a short time, but towards the end, I was starting to slide back down into depression. My side effects were a bit…um…different. While I still had orgasm issues, my sex drive went through the roof! Don’t think that wasn’t frustrating. That’s the primary reason I stopped taking it. My doc prescribed Wellbutrin, but I haven’t had the funds to get it filled yet. Hopefully, the way Wellbutrin works will be more appropriate for me, since my problem my be compounded, situationally speaking, but at the root it is just a chemical imbalance.

Response:

I was on effexor for a while for my chronic anxiety and it didn’t do too much, I was up to 150 the withdraw was awful!! I am on paxil now 50 ml and no anxiety what a relieve! But a friend of mine is on it for depression and it works well for her, except she has nightmares.  I had anxiety still and bruised easily and had no sex drive with no orgasm, that was enough of that one, for sure, cuz that is just wrong. No side effects for paxil, so far, might be going up to 60, cuz I still get the odd attack, not sure what doctor will do, perhaps some anxiety is normal…who knows… Hope that helps a bit.  I started on 37.5 and went up slow, and came down slow because they side effects can be extreme and they were, I had to go to my parents to stay to get help with my baby…while I was going through med change.

– Hide quoted text — Show quoted text – I recall starting on 75 mg as XR did not come in lower doses here. I also upped my Xanax at the start as I had a couple of days where my anxiety was exacerbated and I had insomnia. It passed. Meryl I think for starting Effexor 37.5 mg should be the maximum dose. One can start with Effexor IR (even at a lower dose if necessary) and replace it by the XR version later. Philip I am not sure Efexor 37.5 was available here when I  commenced XR. I know the conventional wisdom at ASAP is to start with 37.5 IR. One thought. Given that non-anxiety patients are advised (here at least) to take 37.5 mg twice per day, I wonder about how just taking the tablet once a day would work. Maybe half a 37.5 mg twice a day would keep patients more stable.  As for me, back in ‘98, I  needed relief from depression quickly. Efexor 75 mg plus extra Xanax for a few days worked for me. As always, YMMV. :0) Meryl

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Question:

commonly used slow serotonin reuptake inhibitor (SSRI)

ROTFL!  What a load of BS … —   -john

Response:

Recent studies have shown SJW to be equally as effective as Zoloft (sertraline) and Prozac (fluoxetine) in mild to moderate depression. It also seems to have a better side-effect profile. See the references below: – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – Equivalence of St John’s wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderate depression. Schrader E Int Clin Psychopharmacol 2000 Mar;15(2):61-8 Treatment with St John’s wort extract tablets (hypericum Ze 117) and the commonly used slow serotonin reuptake inhibitor (SSRI) fluoxetine was compared in patients with mild-moderate depression with entry Hamilton Depression Scale (HAM-D) (21-item) in the range 16-24, in a randomized, double-blind, parallel group comparison in 240 subjects; fluoxetine: 114 (48%), hypericum: 126 (52%). After 6 weeks’ treatment, mean HAM-D at endpoint decreased to 11.54 on hypericum and to 12.20 on fluoxetine (P < 0.09), while mean Clinical Global Impression (CGI) item I (severity) was significantly (P < 0.03) superior on hypericum, as was the responder rate (P = 0.005). Hypericum safety was substantially superior to fluoxetine, with the incidence of adverse events being 23% on fluoxetine and 8% on hypericum. The commonest events on fluoxetine were agitation (8%), GI disturbances (6%), retching (4%), dizziness (4%), tiredness, anxiety/nervousness and erectile dysfunction (3% each), while on hypericum only GI disturbances (5%) had an incidence greater than 2%. We concluded that hypericum and fluoxetine are equipotent with respect to all main parameters used to investigate antidepressants in this population. Although hypericum may be superior in improving the responder rate, the main difference between the two treatments is safety. Hypericum was superior to fluoxetine in overall incidence of side-effects, number of patients with side-effects and the type of side-effect reported. – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – "Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: a double-blind, randomized pilot study." Brenner R, Azbel V, Madhusoodanan S, Pawlowska M Clin Ther 2000 Apr;22(4):411-9 BACKGROUND: Hypericum (St. John’s wort) has been shown to be as efficacious and well tolerated as standard antidepressants in the treatment of depression but has not been compared with selective serotonin reuptake inhibitors (SSRIs). OBJECTIVE: This study compared hypericum and the SSRI sertraline in the treatment of depression. METHODS: In a double-blind, randomized study conducted in a community hospital, 30 male and female outpatients (19 women, 11 men; mean age, 45.5 years) with mild to moderate depression received 600 mg/d of a standardized extract of hypericum (LI 160) or 50 mg/d sertraline for I week, followed by hypericum 900 mg/d or sertraline 75 mg/d for 6 weeks. RESULTS: The severity of symptoms, as assessed by scores on the Hamilton Rating Scale for Depression (HAM-D) and the Clinical Global Impression scale, was significantly reduced in both treatment groups (P < 0.01). Clinical response (defined as a or =50% reduction in HAM-D scores) was noted in 47% of patients receiving hypericum and 40% of those receiving sertraline. The difference was not statistically significant. Both agents were well tolerated. A post hoc power analysis indicated that failure to reach statistical significance between treatments resulted primarily from an absence of clinical differences rather than the small sample size. CONCLUSION: The hypericum extract was at least as effective as sertraline in the treatment of mild to moderate depression in a small group of outpatients.

– Hide quoted text — Show quoted text – The interesting thing with St. John’s Wort, is that it alters the ‘mood/mind’ enough to allow an objective and clear perspective of the Self. And therefore a clear insight into those parts of the Self that causes the depression. Is your intent to clear yourself of the depression?… or clear yourself of the sources of that depression? Translation: SJW is not strong enough to cure many cases of depression by itself, and works best with psychotherapy combination. By extension, an SSRI plus that kind of psychotherapy ought to be better yet? —

com for the reply address.

Response:

I am interested in info. on St. John’s Wort and Kava for OCD and anxiety.

Here is some info. I found on St. John’s Wort and OCD: "Gridrunner: Have you heard of some success using St. John’s Wort or 5-htp to lessen OCD? Dr. Jenike: Yes, there are a few cases where St. John’s Wort has helped OCD. In Germany, there are dozens of studies using SJW for mild to moderate depression, but its use for treating OCD is relatively new. I have tried it in quite a few patients, with not much success. But then again, most of the patients I see now, are on the more severe end of the spectrum." – http://www.healthyplace.com/Communities/OCD/site/transcripts/obsession s_ocd.htm See also: http://www.biopsychiatry.com/stjohnocd.htm

Response:

The interesting thing with St. John’s Wort, is that it alters the ‘mood/mind’ enough to allow an objective and clear perspective of the Self. And therefore a clear insight into those parts of the Self that causes the depression. Is your intent to clear yourself of the depression?… or clear yourself of the sources of that depression?

Translation: SJW is not strong enough to cure many cases of depression by itself, and works best with psychotherapy combination. By extension, an SSRI plus that kind of psychotherapy ought to be better yet? —

Response:

Dear R.P.,      I have used Kava for anxiety and it does help though if your anxiety is high it may take a few days for it to really catch up with you.  To be on it is to be mellow but alert at the same time so I think it would help with OCD.                    Rusty

– Hide quoted text — Show quoted text – I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

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I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

Response:

I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

I had a lot of luck with Kava Kava for anxiety, but it brought back eczema that had lain dormant for over 6 years (and which I have yet to get rid of). Take care if you have any dermatological problems.

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My psychiatrist said it was useless for OCD. Only good for *mild* depression. Ida

– Hide quoted text — Show quoted text – I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

Response:

In article <   "Bill & Ida Kern" < My psychiatrist said it was useless for OCD. Only good for *mild* depression. Ida

The interesting thing with St. John’s Wort, is that it alters the ‘mood/mind’ enough to allow an objective and clear perspective of the Self. And therefore a clear insight into those parts of the Self that causes the depression. Is your intent to clear yourself of the depression?… or clear yourself of the sources of that depression? The Wort (like LSD; magic mushrooms; kava-kava) open-up the psyche for deeper investigation… rather than offer a cure-all. Later Gerrit

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Question:

Hi Sophie, When I went on Zoloft for the first time, two years ago, I didn’t have any side-effects at all!! I had another doctor at that time. Now, the new doctor gave me the 50mg. I told her I remembered starting with a lower dose last time, but she said, no, 50 mg are the normal starting dose.

To bad we couldn`t make her take 50mgs of Zoloft and see if she likes it<EG!! Since my memory is generally very bad these days, I didn’t want to insist. Later, when the side-effects got so bad, I asked her again if I shouldn’t have started with a lower dose… she said no again.

I hate hearing this!! So many people are afraid to take anti-depressants because of bad experiences like this. You should have started at  12.5mgs or 25mgs, and weaned slowly. I also asked her if I couldn’t go up to the 100 mg a little slower then just doubling the dose. She said that wouldn’t have any effect at all. –

Well, the other day I went through my drawers and discovered a lonely left-over Zoloft tablet from two years ago, 25mg… Well, this teaches me to trust my own mind, however impaired it may be through depression and AD.. and not to believe everything my doc tells me. Thanks for your information!

Your welcome. I feel bad that you had to go through something like this. I am glad you realize that the fault lays with your doctor and not the Zoloft. Take care and good luck. Jackie "Am I right side up or upside down? Is this real or am I dreaming?"

Response:

Hi Jackie, When I went on Zoloft for the first time, two years ago, I didn’t have any side-effects at all!! I had another doctor at that time. Now, the new doctor gave me the 50mg.

Is she a GP or a psychiatrist? I told her I remembered starting with a lower dose last time, but she said, no, 50 mg are the normal starting dose.

12,5 mgs sounds more like it. Since my memory is generally very bad these days, I didn’t want to insist. Later, when the side-effects got so bad, I asked her again if I shouldn’t have started with a lower dose… she said no again.

Sweet, caring doc you have there…. I also asked her if I couldn’t go up to the 100 mg a little slower then just doubling the dose. She said that wouldn’t have any effect at all. –

Good grief….she doesn’t know the first thing about oanic and medication. Well, the other day I went through my drawers and discovered a lonely left-over Zoloft tablet from two years ago, 25mg… Well, this teaches me to trust my own mind, however impaired it may be through depression and AD.. and not to believe everything my doc tells me. Thanks for your information!

Sack the doc! Sophie

Philip – Hide quoted text — Show quoted text – Hi Sophie, You don`t have to go right to 100mgs….you could wean slowly to that dose, that is up to you though. You could go to 75mgs, or even 62.5mgs by cutting the tablet, you would stay at that dose for a week then either increase in 25mg increments, or 12.5mg increments until you reached the 100mgs. For many people a slow weaning process helps to minimize the side-effects. Alot of the side-effects you describe are normal, even the increase in anxiety, perhaps you didn`t wean to 50mgs, you just started at 50mgs? That could explain the hard time you had. Increase in anxiety can be helped by getting a script for a benzo, nausea can be helped by taking the Zoloft on a full stomach. Insomnia can be helped by taking the Zoloft in the AM. Fatigue should dissipate over time. Good luck. Jackie Share what you know. Learn what you don’t.

Response:

Hi Jackie, When I went on Zoloft for the first time, two years ago, I didn’t have any side-effects at all!! I had another doctor at that time. Now, the new doctor gave me the 50mg. I told her I remembered starting with a lower dose last time, but she said, no, 50 mg are the normal starting dose. Since my memory is generally very bad these days, I didn’t want to insist. Later, when the side-effects got so bad, I asked her again if I shouldn’t have started with a lower dose… she said no again. I also asked her if I couldn’t go up to the 100 mg a little slower then just doubling the dose. She said that wouldn’t have any effect at all. – Well, the other day I went through my drawers and discovered a lonely left-over Zoloft tablet from two years ago, 25mg… Well, this teaches me to trust my own mind, however impaired it may be through depression and AD.. and not to believe everything my doc tells me. Thanks for your information! Sophie – Hide quoted text — Show quoted text – Hi Sophie, You don`t have to go right to 100mgs….you could wean slowly to that dose, that is up to you though. You could go to 75mgs, or even 62.5mgs by cutting the tablet, you would stay at that dose for a week then either increase in 25mg increments, or 12.5mg increments until you reached the 100mgs. For many people a slow weaning process helps to minimize the side-effects. Alot of the side-effects you describe are normal, even the increase in anxiety, perhaps you didn`t wean to 50mgs, you just started at 50mgs? That could explain the hard time you had. Increase in anxiety can be helped by getting a script for a benzo, nausea can be helped by taking the Zoloft on a full stomach. Insomnia can be helped by taking the Zoloft in the AM. Fatigue should dissipate over time. Good luck. Jackie

Share what you know. Learn what you don’t.

Response:

writes – Hide quoted text — Show quoted text -Hi all, I have a question about Zoloft and Valerian. I just moved, I left my boyfriend of 4 years and moved in with two roommates. They are absolutely sweet and all the changes in my life are for the better, but still I find my anxiety skyrocketing!! It is as bad a I never thought it would be… I am on 50 mg of Zoloft and I don’t really want to increase the dose (I don’t even know if it would help at all, since it works mainly against depression, not the anxiety itself, if I understand this correctly?), so I thought I’d try some Valerian to get me through the day and help me sleep. Do any of you have any information on SSRIs and Valerian? I seem to recall somebody saying one shouldn’t mix them… but on the other hand I always thought Valerian is a relatively harmless herb… some feedback would be greatly appreciated, Sophie Share what you know. Learn what you don’t.

I tried Valerian some time ago, and I can’t say that I was very impressed personally.  If you use the herb form to make an infusion, it makes your kitchen smell like something died in there, and of course it gives you no way of knowing what kind of dose you are taking.  I also tried the tablet form, and found that it made me feel like hell the next day.  As always, YMMV . — Jon Guite When replying by email, please remove the trailing x from my return address

Response:

Thanks for your kind replies….. actually, it is a side-effect problem. When I started on Zoloft I was sick for over a week – not only did my anxiety increase, but I was tired at the same time, insomnia and most of all nausea.. I lost quite a bit of weight, which was nice, still I am not too keen on repeating this experience… but what you say sounds convincing, so I think I’ll try the 100 mg. Maybe it’ll work as well for me as for you… thanks again!! Sophie

Hi Sophie, You don`t have to go right to 100mgs….you could wean slowly to that dose, that is up to you though. You could go to 75mgs, or even 62.5mgs by cutting the tablet, you would stay at that dose for a week then either increase in 25mg increments, or 12.5mg increments until you reached the 100mgs. For many people a slow weaning process helps to minimize the side-effects. Alot of the side-effects you describe are normal, even the increase in anxiety, perhaps you didn`t wean to 50mgs, you just started at 50mgs? That could explain the hard time you had. Increase in anxiety can be helped by getting a script for a benzo, nausea can be helped by taking the Zoloft on a full stomach. Insomnia can be helped by taking the Zoloft in the AM. Fatigue should dissipate over time. Good luck. Jackie

Response:

I have a question about Zoloft and Valerian. I just moved, I left my boyfriend of 4 years and moved in with two roommates. They are absolutely sweet and all the changes in my life are for the better, but still I find my anxiety skyrocketing!! It is as bad a I never thought it would be… I am on 50 mg of Zoloft and I don’t really want to increase the dose (I don’t even know if it would help at all, since it works mainly against depression, not the anxiety itself, if I understand this correctly?), so I thought I’d try some Valerian to get me through the day and help me sleep. Do any of you have any information on SSRIs and Valerian? I seem to recall somebody saying one shouldn’t mix them… but on the other hand I always thought Valerian is a relatively harmless herb… some feedback would be greatly appreciated,

Hi Sophie, You have had some major life changes recently no wonder you anxiety is still skyrocketing. I am not sure about mixing Zoloft and Valerian, I would call your doctor and ask, many times herbs and meds don`t mix. I think your best bet is to increase the Zoloft, you can go as high as 200mgs, 50mgs might not be enough. Zoloft is effective for anxiety disorders as well as depression. You might be pleasantly surprised at what a increase might do for you. You could also ask your doctor for a benzo for your anxiety, many people take both a AD and a benzo. Take care. Jackie "Am I right side up or upside down? Is this real or am I dreaming?"

Response:

Thanks for your kind replies….. actually, it is a side-effect problem. When I started on Zoloft I was sick for over a week – not only did my anxiety increase, but I was tired at the same time, insomnia and most of all nausea.. I lost quite a bit of weight, which was nice, still I am not too keen on repeating this experience… but what you say sounds convincing, so I think I’ll try the 100 mg. Maybe it’ll work as well for me as for you… thanks again!! Sophie – Hide quoted text — Show quoted text – Sophie –   Actually, unless you have a particulary side-effect problem, I would highly recommend upping your Zoloft dose…My anxiety was not affected at all at 50 mg, but at 100 mg – it is almost entirely gone!  Like night and day…And you can take up to 200 mg/day if it’s needed…   It took some time, but it was worth it…Anyway, Zoloft is recommended for panic and anxiety, so give it a try…I think you’d be better off taking one med anyway (not really sure why you don’t want to increase the dose unless it’s a side-effect thing) than mixing meds…   Hope this helps…Not sure about Valerian…I took some Kava and it helped a little, but you shouldn’t take it with Xanax (which I also started taking with the Zoloft)…Valerian was also suggested to me as far as herbs…Not sure of any interactions here…   Email me anytime if you want…You sound like you are in the same boat as me with a series of life changes leading to terrible anxiety…I am much better with 100 mg Zoloft…I think you could be too… Best, — Charles Phipps

Share what you know. Learn what you don’t.

Response:

Hi all, I have a question about Zoloft and Valerian. I just moved, I left my boyfriend of 4 years and moved in with two roommates. They are absolutely sweet and all the changes in my life are for the better, but still I find my anxiety skyrocketing!! It is as bad a I never thought it would be… I am on 50 mg of Zoloft and I don’t really want to increase the dose (I don’t even know if it would help at all, since it works mainly against depression, not the anxiety itself, if I understand this correctly?), so I thought I’d try some Valerian to get me through the day and help me sleep. Do any of you have any information on SSRIs and Valerian? I seem to recall somebody saying one shouldn’t mix them… but on the other hand I always thought Valerian is a relatively harmless herb… some feedback would be greatly appreciated, Sophie Share what you know. Learn what you don’t.

Response:

- Hide quoted text — Show quoted text – Hi all, I have a question about Zoloft and Valerian. I just moved, I left my boyfriend of 4 years and moved in with two roommates. They are absolutely sweet and all the changes in my life are for the better, but still I find my anxiety skyrocketing!! It is as bad a I never thought it would be… I am on 50 mg of Zoloft and I don’t really want to increase the dose (I don’t even know if it would help at all, since it works mainly against depression, not the anxiety itself, if I understand this correctly?), so I thought I’d try some Valerian to get me through the day and help me sleep. Do any of you have any information on SSRIs and Valerian? I seem to recall somebody saying one shouldn’t mix them… but on the other hand I always thought Valerian is a relatively harmless herb… some feedback would be greatly appreciated, Sophie

Sophie –   Actually, unless you have a particulary side-effect problem, I would highly recommend upping your Zoloft dose…My anxiety was not affected at all at 50 mg, but at 100 mg – it is almost entirely gone!  Like night and day…And you can take up to 200 mg/day if it’s needed…   It took some time, but it was worth it…Anyway, Zoloft is recommended for panic and anxiety, so give it a try…I think you’d be better off taking one med anyway (not really sure why you don’t want to increase the dose unless it’s a side-effect thing) than mixing meds…   Hope this helps…Not sure about Valerian…I took some Kava and it helped a little, but you shouldn’t take it with Xanax (which I also started taking with the Zoloft)…Valerian was also suggested to me as far as herbs…Not sure of any interactions here…   Email me anytime if you want…You sound like you are in the same boat as me with a series of life changes leading to terrible anxiety…I am much better with 100 mg Zoloft…I think you could be too… Best, — Charles Phipps

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Question:

Hi there, I used to think the exact same thing.  But, not anymore.  I can’t do this with the aid and assistance of meds.  I am beginning to believe that it is all in my head.  I will still be able to "feel" things, but it won’t be as strong.  I think I am finally coming into my own person.  I just want to be the old me, and if medication will do that and help me accomplish that, then I will be forever grateful. Kelly

Response:

to me, the first step to recovery, is to not need any meds.  we can do this without the assistance of meds.

Response:

Hi…I don’t know what your docs are thinking, but Prozac can cause weight loss.  If prescribed for a person with ed, it’s usually bulimia since this med can help the b/p urges.  I also asked my dr about Zyban and she wouldn’t give it to me b/c apparently it can cause seizures in people with eds.  I think you should ask your docs about switching you to Paxil, Zoloft, Effexor or something else that doesn’t have a high incidence of weight loss as a side effect, but probably not Wellbutrin…the seizure side effect was scary enough to me to forget that idea.  Good luck.  H.

Response:

Poeople with ED’s should NOT take Wellbutrin, unless specifically directed by a physician who is  fully aware of the ED To email, leave off the "xyz"

Response:

Here is an entry from my ‘Journal’: (spoilered for drug and other info) * * * * * * * * * * * * * * * * * * * * * * On the news this morning they did a thing about Wellbutrin (which is the

same as Zyban) to stop smoking.. I did a little research online and something ‘clicked’…    the dr.’s keep telling me to take my pills, but then tell me they don’t know much about anorexia and what to do about it and stuff..  They don’t seem to see a connection… for anorexia i read that you need to let the person know they are loved

and wanted and have worth..  I keep telling myself that, and i do believe it.. But i think it’s something medical as well… Well..  what ‘clicked’ was when i was reading about Wellbutrin messing

with your ‘pleasure centers’ and replacing other cravings and pleasures in the brain with the drug..  The dopamine thing… Well, ‘hunger’ (for food) is a mild form of ‘craving’…… I no longer

have cravings for foods or even hunger for them, although my body feels/displays the effects of no nutrition.   And the ‘pleasure’ i used to get from foods/tastes/etc. is gone a lot of the time…. Just like the smokers who quit with Zyban, the pleasure of smoking went

away and they were able to quit.. Please, does this make any sense at all?  I am desperate for an answer

before it’s too late…  I started losing the most weight when i started prozac 2 years ago, and the psychs told me it was not the meds doing it. But before that i was never anorexic and i was over 20 pounds heavier than now. i need help to make sense of it, the doc’s won’t listen when i say i need

off meds.. i can’t do it myself, i feel suicidal when i cut the meds.  that scares me becuz that’s not what i want, that’s the meds talking…   i don’t want that at all; i never acted on feelings like that before meds…….but i feel so alone at times…   ignoring the ED doesn’t make it go away…. Does it make sense, my theory about the Wellbutrin and cravings?  I mean,

don’t smokers flll the smoking void with food?.. now they can fill it with Wellbutrin… I have read repeatedly that Wellbutrin is not supposed to be given to anyone with anorexia.  And i never in my life felt TRUE ‘anxiety’ before i was on meds… But my doc’s say that’s not so… Who do i believe???   The stuff i read online is real medical info, not just someone’s personal

opinions..  Are the drug companies paying off the medical ppl, at the expense of the patients???  At $100 a bottle of Wellbutrin, i wouldn’t doubt it… I feel it’s my obligation to find an answer, and then i can help the other

people.  

Response:

Question:

    Recently I read a study on sibutramine (Meridia).  I had read several others, but not recently.  In this study patients on 5 mg lost more weight than those on placebo.  Patients taking 20 mg lost far more than those taking 5 mg or placebo.  All patients were consuming structured diets, using behavioral modification, and mild exercise.     My question is this: since the drug appears useful in weight reduction (which I guess it’d have to be, to have ever been approved) why are so many people not seeing results with it?  I know a few people have seen results, but the majority, myself included, have been disappointed.     Why would prior phen-fen use make one less likely to benefit from Meridia (which seems to be the common opinion)?  I only took Meridia for 4 weeks; I didn’t want to fork out that much money for another month if it wasn’t doing anything.  Do the effects increase with time?  The study I refer to was only a 12-week study, although none of the participants  were currently using other meds, so phen users would have been excluded from the study.     Any ideas? Adria

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I’ve been on 10mg per day of Meridia for two weeks and I’ve lost 8 pounds. As a purely subjective speculation, I wonder if it may be effective for so few people because it may work on just a single cause of obesity, that being due to an out-of-whack appetite. For as long as I can remember I’ve been able to look at what most people would consider a normal sized portion of food and know before I ever start eating that my appetite won’t be satisfied until I eat two or three times that amount. This is even more of a problem with sweet and/or fatty foods than it is with things like fruits and vegetables. I also tend to think about food very frequently throughout the day and as a result eat frequent snacks. This is independent of habit, mood, emotional or physical condition or any other variable I can think of. The bottom line is I just seem to be hard-wired to overeat. The Meridia seems to have almost magically "reset" my perception of how much food is enough. I prepare small portions of relatively healthful, varied kinds of foods, and even though sometimes my stomach feels physically hungry, I can easily resist what is now a much weakened urge to snack or overeat. And although it’s a distant secondary consideration, the price of the medication is a motivating factor, too! I’d hate to be spending so much money on something that turned out to be ineffective. Of course I realize 2 weeks isn’t very long, but since my doctor is concerned about my gradually but steadily increasing blood pressure and has told me a weight loss of even 10 or 20 pounds will likely prevent my having to control it with medication, even the weight I’ve already lost is of beneft.

<most of reply snipped – Hide quoted text — Show quoted text -4) In the Meridia studies, patients did the best on the larger doses (20 and 30 mg), but the blood pressure results were unacceptable. The largest dose Knoll could get approved was 15 mg. Of the surveys I’ve gotten (something like 300 of them), I’d say about 80 percent of the people were not satisfied with the results they got. Barbara Barbara Hirsch, Publisher Obesity Meds and Research News OMR Web Site: http://www.obesity-news.com

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   Why would prior phen-fen use make one less likely to benefit from Meridia (which seems to be the common opinion)?  

Here are a few reasons: 1) Phentermine and fenfluramine are releasers and reuptake inhibitors, Meridia is only a reuptake inhibitor of norepinephrine and serotonin. 2) Phentermine works on dopamine, whereas Meridia has a very small action on dopamine (which is one of the reasons some folks get sleepy on it). 3) Most people develop some what of a tolerance to obesity medications after a while. So if you develop a tolerance,  and you start taking a weaker drug, you are likely to see poor results. Of course, every one’s receptors are different, and YMMV. 4) In the Meridia studies, patients did the best on the larger doses (20 and 30 mg), but the blood pressure results were unacceptable. The largest dose Knoll could get approved was 15 mg. Of the surveys I’ve gotten (something like 300 of them), I’d say about 80 percent of the people were not satisfied with the results they got. Barbara Barbara Hirsch, Publisher Obesity Meds and Research News OMR Web Site: http://www.obesity-news.com

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I’ve been on 10mg per day of Meridia for two weeks and I’ve lost 8 pounds. As a purely subjective speculation, I wonder if it may be effective for so few people because it may work on just a single cause of obesity, that being due to an out-of-whack appetite.

Meridia doesn’t work on any cause of obesity, it’s an appetite suppressant, and the serotonin component *may* help with OCD. But the jury is still out on that. But phen/fen didn’t work on a cause of obesity either. At this point in time researchers conclude that a variety of "susceptibility genes" cause people to be obese. The only way you could accurately treat an obese person is by knowing what those genes were, and then develop drugs or gene therapy to treat. We are many, many years from that point. I can easily resist what is now a much weakened urge to snack or overeat. And although it’s a distant secondary consideration, the price of the medication is a motivating factor, too! I’d hate to be spending so much money on something that turned out to be ineffective.

I’m glad it’s working for you. There’s no arguing with success <G! Of course I realize 2 weeks isn’t very long

No it isn’t. Let me know how you feel in another six months. If you still think it’s effective. Barbara Barbara Hirsch, Publisher Obesity Meds and Research News OMR Web Site: http://www.obesity-news.com

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– Hide quoted text — Show quoted text –    Recently I read a study on sibutramine (Meridia).  I had read several others, but not recently.  In this study patients on 5 mg lost more weight than those on placebo.  Patients taking 20 mg lost far more than those taking 5 mg or placebo.  All patients were consuming structured diets, using behavioral modification, and mild exercise.    My question is this: since the drug appears useful in weight reduction (which I guess it’d have to be, to have ever been approved) why are so many people not seeing results with it?  I know a few people have seen results, but the majority, myself included, have been disappointed.    Why would prior phen-fen use make one less likely to benefit from Meridia (which seems to be the common opinion)?  I only took Meridia for 4 weeks; I didn’t want to fork out that much money for another month if it wasn’t doing anything.  Do the effects increase with time?  The study I refer to was only a 12-week study, although none of the participants  were currently using other meds, so phen users would have been excluded from the study.

My own belief is that the mechanisms involved are quite different.  If you were having success with phen/fen, this points heavily in the direction of problems with serotonin levels (Phen increases the release of serotonin, fen slows down the reabsobtion).  Meridia does not greatly affect the serotonin levels – it works (when it works) in other ways.  So it PROBABLY would be true in the other direction as well – IF you are helped by Meridia the odds would be good that Phen/Fen wouldn’t help you much (if you could get it).

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My own belief is that the mechanisms involved are quite different.  If you were having success with phen/fen, this points heavily in the direction of problems with serotonin levels (Phen increases the release of serotonin, fen slows down the reabsobtion).

Phentermine is thought to act by releasing dopamine and retarding its reuptake.  I’ve never heard of it affecting serotonin. Meridia does not greatly affect the serotonin levels – it works (when it works) in other ways.

Siburamine is, like venlafaxine (Effexor), a NE/SRI, reducing the reuptake of both norepinephrine and serotonin. — Steve Dyer

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Harold, I read what you wrote about Phentermine. You got it all wrong. I’d suggest reading the articles on Phentermine on the web site for Rx on the Internet. Love your Dutch name. I am Dutch also.   John Bowen   Nipomo, California   http://www.thegrid.net/jhbowen/life.htm  "Too bad the only people who know how to run this country are too   busy driving cabs and cutting hair." — George Burns

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phentermine releases stored norepinephrine. Main site of activity appears to be thecerebral cortex and the reticular activating system. Promotes nerve impulse transmissions by releasing stored norepinephrine from nerve terminals in the  brain.

I always understood amphetamine, phentermine and the like worked (to the extent that we know how any of these drugs "work") by enhancing the release and reducing the reuptake of dopamine, not NE. — Steve Dyer

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phentermine releases stored norepinephrine. Main site of activity appears to be thecerebral cortex and the reticular activating system. Promotes nerve impulse transmissions by releasing stored norepinephrine from nerve terminals in the  brain.

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Steve, Since sibutramine inhibits re-uptake of serotonin and dopamine, do you think that Wellbutrin (buproprion) would also work for weight loss since it is a dopamine-reuptake inhibitor?   Thanks! Cindy – Hide quoted text — Show quoted text – phentermine releases stored norepinephrine. Main site of activity appears to be thecerebral cortex and the reticular activating system. Promotes nerve impulse transmissions by releasing stored norepinephrine from nerve terminals in the  brain. I always understood amphetamine, phentermine and the like worked (to the extent that we know how any of these drugs "work") by enhancing the release and reducing the reuptake of dopamine, not NE. — Steve Dyer

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Since sibutramine inhibits re-uptake of serotonin and dopamine, do you

Serotonin and norepinephrine. think that Wellbutrin (buproprion) would also work for weight loss since it is a dopamine-reuptake inhibitor?  

Although bupropion is one of the few antidepressants that rarely causes weight gain, and often causes a slight amount of weight loss in people taking it for depression, and even though it’s chemically related to the anorectic drug diethylpropion (Tenuate), I don’t think it’s a very powerful drug when it comes to weight loss. — Steve Dyer

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If one is already taking Prozac, is it safe to try Meridia? I used Fen/Phen and Prozac successfully with no side affects and had good results in  weight loss, FM pain relief, and depression control. My doctor is recommending Meridia, but would like to have me discontinue the Prozac, I’m worried about removing the Prozac. Have been advised by other doctors not to stop taking it because of previous "crashes" following attempts to come off it.

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If one is already taking Prozac, is it safe to try Meridia?

Meridia product info specifically states "no Prozac." My doctor said the same thing. Weening off Prozac should help "crashes." This is conjecture…I "crashed" big time 4 weeks after stopping cold (only 20mg dose/day). It was not fun, but only lasted about 2 weeks. Waited another week before starting Meridia and am not having any difficulty. I used Fen/Phen and Prozac successfully with no side affects and had good results in  weight loss, FM pain relief, and depression control. My doctor is recommending Meridia, but would like to have me discontinue the Prozac, I’m worried about removing the Prozac. Have been advised by other doctors not to stop taking it because of previous "crashes" following attempts to come off it.

– Mary

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I don’t know about Meridia, but if it’s like Phentermine you CAN’T take Prozac with it. Please refer to an MIT study posted at: http://drugawareness.org/MIT.html Appetite suppressants are MAO inhibitors and cause an internal battlefield when paired with anti-depressant drugs such as Prozac (or fenfluramine, the phen/fen combo we all know and love.) From the article: "Maher said that the information that appears on drug labels, in the   Physician’s Desk Reference and on package inserts that reach   consumers is negotiated between the manufacturer and the    FDA."When the labels for phentermine and Sudafed were negotiated,    their MAO inhibitory activity was not known or appreciated or    considered to be important. And apparently there was no requirement    for phentermine’s label to be updated 20 years ago when it was first    shown to be an MAO inhibitor," he said.    The new findings also probably explain why only a handful of the tens     of millions of patients outside America who took drugs in the     fenfluramine family without phentermine developed pulmonary     hypertension or heart valve lesions, and almost all of these people were     also taking other drugs that we have found are unrecognized MAO      inhibitors," he said." So, my advice would be to find out if Meridia (like all other appetite suppresants is an MAO inhibitor). If so, Prozac and Meridia can be a dangerous combination. Good luck – Hide quoted text — Show quoted text – If one is already taking Prozac, is it safe to try Meridia? Meridia product info specifically states "no Prozac." My doctor said the same thing. Weening off Prozac should help "crashes." This is conjecture…I "crashed" big time 4 weeks after stopping cold (only 20mg dose/day). It was not fun, but only lasted about 2 weeks. Waited another week before starting Meridia and am not having any difficulty. I used Fen/Phen and Prozac successfully with no side affects and had good results in  weight loss, FM pain relief, and depression control. My doctor is recommending Meridia, but would like to have me discontinue the Prozac, I’m worried about removing the Prozac. Have been advised by other doctors not to stop taking it because of previous "crashes" following attempts to come off it. — Mary

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I don’t know about Meridia, but if it’s like Phentermine you CAN’T take Prozac with it.

There’s no absolute contraindication in taking phentermine with Prozac. Please refer to an MIT study posted at: http://drugawareness.org/MIT.html Appetite suppressants are MAO inhibitors and cause an internal battlefield when paired with anti-depressant drugs such as Prozac (or fenfluramine, the phen/fen combo we all know and love.)

Appetite suppressants like amphetamine and phentermine are "MAO inhibitors" only in an extremely restricted sense; one with unproven clinical relevance, despite the claims on that web page. The reason you wouldn’t want to take Prozac and Meridia together is that they both act as serotonin-reuptake inhibitors (with Meridia also acting as a norepinephrine-reuptake inhibitor.) — Steve Dyer

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Question:

The doctor tells me it takes time for the meds to start to work, but after taking them for about 10 days I still am waiting for results.  

All the anti-depressents, incl. Zoloft, take 4 to 8 weeks to become fully effective. The reason is that they work by adjusting the number of receptors for one or more neurotransmitters and this takes time. As you’ve been on the 50mg. dose for a while now it may be best to stick with it rather than reduce to 25mg. The worst is probably nearly over. Ian    Ian<<atdragoncon<dotnet

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hello there… Me too on Zoloft and Xanax… Increasing to the 200Mg mark in a week I get the shakes every day about an Hour after I take the Zoloft ….I take a Xanax.5Mg at the same time……It helps. I also try to stay active as this helps to keep my mind on the Job at hand.I can get the kids up and go to work and nobody calls 911..LOL Hang in there and let us Know your progress    J

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I have been taking inc.amts (as prescribed by my doctor) of xanax (0.5mg  3 to 4 times a day) and zoloft (50mg a day) for newly diagnosed panic/anxiety disorder.  So far, I  only have brief periods of  lessened anxiety, but alot of jitters and shakiness, and I keep waiting for the next attack to come.  Does anyone have any similar experiences with these meds?  The doctor tells me it takes time for the meds to start to work, but after taking them for about 10 days I still am waiting for results.  I really appreciate any and all feedback.  Thanks again.

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I have been taking inc.amts (as prescribed by my doctor) of xanax (0.5mg  3 to 4 times a day) and zoloft (50mg a day) for newly diagnosed panic/anxiety disorder.  So far, I  only have brief periods of  lessened anxiety, but alot of jitters and shakiness, and I keep waiting for the next attack to come.  Does anyone have any similar experiences with these meds?  The doctor tells me it takes time for the meds to start to work, but after taking them for about 10 days I still am waiting for results.  I really appreciate any and all feedback. Thanks again.

That’s gonna be  starting next week.  I hope I don’t have the jitters.  I’m really scared in that respect.  But if it helps in the long run,lmk. I just hope that I can find a med combo that will make me a confident person again. Foote

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- Hide quoted text — Show quoted text – I have been taking inc.amts (as prescribed by my doctor) of xanax (0.5mg  3 to 4 times a day) and zoloft (50mg a day) for newly diagnosed panic/anxiety disorder.  So far, I  only have brief periods of  lessened anxiety, but alot of jitters and shakiness, and I keep waiting for the next attack to come.  Does anyone have any similar experiences with these meds?  The doctor tells me it takes time for the meds to start to work, but after taking them for about 10 days I still am waiting for results.  I really appreciate any and all feedback. Thanks again. That’s gonna be  starting next week.  I hope I don’t have the jitters.  I’m really scared in that respect.  But if it helps in the long run,lmk. I just hope that I can find a med combo that will make me a confident person again. Foote

Hi there: I just wanted to add, I am a Zoloft/Xanax user too. To be honest, now I don’t want to interfere with what your doc said, but my doc started me off on 25mg, and told me to break the caplet open to halve it if needed, and then, again if needed, build up to 50 mg. So, it IS your body, and you might want to consider breaking your caplet into 25mg to start off with. Now, I take this at bedtime, along with 1mg of Xanax. I take 25mg of benadryl (prn) if I have a hard time getting to sleep. You also might find Zoloft gives you heart-burn, as it did me, and upset stomach. My doc just told me to take pepcid or zantac, which I have done, and it works just great. BTW, Zoloft is available in 25mg capsules, so if you find the 25mg works best for you, stick with it. My problem was I just kep’t on increasing my dose of ZOloft, up to 200mg a day, and I felt like a miserable zombie. Anyways, YMMV, and discuss any results or problems with your doctor. BTW, I would save the extra Xanax for the next day…if you run into some stressors or something, take it once or twice…depending on your day. Just make sure you get that 1mg at bedtime:-) Peace and best wishes.. James (3rd year Zoloft user (major)..hahah:) — "All of us get lost in the darkness… Dreamers learn to stear by the stars.." Neil Peart, Rush, "The Pass"

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Question:

 I used Zoloft for a year or so along with other  mood altering  meds. I have sever deppresion and am schizoaffective disorder, Zoloft provided some relief, however  I experienced headaches and weight gain. When I stopped the headaches subsided, Ilost the excess weight and noticed little difference  in my mood. I really did’nt  benifit  from it.

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Hi, I have been on Zoloft since 94 or 95 (cant remember which)  The only side effects I have noticed is a decreased sex drive and touble reaching climax. But I also have a fertility hormonal problem that could be producing the low sex drive.  To conquer the insomnia, you need to take the Zoloft in the morning, perferably before noon, or Im up all night.  I take 100mg per day since about a year ago, but was on it for  a year at 50mg.  But got out in the real world again and work, so it got stressful, which stress brings on panic, and depression, so it was upped to 100mg.  One note of caution, I was a few months ago having a teriible problem with teh depression, and upped it to 125 (with approval) and notcied panic got worse, shakes and  dizziness with it.  It was too high for me and one side effect of zoloft if its too high a dose is that it can cause some anxiety.

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Hi Jo, I dont know if 3 years is quite long enough for what you have in mind, but 3 years is 3 years..lol… Hmmm…. I think, and this is a personal opinion based on what I have seen, read and heard, that one reason Zoloft hasnt been able to document long term effects is two things: 1) the person gets better, by whatever means they found to be valuable to them and /or 2) a very wide-spread common complaint regarding the long-term effects of Zoloft is that the effect seems to decrease after around the 2 year mark. I dont know why, and I have yet to understand it, yet to understand the clinical reasoning… But here I was, thinking Zoloft was just 10 kinds of heaven when I started it three years ago, and now, whether it is a combination of many stressors addingtaking away from the effects, I find myself REgressing rather than PROgressing… I am very frustrated by this, as I know Zoloft, I know the way it effects me, etc. and now I am faced with the decision of either increasing the dose to 100mgs a day and combining it– I could be wrong, but I think it was Ativan recommended for the sleep problems–or switching to a new med, like Prozac…Or, of course, there is always the option of living with the panic/anxiety, depression and eating disorders without meds, but I dont find that a very realistic option…I trust my new counselor, but sheesh! It is like starting all over from square one again… Good luck to you! ] ~~Miriam~~ – Hide quoted text — Show quoted text – (I’m new to this group, so bear with me)   I’ve been on Zoloft (50mg/day) for the past 9 months.  I’ve got G.A.D. (generalized anxiety disorder) and also suffer from PA and depression. I’ve been having reasonable success with Zoloft (only side effects being decreased sex-drive and sometimes-insomnia), but I did some research on it and noticed that Pfizer (co. that makes it) hasn’t done any studies on the long-term effects.  So….I’m curious if anyone out there has been on it for awhile and can let me know if anything bad/good has happened. Thanks! jo

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It’s only been out since 92, so it’s a bit tough to have the sort of long-term studies it’d be nice to have.   Nobody seems to understand why this is the case, but all the SSRIs seem to have a tendency to "poop out" after a period of time.  This isn’t to say they will for everyone, but quite often they do.  For me on Prozac, it was 3 years.  Another joyous thing about the SSRIs. Matt

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It’s only been out since 92, so it’s a bit tough to have the sort of long-term studies it’d be nice to have.   Nobody seems to understand why this is the case, but all the SSRIs seem to have a tendency to "poop out" after a period of time.  This isn’t to say they will for everyone, but quite often they do.  For me on Prozac, it was 3 years.  Another joyous thing about the SSRIs. Matt

Prozac quit working for me after about 6 months! Tammy

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– Hide quoted text — Show quoted text – It’s only been out since 92, so it’s a bit tough to have the sort of long-term studies it’d be nice to have.   Nobody seems to understand why this is the case, but all the SSRIs seem to have a tendency to "poop out" after a period of time.  This isn’t to say they will for everyone, but quite often they do.  For me on Prozac, it was 3 years.  Another joyous thing about the SSRIs. Matt Prozac quit working for me after about 6 months! Tammy

Well, one good thing is that there is a whole spate of ad’s currently being tested (something like 40).  So, in a few years there should be more in the way of options, hopefully of drugs that don’t poop out.  (Many of these drugs aren’t SSRIs.) Matt

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(I’m new to this group, so bear with me)   I’ve been on Zoloft (50mg/day) for the past 9 months.  I’ve got G.A.D. (generalized anxiety disorder) and also suffer from PA and depression. I’ve been having reasonable success with Zoloft (only side effects being decreased sex-drive and sometimes-insomnia), but I did some research on it and noticed that Pfizer (co. that makes it) hasn’t done any studies on the long-term effects.  So….I’m curious if anyone out there has been on it for awhile and can let me know if anything bad/good has happened. Thanks! jo

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Question:

– Hide quoted text — Show quoted text – Doea anyone know if there is an effect on arthritis if you are in that time of your life when estrogen levels are behaving like the latest roller coaster from hell.  I know I read somewhere that this could impact one’s immune system and arthritis and Ijsut wondered if going on the birth control pill might even it out.  I am not yet menopausal but at 43 I am heading down that road soon. I know they will not start you on HRT until you are not having your period for at least 6 months.  I woul like to talk with someone who may have experienced this.  Thanks for your help! Nan

I am on HRT and I am menopausal.  Prior to menopause, my arthritis ebbed and flowed with the level of my estrogen.  As the estrogen dropped, the pain increased.  As you probably know, it’s the drop in estrogen–that brings on a period every month. For me, it also brought on pain. Four months ago, I started HRT. I would take Premarin (estrogen) for 25 days and Provera (progestin) for the last 9 of those 25 days.  Then nothing for 5 days.  As soon as I would start the progestin, I would get a killer flare. The gyn adjusted the Premarin dose (up) and I’ve been great since…no flare, more energy…not such a crab ass. Carol                 Human beings are flawed individuals…the cosmic bakers took us out a little too early.  That’s why we’re as crazy as we are—Jimmy Buffett

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 I know they will not start you on HRT until you are not having your period for  at least 6 months.

I didn’t know this,is it standard procedure? Shel – Hide quoted text — Show quoted text –

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Doea anyone know if there is an effect on arthritis if you are in that time of  your life when estrogen levels are behaving like the latest roller coaster  from hell.  I know I read somewhere that this could impact one’s immune system  and arthritis and Ijsut wondered if going on the birth control pill might even  it out.  I am not yet menopausal but at 43 I am heading down that road soon.  I know they will not start you on HRT until you are not having your period for  at least 6 months.  I woul like to talk with someone who may have experienced  this.  Thanks for your help! Nan

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Doea anyone know if there is an effect on arthritis if you are in that time of  your life when estrogen levels are behaving like the latest roller coaster  from hell.  I know I read somewhere that this could impact one’s immune system  and arthritis and Ijsut wondered if going on the birth control pill might even  it out.  I am not yet menopausal but at 43 I am heading down that road soon.  I know they will not start you on HRT until you are not having your period for  at least 6 months.  I woul like to talk with someone who may have experienced  this.  Thanks for your help!

Well, I’m perimenopausal, I have severe RA, and yep, fluctuations in hormone levels *do* have an effect.  In my case, I’ve always had a worsening of my symptoms during the pre-menstrual period, when estro- gen levels spike.  These days, I’m experiencing out-of-cycle spikes, with the same worsening in joint pain, swelling, and length of morn- ing stiffness. I’ve discussed the problem with both my RD and my gyn, but there’s been no mention of using birth-control pills to level out the effect. Actually, I wouldn’t use them if they did have this effect; I still remember vividly the surge in well-being I experienced when I stop- ped using Lo-Ovral years ago (this was a low-dose combination pill). My gyn has recommended evening primrose oil, on the basis of what other patients have told him — he believes it to be safe, and did not think it would conflict with my other medications.  I’ve done some checking on the web and I believe this is probably true, but I’m waiting to check with my RD before I start.  According to the abstracts available through Medline, trials of evening primrose oil both for RA and for menopausal flushing have shown no significant benefit, but neither did they report any significant difficulties. Stacy Scott

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Hi Nan and group, – Hide quoted text — Show quoted text – Doea anyone know if there is an effect on arthritis if you are in that time of your life when estrogen levels are behaving like the latest roller coaster from hell.  I know I read somewhere that this could impact one’s immune system and arthritis and Ijsut wondered if going on the birth control pill might even it out.  I am not yet menopausal but at 43 I am heading down that road soon. I know they will not start you on HRT until you are not having your period for at least 6 months.  I woul like to talk with someone who may have experienced this.  Thanks for your help! Nan

      I’m not perimenopausal but I did think that there might have been a  connection between my overall increase in disease activity in the last year,  year and a half and my going off the pill.  My gyn/RD said it would be worth a  shot, so I’m back on the pill now for about 4-5 months.  Can’t say there’s  been any noticable change as yet and I’ve also added sulfasalzine to the mix  in the last month, so I’m hedging my bets, I guess.        I’m sure if you did a search on Medline, you’d get some info.  A friend  sent me the following abstract after hearing of my decision to get back on the  pill and I’m sure there’s lots more. Best wishes, Denise Sex hormones and rheumatoid arthritis: cause or effect relationships in a complex pathophysiology? Abstract: Sex hormones are believed to contribute to the risk of rheumatoid  arthritis (RA) because of the disease’s female preponderance, especially during the child-bearing  years, and because of the dramatic improvements seen during pregnancy. Available controlled data on serum dehydroepiandrosterone sulfate (DHEAS), testosterone (T) and estradiol (E2) in  RA patients not treated with glucocorticoids are summarized. Hypotheses of sex hormone  contributions to RA are tested by judgemental criteria for the causes or determinants of disease.  Available data support hypoandrogenicity in RA patients, especially among premenopausal females and  males. Limited prospective studies in women and therapeutic trials of testosterone therapy in  men further support a role of sex hormones in RA. Interactions of sex hormones and glucocorticoids  are also believed to be important and deserve priority in future research. Author: Masi AT Address: University of Illinois College of Medicine at Peoria (UICOM-P) 61605,  USA. Abbreviated Journal Title: Clin Exp Rheumatol Date Of Publication: 1995 Mar-Apr Journal Volume: 13 Page Numbers: 227 through 240 Number of References: 105 Country of Publication: ITALY Language of Article: Eng Issue/Part/Supplement: 2 ISSN: 0392-856X MESH Headings: Animal Arthritis, Rheumatoid (Central Concept) Disease Models, Animal Female Gout Human Immunity Male Pregnancy Risk Factors Sex Hormones (Central Concept) Steroids Support, Non-U.S. Gov’t Chemical Abstract Service Registry Number: 0 (Sex Hormones) 0 (Steroids) Article ID: 95385254

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Before I developed the RA I was the study coordinator for PMS and Preimenapause  studies at the University of Pennsylvania Medical Center.  I agree, nono of  our data supports more than a placebo response from eveing primrose oil.  It  has some diaretic properties, so some women troubled with fluid retention may  experience some relief of that symptom only.   If you are taking an SSRI (Prozac, Zoloft, etc.) you may find that increasing  your dose during the premenstrual time decreases your symptoms.  Our research  showed strong evidence that PMS and preimenapausal symptoms could be reduced  by mid-cycle dosing, or mid-cycle increase.  I have seen good results during  studies, and I have good results increasing  my own Zoloft dose from 50 mg to  100mg pre-menstrually.  Good results meaning no increase in RD symptoms at  that time — not a reduction in overall symptoms. We were just doing some DHEA studies when I left, and I think that it an  interesting idea.  Be careful with DHEA from health food stores.  As DHEA is  not yet FDA approved except for research proposes as a medicine, it is not  regulated by the FDA for safety or efficacy.  Health Food store preparations  are regulated as a food, and purity and dose may vary widely. Donah Zack Crawford

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