Efexor - Anxiety Medication

Caoimhín

jimpe wrote: »

I got prescribed Efexor XL 75mg today from my GP, have been suffering from panic attacks and agoraphobia for 2.5 years, but it's much worse in the last few weeks, difficulty leaving house etc. I didn't really want to go on medication, so I asked if there were any other options, eventually she gave me the number for a counsellor. I got the pills earlier on, but she said not to start until tomorrow...I think I'll call the counsellor before I start taking them and see what he/she thinks. I went through an unbelievably stressfull few years, starting 3 years ago, so I'm guessing that's what caused the whole thing...so maybe there's another option for me other than medication.

I wasn't too impressed with the doctor to be honest, she wants me to go for blood tests, and her final words were that I need to relax (wow, great advice). Anyway, at least I'm doing something about it now, and not just waiting around letting it get worse and worse.

Hi,
I was on them for depression and i did feel that they helped. I had some trouble sleeping with them but that was the extent of the side effects for me. I doubt a counsellor will contradict your doctors prescription or tell you not to take them.

nesf

jimpe wrote: »

I wasn't too impressed with the doctor to be honest, she wants me to go for blood tests, and her final words were that I need to relax (wow, great advice).

It is good advice. Excessive worry about the problem can be as damaging as the problem itself. It's a spiral that can turn a minor panic into a full blown panic attack in my experiences with anxiety. One of the things that helped me most with the anxiety and panic attacks that came with my depressions was recognising that they were anxiety and panic attacks and learning to relax more when I could. Even if I am too anxious to leave the flat, I relax, stop thinking about that which is making me anxious (i.e. the idea of leaving the flat) and try to distract myself from it with TV/Computer Games/book/child/fiancee/whatever. Worrying about the fact that I was too anxious to leave the flat (and similar) was what was turning my anxiety into panic attacks because I was working myself up over it into a frenzy of panic and worry. I had to first accept that my anxiety was there and that I couldn't think my way out of it and that I had to simply wait it out (which might take until the next day on a bad day) but that was the only way to cope until the symptoms were brought under control (in my case by medication).

The advice seems glib at first glance but actually there's probably a lot of stuff you can do to help you relax. You mightn't be able to get rid of your anxiety by this alone but it will help (it's almost impossible that you haven't picked up some bad habits that aggravate it over the past several years of attacks that either you or you and a therapist need to work out).

jimpe wrote: »

Anyway, at least I'm doing something about it now, and not just waiting around letting it get worse and worse.

Exactly, that's the first important step. Don't dismiss medication immediately, it might help you. Therapy is also worth trying but setting your heart on one of them and dismissing the other out of hand is just going to make getting better harder.

jimpe

nesf wrote: »

It is good advice. Excessive worry about the problem can be as damaging as the problem itself.

Yes, of course, but it was the offhanded way she said it as I was walking out the door.

I've started on the Efexor today, so hopefully I'll see some improvements over the next few weeks.

nesf

jimpe wrote: »

Yes, of course, but it was the offhanded way she said it as I was walking out the door.

Yeah, I know. It can be very hard to not take such things badly when you're not doing well but it helps I find to try and give people the benefit of the doubt about these things. Good luck with the medication, hopefully it'll give some relief.

jimpe

Have been on the Efexor for 7 days now, first few days I felt pretty crappy, nausea, aches and pains etc., trouble sleeping (not anxiety, just wide awake). Almost back to normal now again, i.e. same as before I started taking the pills, same anxiety levels etc., but the doctor said the pills wouldn't kick in for about 2 weeks. The only remaining side-effect is a loss of libido, hopefully that too will pass.

nesf

jimpe wrote: »

Have been on the Efexor for 7 days now, first few days I felt pretty crappy, nausea, aches and pains etc., trouble sleeping (not anxiety, just wide awake). Almost back to normal now again, i.e. same as before I started taking the pills, same anxiety levels etc., but the doctor said the pills wouldn't kick in for about 2 weeks. The only remaining side-effect is a loss of libido, hopefully that too will pass.

You'll get a lot of side effects in the first 3-4 weeks that are only there for the start and lessen or disappear after that in my experience. Honestly, unless you've a really bad reaction to a pill, you've got to give meds like these two months or so before you can evaluate whether they are working for you or not. Which is unfortunate, it'd be much handier if you could tell after a week or two. Either way, your doctor will have seen quite a few people on this drug so they're in the best position to judge side effects etc really.

Esel

Yeah, I'm always a bit wary when doctors trot out the 'two weeks' line. It can certainly take up to eight or even twelve weeks for some ADs to have a noticeable effect.

nesf

esel wrote: »

Yeah, I'm always a bit wary when doctors trot out the 'two weeks' line.

Arguably from a point of view of encouragement to get through the definitely tough first few weeks on an anti-depressant it makes some sense. You first time on your first anti-depressant can be a very tough experience if you haven't had to deal with side effects from medication before. But once you've gone through it once and seen the initial side effects fade over time, it gets a lot easier. It can be quite hard to get into the mindset of just getting through the first few weeks in your first experience of it.

jimpe

nesf wrote: »

Arguably from a point of view of encouragement to get through the definitely tough first few weeks on an anti-depressant it makes some sense. You first time on your first anti-depressant can be a very tough experience if you haven't had to deal with side effects from medication before. But once you've gone through it once and seen the initial side effects fade over time, it gets a lot easier. It can be quite hard to get into the mindset of just getting through the first few weeks in your first experience of it.

This is my first time on any kind of medication like this, and to be honest the side-effects haven't been too bad...maybe the dose is very low? I'm not suffering from depression (at least I don't think I am) but the medication is to alleviate the severe panic attacks, anxiety and agoraphobia I have...maybe I'll start seeing relief from these sooner than 12 weeks? Anyway, I'm prepared to wait as long as it takes, and just the fact that I'm doing something about it is making me feel better.

On a related note, the doctor also prescribed me something called Calmax, 0.25 mg, which I'm supposed to take for quick relief of panic attacks whenever I need to. Calmax is the same as Xanax, and I'd prefer not to take it unless I absolutely have to...the fact that I have it in my pocket kind acts like a crutch, so hopefully I won't need to take it.

nesf

jimpe wrote: »

Anyway, I'm prepared to wait as long as it takes, and just the fact that I'm doing something about it is making me feel better.

That's the healthiest way to approach things like this in my opinion. As for dosages, yes some side effects of Effexor are very much dose dependent, most psychiatric drugs are the same in my experience. Some aren't though. The main thing is to hang in there and give it a shot and work with your doctor or therapist about it.

jimpe wrote: »

Calmax is the same as Xanax, and I'd prefer not to take it unless I absolutely have to...the fact that I have it in my pocket kind acts like a crutch, so hopefully I won't need to take it.

Again, that's the healthiest way to approach it. Because of their nature they're not drugs you want to get "used to taking". This doesn't mean they don't have their place in dealing with acute panic symptoms. It's a bit like painkillers, some people get too used to taking them and take them every day to "ward off" headaches, which is really not what they should be doing (some people have to take both pain meds and anxiety meds daily, but these aren't the people I'm thinking about here).

Have you thought about seeing a psychologist also?

jimpe

nesf wrote: »

Have you thought about seeing a psychologist also?

I'm seeing a counsellor, had a preliminary meeting last week, and having a full session next week. If they feel I need more help, they said they would send me on to a psychotherapist. I suppose the plan is to allow the medication to reduce the anxiety, and then to start desensitising myself to all the different situations I've been avoiding, and learn to control the anxiety/panic attacks so that long term I can come off the medication.

My long term plan last week was to confine myself to the house for the rest of my life, this new plan is much better

nesf

jimpe wrote: »

My long term plan last week was to confine myself to the house for the rest of my life, this new plan is much better

Indeed.

Esel

nesf wrote: »

Arguably from a point of view of encouragement to get through the definitely tough first few weeks on an anti-depressant it makes some sense. You first time on your first anti-depressant can be a very tough experience if you haven't had to deal with side effects from medication before. But once you've gone through it once and seen the initial side effects fade over time, it gets a lot easier. It can be quite hard to get into the mindset of just getting through the first few weeks in your first experience of it.

I take your point, but I'm not referring to the situation where a doctor tells a patient that side-effects will decrease after two weeks.

Telling a patient suffering from depression (or anxiety etc.) that the medication they have been prescribed will take effect within two weeks is irresponsible imo. What if that person is 'hanging by a thread', and feels no change after two weeks? Or three weeks, four weeks etc.? I feel it would be far better to err or the side of caution. Well and good if the patient's condition and symptoms improve earlier than expected by them.

nesf

esel wrote: »

Telling a patient suffering from depression (or anxiety etc.) that the medication they have been prescribed will take effect within two weeks is irresponsible imo. What if that person is 'hanging by a thread', and feels no change after two weeks? Or three weeks, four weeks etc.? I feel it would be far better to err or the side of caution. Well and good if the patient's condition and symptoms improve earlier than expected by them.

What about the placebo effect?

Victor

And what of seeeing your doctor regularly at the start of new medication?

Esel

nesf wrote: »

What about the placebo effect?

Don't see the relevance here?

Victor wrote: »

And what of seeeing your doctor regularly at the start of new medication?

Fair point, but does every doctor insist on this? Or does every patient comply? (especially if they may have been given a longer prescription).

nesf

esel wrote: »

Don't see the relevance here?

You assume that everyone put on an antidepressant actually needs an antidepressant. Some people might only need the reassurance of taking a pill, and the placebo effect alone could bring them back on track. Just a factor to consider in all of this.

eth0_

jimpe wrote: »

I didn't really want to go on medication, so I asked if there were any other options, eventually she gave me the number for a counsellor. I got the pills earlier on, but she said not to start until tomorrow...I think I'll call the counsellor before I start taking them .

That was really pathetic of her. IMO if the patient doesn't appear to be a danger to themselves or others, they should be offered therapy as a FIRST resort. I'm in my final year studying psychology and i'm becoming more and more disillusioned with drug treatments, through personal experience. I really don't believe they work for the majority of people. And taking drugs and then going to a therapist seems counterproductive, you're less likely to get to the real root of the problem when someone is medicated.

For example, your agorophobia. I'm sure you didn't just wake up one day and feel agorophobic. There must have been a trigger for it. Yes, taking effexor (which I think is a particularly nasty drug and would not recommend at all) might dampen down the agorophobic tendencies, but at some stage you're going to want to stop taking medication, and the agorophobia will quite possibly return when you do. So, all effexor is doing is masking your "illness", it's not really fixing the problem.

Obviously this is just my opinion and i'm not advocating anyone just stop taking their medication. Just think about if it's really helping you on its own.

Victor

An anti-depressant can give a patient the time and space to overcome a crisis situation and use other treatment to resolve the bulk of their problem.

jimpe

eth0_ wrote: »

That was really pathetic of her. IMO if the patient doesn't appear to be a danger to themselves or others, they should be offered therapy as a FIRST resort. I'm in my final year studying psychology and i'm becoming more and more disillusioned with drug treatments, through personal experience. I really don't believe they work for the majority of people. And taking drugs and then going to a therapist seems counterproductive, you're less likely to get to the real root of the problem when someone is medicated.

For example, your agorophobia. I'm sure you didn't just wake up one day and feel agorophobic. There must have been a trigger for it. Yes, taking effexor (which I think is a particularly nasty drug and would not recommend at all) might dampen down the agorophobic tendencies, but at some stage you're going to want to stop taking medication, and the agorophobia will quite possibly return when you do. So, all effexor is doing is masking your "illness", it's not really fixing the problem.

Obviously this is just my opinion and i'm not advocating anyone just stop taking their medication. Just think about if it's really helping you on its own.

Can you explain what you think are the problems with Efexor...why is it "particularly nasty"?

LegacyUser

Hi,

I have just been prescribed Efexor today but am now worried about talking it! Also, when dispensed to me the chemist did not provide the information leaflet about the medication so I have no idea what kind of side effects to be expecting. I am at my wits end, I know I need something, but after a little reading on the internet am now wary of talking it.
Any advise or information would be much appreciated!

nesf

Tazzg wrote: »

Hi,

I have just been prescribed Efexor today but am now worried about talking it! Also, when dispensed to me the chemist did not provide the information leaflet about the medication so I have no idea what kind of side effects to be expecting. I am at my wits end, I know I need something, but after a little reading on the internet am now wary of talking it.
Any advise or information would be much appreciated!

drugs.com is useful if you want to read up on a particular drug. It's roughly equivalent to the leaflet you get with the drugs themselves, standard warnings and side effects lists: http://www.drugs.com/effexor.html



The main this is to be extremely sceptical about anything you read online. There is a lot of crap out there on websites about mental illness that is potentially extremely misleading. If you want to get more information about the drugs you are on (not on your specific condition or symptoms), an excellent place to start is the Biology/Medicine forum on boards. You cannot get medical advice for you on there but what you can get is very good information about the drugs you take and similar which may help put your mind at ease about a few points.

LegacyUser

Nesf, thanks for the info, will check that out.
Just scared out of my wits will become addicted to this medicine or will affect me negatively. Some reports have read have scared me. I know not all you read on internet is true, but I just keep finding really negative reports on Efexor and its side effects. I know everyone is different. Hopefully it will work for me, just scared!

nesf

You can't become addicted to Effexor as far as I am aware. It does have pretty bad withdrawal effects that happen if you suddenly stop taking it, especially at high doses, which may be the cause of the rumour but these can be mostly avoided by stepping slowly down in the dose when you are coming off it which is fairly standard practice from what I've seen.

Withdrawal effects are not the same as addiction. I had bad headaches for the month I came down off Effexor (from 300mg to 0mg over about 6 weeks iirc which is a very high dose of the drug to have to come down from) but I never once felt like taking another dose of it nor did I ever want it again. There was no addiction, merely withdrawal effects which while very unpleasant aren't the same thing at all.

JuliusCaesar

eth0_ wrote: »

That was really pathetic of her. IMO if the patient doesn't appear to be a danger to themselves or others, they should be offered therapy as a FIRST resort. I'm in my final year studying psychology and i'm becoming more and more disillusioned with drug treatments, through personal experience. I really don't believe they work for the majority of people. And taking drugs and then going to a therapist seems counterproductive, you're less likely to get to the real root of the problem when someone is medicated.

Often starting medication HELPS with the therapy. Without meds, many clients/patients are too demotivated to work in therapy. As they get better, then the meds get gradually tailled off and hopefully the therapy work sticks - but we can monitor progress. (I'm a psychologist with 20 yrs experience)

Dinkie

Hi,

I'm not sure If i'm allowed post this link (Mods - please delete if necessary), but I sound this website a lifesaver (literally) when I was depressed. I was given Effexor to take, and most of my extra research was done on this site.

It is a recognised site in Oz

http://www.depressionet.com.au/

tbh

in some forums, mods don't like linking to external sites for various reasons, but in here any resource you've found useful is fine as long as you're not trying to sell anything (and sometimes that's ok too). There's a sticky thread for useful resources, might be a good place to post it as well.

Esel

Tazzg wrote: »

Hi,

I have just been prescribed Efexor today but am now worried about talking it! Also, when dispensed to me the chemist did not provide the information leaflet about the medication so I have no idea what kind of side effects to be expecting. I am at my wits end, I know I need something, but after a little reading on the internet am now wary of talking it.
Any advise or information would be much appreciated!

It sounds to me that your doctor may have given you a short prescription (7 or 14 days?), and as the pharmacist was not dispensing a full box (28 days worth), they omitted to include the Product Information Leaflet (PIL). I think that was very remiss of them. You really should go back and get one.

Don't be afraid to start your medication. You will always find stories of bad reactions to medications on the net, especially as people are less likely to post about more normal experiences. Every case is different imo.

Also, some of the SSRIs (like Prozac etc), and SNRIs (like Effexor) which were originally used as antidepressants only, are now prescribed for other conditions such as anxiety disorders, eating disorders and OCD. So it is possible that different side-effects may arise depending on what is being treated.

I would advise you to get and read the PIL, take the medication as prescribed, be alert for adverse reactions, and/or worrying side-effects, and check with your doctor or pharmacist if you have any concerns.

Effexor, unlike Prozac say, has a very short half-life (the time taken for the levels in your blood to drop by half), and so it is important that you take it regularly as prescribed. Try not to miss a dose. If you stop taking it suddenly, without tapering off under your doctor's supervision, you will more than likely feel pretty bad for a number of days.

This does not mean that it is an addictive drug, however. It's more that the therapeutic level of the drug in your bloodstream has dropped suddenly (it is completely washed out of your body in three days, compared to a number of weeks in the case of Prozac), and your body has to re-adjust very rapidly.

Also, be aware that the full benefit of the drug may not become apparent for a good few weeks, so don't be expecting instant or short term improvement.

I hope your doctor has discussed with you the possible benefits of some form of therapy/counselling also. If not, you could ask about it. It may not be appropriate for you just right now, but could be very beneficial in helping you to gain insight into your overall situation, and you could learn valuable techniques and strategies for the future, which could help greatly in minimising the possibilty of relapsing.

I want to stress here that the above is purely my own opinion, based on personal experience and self-education. I am not qualified in any medical or pharmaceutical field.

Here's hoping things improve for you!

Odysseus

JuliusCaesar wrote: »

Often starting medication HELPS with the therapy. Without meds, many clients/patients are too demotivated to work in therapy. As they get better, then the meds get gradually tailled off and hopefully the therapy work sticks - but we can monitor progress. (I'm a psychologist with 20 yrs experience)

Fully agree I have ten years experience myself, some times meds are needed just to kick start things, some times there needed for much longer.

LegacyUser

Hi all,

Just wanted to say thanks for all your insight and advice. I do really appreciate it. Hopefully the medication will start to help soon and am waiting for appointment for counselling.