Wednesday, February 12, 2003

EffexorXR and Me

Okay, most folks will want to just skip this one... it's a full train-of-thought note set, which means lots of random stuff and links while I'm trying to find information on EffexorXR side-effects and tapering.

Words I never really wanted to know... (some are potential side-effects of EffexorXR, others are possibly associated with serotonin syndrome. Mostly, I'm just trying to piece together the exact terminology for the side-effects (probably from EffexorXR) that I'm experiencing. The falling-asleep twitches are the most troublesome and the hardest to get a label for (so far). The other side-effects either never bothered me or were ones I can live with (even ones like nausea which I only had when I started the medication last June at 75mg/day).

myoclonus - A sudden twitching of muscles or parts of muscles, without any rhythm or pattern, occurring in various brain disorders.

hypomania - A mild state of mania, especially as a phase of a manic-depressive cycle.

Other stuff that I've found (lots of random links here to EffexorXR, etc.):

Serotonin Syndrome - Mon 30th Sep 2002 - Associate Professor Chris Alderman - quote: An excellent reference to "Serotonin States" in Therapeutic Guidelines Psychotropic 2000 lists the distinguishing features between SSRI discontinuation syndrome, adverse effects, depression symptoms and serotonin syndrome.

Other possible words to add to the search are limb, ticking (as one person described it). "Limb" is probably a good one.

Huge message base at Dr. Bob.org (Anyone had success on Effexor XR?) about EffexorXR, about three and a half years of messages. (This is also where I'm getting ideas for search terms, seeing what other folks have felt.)

I found that sudden lateral eye movements would accentuate the feelings - in a posting about the "withdrawal" feelings (the ringing in the brain sensation). Same thing that I'm experiencing, after a sudden eye movement, it's like someone turned the knobs up to 11 for an instant. brain whoosh - yeah, that sounds familiar, LOL. Ah, here we go, Intercostal tension (muscle pains in my chest muscles), another good term to search on.

At this point, I'm pretty much down to a 75mg tablet every other day (just took my last one). While the withdrawal symtoms are less then they were last week, I'm definitely going to get my refill tomorrow (giving me 90 more 75mg capsules) which will give me some breathing room. My next visit with the pharmacologist (heck, I think that's the term) is Tuesday, at which point we'll be able to discuss tapering in more detail (perhaps supplementing with another medication to complete the taper process).

Still trying to figure out what "brain shivers" are... oh and LONDON (Reuters) - Humans make an attractive meal for all lions and not, as had traditionally been believed, just old and infirm animals unable to catch faster-moving meals. (today's favorite news quote).

Oh wait, here we go Brain Shivers at the ol' standby about.com. laugh the best quote of the bunch so far:

but if you really want to know what it is like, spin around and around real fast for a minute or two, then stop and try to stand up. for added effect, taste a 9-volt battery or touch the chassis of an mproperly-grounded appliance as soon as you stop spinning.

A recommendation that EffexorXR not be a primary line of treatment. quote: This would tend to indicate, in our opinion, that venlafaxine should be considered as a second line antidepressant for resistant depression.

(shrug) I was started on the medication by my primary care physician, mostly as a stop-gap measure until I could get in and see the pharmacologist / care-coordinator (dunno what else to call him, he's the one that sets the dosage, provided me with sleeping pills for when I had insomnia and setup the initial appointment with the therapist). IIRC, he chose to keep me on EffexorXR since I had already pretty much acclimated to the 75mg/day dosage (it was 2-3 weeks after I saw my PCP until I could get my first appointment with him). At that point in time, I was definitely not up to making good decisions so I deferred to his expertise (cold-blooded says that it's what I'm paying him for, ne?). He bumped me up to 150 mg/day and then we upped the dosage to 225 mg/day (I think in Sep/Oct/Nov).

One person said that their withdrawal symtoms got better after 6 days cold-turkey, although that was with lots of fluids and exercise (one of the articles that I saw mentioned IV as a treatment - which is essential fluids for when your system won't/can't take fluids in AFAIK). More things to talk about with the pharmacologist on Tuesday.

ICFDA Survivor Story - "My Journey Through the Effexor Nightmare
" - Physically I am dizzy, have blurred vision, brain zaps, electrical shocks in all parts of my body, extremely tired, nauseous, gastro, and night sweats. - long article... gonna link to a bunch more in case I don't stay awake long enough to read all of these (here's the link to the ICFDA index). btw, ICFDA is "The International Coalition for Drug Awareness" - their slant is to keep track of and publicize adverse reactions in medications that have been introduced in the recent past. (BTW, even though I'm linking to this stuff doesn't mean that I'm 100% convinced of the bona-fides of the various authors, the truth of the stories that they tell, so read everything with the mind of a skeptic).

Effexor Withdrawal Syndrome Hell

As you can see, when I do web searches, it's a very scattered process. From all of this information, I begin to discern patterns in the deluge - common themes, what seems out of place, or out of whack, or doesn't fit the curve. I try not to sieze on the first article that fits my pre-concieved ideas (or that feels like it fits the situation). Instead, I file it mentally under "feels like truth" category and press on. The goal is to hit as many discrete information sources as possible, looking for the "spin" that each one puts on the issue. (Some are going to be pro-EffexorXR, others anti-EffexorXR, some will be neutral, others will use scare tactics or power-selling tactics.) The more "spin" that I detect from an informational source, the less likely it is to be true or close to reality (meaning a balanced view of the pro's and con's).

Now, I do all of that informational sorting in my head (on a good day) - it's how I learn about things (reading voraciously, as many articles even remotely touching on a subject as possible within a few hour timespan). The big benefit of going for a large dose of informational input like this is that even though I can't conciously remember it all - I may remember in a few months or years from now that I saw an article about an idea (which gives me a jump start on researching). Okay, that's a bad explanation (it's late and I'm tired) - but for those who have ever wondered how I can pull information, solutions, concepts, etc. seemingly "out of the hat" - it's because of this method.

The key to learning in a web of information is not to focus solely on your goal (meaning don't just read articles that are specific to the information that you want), but instead learn to wander as you search. The second key is to not read everything - I know, sounds backwards but it works. Try to skim the source material, reading only the first sentence of each paragraph unless that sentence pulls you in. (Well written paragraphs start off with a summary statement or clue about what information the paragraph contains.) If it looks like you'll need to read the full article, bookmark it or print it and keep searching for more articles. Which brings me to the third key - don't let yourself get bogged down during the search for sources. That's pretty much how you do information triage - don't focus on comprehension during the search, pull it in and sort it out later.

Ah, another search term wildly violent hypnologic jerks as I was falling asleep. hypnologic - well, dictionary.com came up with a blank on the term - but it's related to hypnosis, sometimes refered as the "hypnologic state" which is halfway between awake and asleep. Actually, I think that search term is going to be a wild herring - most of the articles that I'm hitting have to do with "hypnologic halluciantions" (hmmm... time to try google). Well, that's not much better, although only 73 results to search through, although none of which seem to indicate that hyponologic is a medical term. (chuckle) The author was only taking 75mg/day? (chuckle) Try 225mg/day and miss a dosage (I went 2 or 3 days over Thanksgiving weekend by procrastinating running to the store to pick up my refil) -- at least from that goof I knew what was coming down the pike for now (as I try to taper off).

Hmmm, this statement ... and when the savage withdrawal symptoms appeared, I knew the drug was evil and I had to get off of it immediately. strikes me as un-truth (for those who have read the book Dune, you'll have some idea of what a truth-teller is, while a work of fiction, there is a grain of reality in the idea that some people can sense truth). Drugs aren't evil (hyperbole) just because they have nasty side-effects or you undergo withdrawal symptoms when you miss a dosage. (sigh) Just because something is difficult, doesn't make it bad / wrong /etc. Yes, I want off the EffexorXR now that the cure is worse then the cause (I've recovered enough from my disease that I feel the desire / want to try and do without the medication) - but, had I not taken the medication (or undergone psychotherapy, or allowed time to work its magic, or whatever - there was no single cure to the episode), I would probably not be here today. Drugs are a tool - evil resides in the hand that wields the tool.

Ah, here's another good quote It was helpful to know that others had experienced what I was going through and found it thoroughly UNACCEPTABLE! . (rummages for my copy of Feeling Good - I swear I'm seeing one of the patterns in the book here in this writing.) Oh, the injustice of it all, that the medical establishment would dare to prescribe a drug that is addictive. Now if you want to make the case that doctors are prescribing EffexorXR based on the drug manufacturer's sales material, you may have a good argument. But to say that it's unacceptable in this context indicates to me a blind rage, an inability to see more then one side of an issue (thus blinding yourself - and perhaps resulting in believing in the wrong thing). Well, there's more to the article - I'm not going to say that I find truth in 100% of what she wrote about - but it is her experiences, the experience was real even if I don't agree with her conclusions about some of the causes of those experiences.

posted by Wuphon's at 9:24 PM