Description

Effexor (venlafaxine hydrochloride) is a structurally novel antidepressant for oral administration. It is chemically unrelated to tricyclic, tetracyclic, or other available antidepressant agents. It is designated (R/S)-1-(2-(dimethylamino)- 1-(4-methoxyphenyl)ethyl) cyclohexanol hydrochloride or (+)-1 -(a-((dimethyl-amino) methyl)-p-methoxybenzyl) cyclohexanol hydrochloride and has the empirical formula of C17H27NO2 HCI. Its molecular weight is 313.87.

Venlafaxine hydrochloride is a white to off-white crystalline solid with a solubility of 572 mg/mL in water (adjusted to ionic strength of 0.2 M with sodium chloride). Its octanol water (0.2 M sodium chloride) partition coefficient is 0.43. Compressed tablets contain venlafaxine hydrochloride equivalent to 25 mg, 37.5 mg. 50 mg, 75 mg, or 100 mg venlafaxine. Inactive ingredients consist of cellulose, iron oxides, lactose, magnesium stearate, and sodium starch glycolate.
Effexor has a relatively short half-life, which means that the onset of SSRI Discontinuation Syndrome is quite rapid after eliminating or lowering your dosage of the drug. However, with proper supervision, one can titrate off of the stuff with few if any side effects and no lasting changes; it just takes several weeks of fairly careful dose modifications as opposed to a few days (or worse, immediate) cessation.

I have found Effexor to be a noticeably different drug than the other SSRIs which I have experienced. Unlike Zoloft, the short half-life and somewhat severe side-effects make life on Effexor essentially a twisted version of addiction. When your entire encephalic functionality depends on ingesting the proper dose of the stuff daily, you will find that you will need to bring an addict's focused monomania to your logistical planning in order to avoid the sort of crash more usually associated with heroin or other nastiness. While getting more of the stuff isn't nearly as problematic, I find that this simply contributes to the tendency to avoid proper planning, which results in my running out of supply just as I have reached maximum temporal and spatial distance from a decent pharmacist.

The actual intended effects of the drug are harder to convey. It does provide a 'brighter' and 'more flexible' effect than Zoloft, at least in my case. On the outset, that seemed a good thing. However, there is a distinct and unpleasant schizophrenic effect - schizo in the classic sense of becoming detached from one's emotional impulses and responses, as opposed to the more common (and incorrect) usage describing multiple personality disorder.

I find that I just don't care.

I cannot get anything done that requires connecting the action with any form of abstract motivation (such as, you'll lose weight, you'll be happier in the end, you need to do this because it will help you carry out a more detailed plan, etc. etc.) The link between volition and any form of emotional or even analytical expectation or prediction is shattered completely. As a result, I find myself unable to meet deadlines, unable to complete projects, unwilling to take care of basic but abstract tasks, or in fact do anything at all that doesn't offer immediate results (I'd say gratification, but that's not the only emotion involved).

At this point, the effect of this stuff is far worse than that of Zoloft. After the fifth month, I find myself in constant danger of doing stupid things that might jeopardize my job, creditworthiness, trustworthiness, or even family relationships - not out of pique, but simply through my inability to carry out promised or assigned (or even commonsense expected) tasks.

At a higher level, there is a complete shutdown of most of what I might term my more 'artistic' outlets for my emotions. I cannot write; I can't play keyboard (I usually improvise) and I am entirely unable to hack on projects useful or fun.

While this is an improvement over the Zoloft, I must say that I find myself wishing that Effexor was limited to use as a 'recovery' drug, or an agent used solely to effect a single change or at least a single period of change in the patient, before the numbing effects described above can set it. On the other hand, I'm not sure what my options would be - Zoloft eventually reached the same stage of sheer disconnectedness for me, so I have to wonder if it's truly this particular compound or rather a symptom peculiar to my personal version of depression.

In any case, be warned about the 'side effects' and always, always do your own research about the stuff. I'm not trained, and none of this information can substitute for the advice of a professional and personal experience.

Brand name of venlafaxine

Indications

Effexor is an SSRI that is used as a treatment for depression and general and social anxiety disorders.
Dosage for adults
Usually administered in 37.5, 75, and 150mg doses, with 75mg being the standard starting dose
Dosage for children
Effexor is not approved for use on children
How supplied
This drug is administered in capsule form
Contraindications
Effexor is not to be taken while pregnant or breast feeding
Precautions
Effexor may cause complications with people who have had suicidal thoughts, high blood pressure, heart disease, liver or kidney problems, glaucoma, seizures, symptoms of mania or hypomania, or thyroid problems
Adverse Reactions
Effexor has been shown to cause the following side effects: nausea, dizziness, sleepiness, abnormal ejaculation, sweating, dry mouth, gas, abnormal vision, nervousness, insomnia, anorexia, constipation, confusion/agitation, tremors, yawning, and palpitations
Date of most recent Update
Feb 24, 2004

Now, I'd like to give my own account of just what happens when one takes effexor. I had been feeling depressed for a long, long time. Unfortunately, my parents didn't believe me. Eventually, they got the hint and allowed me to see a psychiatrist. He perscribed me effexor. After a few days, I convinced myself that I was feeling better. I really wanted to ba happy. Then, on the fourth day of taking the drug, I started to experience some rather severe side effects. I wanted to eat, but I simply couldn't. The idea of eating food was just so repellent. I also spiraled into what was probably the deepest depression I had ever been in. Every day was an endless parade of thoughts about suicide. I saw nothing left to live for. I threw away my pocket knife because I had made a solemn oath to a friend a few months back that I wouldn't take my own life, and I didn't want to break that. After a week or so of this, when I met with the psychiatrist again, he took me off of effexor and perscribed me remeron. A few days later, the side effects began to ebb. Then the remeron kicked in, and it was like I was seeing the world through new eyes. It was nice to be on an antidepressant that worked.

To anyone who is going to begin taking effexor, I leave you with this word of caution: if you start feeling any suicidal tendencies at all, call your health care provider IMMEDIATELY. Apparently, effexor makes suicidal people worse, and it can actually cause suicidal tendencies in others. I had never had a problem with these thoughts before effexor, and a promise that a friend had extracted from me was the only thing that saved my life while I was on this drug. If it works for you, that's awesome. More power to you. Happiness is a wonderful thing. Exercise extreme caution when taking ANY mind-altering drug.

It's been 2 days since my last dose of Effexor. I climb into my car, where I can be loud and no one can hear me. I allow all of the indignant rage accumulated since the last point I let it all out build up at the very center of my being. I let forth a torrent of absolute fury, visualizing it ripping away all that embodies the memeplex that we call "Effexor", its black tendrils of nullifying ennui being torn away from my mind, back to the phamaceutical abyss from which it emerged.

"Effexor! I command thee! Begone from my body! Effexor! Leave my body alone! Stay away from my body!
Stay away from my mind! Begone!
Let my emotions flow! Give me back my creativity!
Effexor! I command thee! Begone from my body!
Give me back my motivation! Give me back my life!
Give me back my imagination! Begone from my body!"

I am the supreme master of my own mind and body in that moment. No pretended biological, endocrine, or technocratic manipulation can alter my authority in this moment. I have transcended being a lethargic, drugged up zombie. New avenues of life open up to me.

Suddenly, colors seem more vibrant. Emotions flow through me unhindered. I turn on music, and it sounds wonderful. I walk into the animal clinic to pick up medicine for my mother's dog. Instead of completing the task like an automaton, neither smiling nor frowning, not really paying attention to the people around me except as needed, I am more than a slave to my endocrine system. I flirt with the clerk. I compliment her on her shirt. She smiles back. I pet the dog beside me and ask the owner its name. Withdrawl effects are mere distractions which occasionally bother the body, but cannot touch the invincible spirit I have unchained.

If it comes back to bother me again, I will banish it once more. There will be no tapering of dosages, no advice from shrinks, just utter conquering of anything which harms me.

According to the doctors, psychologists, and psychiatrists I've talked to in the last 10 or so years, my depression isn't related to any specific events. Sure, triggers make it worse, but I'm looking at a long-term chemical imbalance in the brain. Something I'm probably going to have to live with all my life. Great, right?

Well, in the last six months I've been prescribed several different antidepressants. Usually they kick in quite quickly, work extremely well for about two weeks, and then stop working suddenly. I haven't really had any side effects from these medicines. Then, they prescribed (generic) Effexor because Cymbalta worked well in the past but they won't pay for it.

What do you do when the cure is worse than the disease?

I had the pretty typical side effects first--mostly a bit of nausea when I took the medicine, but nothing I couldn't handle. I just had to remember to eat something light but filling in case I did throw up. But then as I increased the dose, the nausea became worse. Much worse.

A few days later the heart problems started kicking in. My heart feels like it's doing jumping jacks in the bottom of my throat! This frightened me because heart problems run in my family. Then I realized I hadn't eaten in three days. The Effexor had completely taken away my appetite!

I started thinking about my feelings and the way I'd been talking to my friends and I realized something was very wrong. I liken it to being trapped in a sensory deprivation chamber or holding your breath submerged in the ocean; I could tell there was activity going on around me but I couldn't respond to it. I was completely numb. I couldn't emphathize with people, I couldn't even really communicate. That was a scary feeling.

I e-mailed my doctor about the heart palpitations. He suggested I come in for an EKG and lower my dosage. A few days later I called the office at about 12:30am and asked if I could come in for the EKG the next day and told them I would be stopping the Effexor completely. I was told this was a very bad idea and that I would likely have some pretty bad withdrawal effects. I don't care about withdrawal effects. I care about getting my heart back into a normal rhythm, not being afraid it's going to stop or something, and being able to eat something.

I know there are other anti-depressants out there that I haven't tried. Wellbutrin was suggested, Remeron looks promising, and Cymbalta might be an option again (except my insurance doesn't cover it and its $130-$140 a month without). I'm almost afraid to though. What if I get something else that only works for a few weeks and then poof--nothing? What if I get something that does worse things to me than the Effexor?

So, because of my experiences with medically treating depression, I've decided to treat it homeopathically. I'm on my way to the drugstore/supplement store today to get some St. John's Wort and 5-HTP. After I get some of this poison Effexor out of my body I plan to begin treating my depression using those two supplements and maybe something else when I do some more research. I've committed to restructuring my life to accommodate my depression, whatever that means. If that means that I can't watch TV for whatever reason, so be it. I've started the process of getting at least one hour a day of light exercise outside in the sunlight (well, probably moonlight, I'm not a fan of summer days). I'm also looking into using Wicca/Witchcraft for the benefit of my depression. Y'know, focusing energies and stuff. I'm thinking that, combined with the time outdoors, is probably going to have the greatest effect. Whatever happens, it's gotta be better than poisoning myself.

I'm not a doctor, yadda yadda yadda. You probably should do what your doctor says and not what crazy Sarah says. Sarah's crazy. Why else would I be taking the happy pills? Don't take advice from me. Or maybe the pills made me crazy. Maybe it's all a government conspiracy. Or the mafia! That's it, the mafia's out to get me. /me hides in blankie fort. Oh, by the way, where'd they get the name St. John's Wort? My theory: there was a guy named St. John who had a funky wart and someone licked it and felt better. So, they bottled it up and sold it, calling it a wort because warts are icky. I told my friend that and she told me I'm crazy.

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