Depression Medications - Changed from Nefazodone to Effexor XR and now I'm changing back HELP

Author

Changed from Nefazodone to Effexor XR and now I'm changing back HELP

aimers

2006-02-25, 6:57 pm

About a year ago I switched to Effexor XR because my insurance company
was no longer going to cover Nefazodone on its formulary. Initially, I
got a fairly good pick up and felt better than I had in awhile. Over
the last year however, I have developed total insomnia, which my
psychiatrist is treating with lorazepam, have gained 25 lbs, and have
completely lost any desire for sex. When I previously took Nefazodone
it worked very well for me. I felt normal - whatever that means. For
some stupid reason, when my insurance company took it off the
formulary, it seemed like a good time to switch. Anyway, at my job, we
just changed to a new carrier and Nefazodone is back on the formulary
so I expressed an interest in wanting to go back on. I started
Nefazodone about 3 weeks ago and stared tapering off Effexor XR at the
same time. I had been taking 150 milligrams every morning, so my psych
immediately had me cut down to 75 mg. I did that for 10 days and then
37.5 mg of Effexor XR for 5 days and now nothing. I am on 300 mg of
Nefazodone which I take at night.

Just for a little history, I have suffered from major depression since
I was 24, and I am now 37. It definitely runs in my family. In
addition I also have terrible migraine headaches and ruptured one disk
in my back and herniated another about 18 months ago. So, my daily
meds include:
300 mg of Nefazodone
25 mg of Topomax (for migrain prevention)
4 mg of Lorazepam (for sleep)
occassionally Maxalt if I do get a migrain
Hydrocodone APAP 550 about 3-5 times a day for back pain.

My problem is that since I quit the Effexor and started the Nefazodone,
I literally feel as though I am in the clouds. For the last 6 days or
so, I have cried and cried and cried over things that I'm sure in hind
sight I may not think were worth all the tears. I have found myself
suicidal, and plainly just unable to cope. What is going on???

If you know whether or not this could be caused by my meds - please -
I'm open to any advice. At some point the water works have got to
stop. I need to work, I need to care for my family, and mostly, I need
to feel better.

Thanks.

Nanceaimers

Nom dePlume

2006-02-25, 6:57 pm

"aimers" <nanceaimers@mac.com> wrote in message
news:1140663699.484215.40700@o13g2000cwo.googlegroups.com...
> About a year ago I switched to Effexor XR because my insurance
company
> was no longer going to cover Nefazodone on its formulary.
Initially, I
> got a fairly good pick up and felt better than I had in awhile.
Over
> the last year however, I have developed total insomnia, which my
> psychiatrist is treating with lorazepam, have gained 25 lbs, and
have
> completely lost any desire for sex. When I previously took
Nefazodone
> it worked very well for me. I felt normal - whatever that means.
For
> some stupid reason, when my insurance company took it off the
> formulary, it seemed like a good time to switch. Anyway, at my job,
we
> just changed to a new carrier and Nefazodone is back on the
formulary
> so I expressed an interest in wanting to go back on. I started
> Nefazodone about 3 weeks ago and stared tapering off Effexor XR at
the
> same time. I had been taking 150 milligrams every morning, so my
psych
> immediately had me cut down to 75 mg. I did that for 10 days and
then
> 37.5 mg of Effexor XR for 5 days and now nothing. I am on 300 mg of
> Nefazodone which I take at night.
>
> Just for a little history, I have suffered from major depression
since
> I was 24, and I am now 37. It definitely runs in my family. In
> addition I also have terrible migraine headaches and ruptured one
disk
> in my back and herniated another about 18 months ago. So, my daily
> meds include:
> 300 mg of Nefazodone
> 25 mg of Topomax (for migrain prevention)
> 4 mg of Lorazepam (for sleep)
> occassionally Maxalt if I do get a migrain
> Hydrocodone APAP 550 about 3-5 times a day for back pain.
>
> My problem is that since I quit the Effexor and started the
Nefazodone,
> I literally feel as though I am in the clouds. For the last 6 days
or
> so, I have cried and cried and cried over things that I'm sure in
hind
> sight I may not think were worth all the tears. I have found myself

> suicidal, and plainly just unable to cope. What is going on???
>
> If you know whether or not this could be caused by my meds -
please -
> I'm open to any advice. At some point the water works have got to
> stop. I need to work, I need to care for my family, and mostly, I
need
> to feel better.

This may be a withdrawal effect from Effexor. The effects can be
long-lasting and pretty severe, and may include low mood. You might
consider asking your doctor if it's OK to supplement with 37.5 or half
that for another couple of weeks, and make the taper as gradual as you
can.

--
Nom dePlume, Ph.D.
Why, yes, in fact, I am a rocket scientist.

Guide to Medications for Mental Illness:
http://www.geocities.com/nomdeplume1000/

=====

aimers

2006-02-25, 6:57 pm

Thanks. My psychiatrist is as old as dirt - I swear. The last time I
was there, he had me look at the PDR because he couldn't find what he
was looking for. I feel like he knows little about switching meds or
about the newer meds. He takes my suggestions, and doesn't really
question me at all. He was the only psychiatrist that would see me
when I needed to see someone and literally NOONE else even returned my
calls. How do you get a GOOD psychiatrist to look at a case with a
long history and a complicated pharmacalogical history? Right now I'm
looking for a therapist and again, noone returns calls. What is going
on with our health care system???
My primary care is concerned but doesn't feel like he knows enough to
comment. Hence him wanting me to see a psychiatrist.

Really - thanks for your suggestions.

Nanceaimers

linny

2006-02-25, 6:57 pm

It's awful having to see someone who doesn't know your case history.
I've been in that situation and I don't want to have to explain all the
dark times again. I want to be able to see my doc, continue from where
I was at and move on but when I tell my doc I feel agitated and can't
sit still he tells me to do something then. It's not helpful so I've
changed again and hopefully I'll find a doc who will take the time to
chek my notes, see if there's a pattern and if there is then treat me
accordingly. I'm worried I might be hypomanic or BPD but the doctor
needs to look at all the symptoms and either put my mind at rest or
refer me back to the psychiatrist, not tell me to keep busy by doing
the ironing.

Nom dePlume

2006-02-25, 6:57 pm

"aimers" <nanceaimers@mac.com> wrote in message
news:1140717284.069940.75800@v46g2000cwv.googlegroups.com...
> Thanks. My psychiatrist is as old as dirt - I swear. The last time
I
> was there, he had me look at the PDR because he couldn't find what
he
> was looking for. I feel like he knows little about switching meds
or
> about the newer meds. He takes my suggestions, and doesn't really
> question me at all. He was the only psychiatrist that would see me
> when I needed to see someone and literally NOONE else even returned
my
> calls. How do you get a GOOD psychiatrist to look at a case with a
> long history and a complicated pharmacalogical history? Right now
I'm
> looking for a therapist and again, noone returns calls. What is
going
> on with our health care system???

I don't know. I've heard of these kinds of problems, but have been
fortunate not to encounter them. It must depend a lot on where you are
located. It helps to be near research universities where there are
doctors that do clinical research in psychopharmacology. They tend to
have lots of ideas, and specialize in the hard problems.

> My primary care is concerned but doesn't feel like he knows enough
to
> comment. Hence him wanting me to see a psychiatrist.
>
> Really - thanks for your suggestions.

You're welcome, and good luck.

--
Nom dePlume, Ph.D.
Why, yes, in fact, I am a rocket scientist.

Guide to Medications for Mental Illness:
http://www.geocities.com/nomdeplume1000/

=====

harmaa

2006-02-25, 6:57 pm

I've heard that the effects from stopping Effexor can be quite horrid.
As I'm on 3 75mg pills a day, I feel like I'll never get off it.

Even missing a day's dosage leaves me quite ill.

I hope everything passes quickly for you.