Mental Health Blog - antidepressant treatment review

I’m sure if you browse throughout the Effexor forums on “weight” you will notice people claiming they are rapidly losing or gaining weight. I have browsed through countless forums through countless hours looking for some hope or some type of original experience. In the end I have realized all of the stories end up the same.  – Those who are lucky to lose 10, 20, even 30 lbs in the first 6 months of taking effexor eventually gain it back.  And then they gain more and more weight until they are left like me 80 lbs heavier than they were before they ever took this drug.  I have been unable to find a story where someone has been on this drug more than a year and kept losing weight.  Inevitably as in any honeymoon, the phase will end and turn into an abusive relationship between you and a drug which lowers your metabolism, changes the chemistry of your fat, destroys your thyroid, retains your water and adds it to fat composites,  tricks your brain into thinking it’s not full by blocking the histamine receptor, and tells your body to crave mountains of sweets.  This information I have attained from reading various scholastic sources.

And if you haven’t heard the myth that doctors told you yet about diet and exercise, I’m here to give you the gruesome fact.  Drinking extra water, normal diet and exercise does NOT neutralize the weight gaining effects of effexor.  Anything else contradictory to this is a blatant lie.  If you were eating healthy and maintaining your weight before taking this medication, get ready for a diet and exercise regimen of your life in order to MAINTAIN YOUR WEIGHT.  Because I can tell you the second you stop dieting and exercising EXCESSIVELY, your weight will pile on like you wouldn’t believe.

For 7 of the 9 years I have been on effexor I actually fought for my weight and maintained it.  I worked out 6 days a week doing an hour of running and 40 minutes of weight lifting as well as keeping a strict diet to prevent myself from getting fat.  The second I went to graduate school I had to limit my exercising to 2-3 times a week and had to go back to a normal diet due to time restrictions. (Although a normal diet for me is still a diet.  It is high in fruits and vegetables and limited to lean protein and low on junk food and bad carbs.  The diet I need to be on while trying to keep my weight off is more extreme.)  In that year of graduate school I gained 50 lbs.  That’s right- 50 POUNDS with diet and some exercise.  This is the same type of diet and exercise a ‘normal’ person ‘not’ on antidepressants could lose weight on.  After a year and a half of graduate school I gave up.  I rarely exercised and just kept on my diet.  When I cut out most exercise I gained 30 POUNDS IN THREE MONTHS!  So after a study of just my experience I find that:

A) extreme diet and exercise (14-20 hours of exercise a week and eating nothing) will maintain my weight.                                                                                                                                                                                                   B) moderate exercise and a diet (6 hours of exercise a week and eating a weight watchers diet) will make you gain weight (for me the rate of gain 4.2 lbs a month)                                                                                                                         C) rare exercise and a diet (1 hour of exercise a week and eating a weight watchers diet) will make you gain a TON OF WEIGHT  (for me 10 lbs a month)

This is just my story.  There are thousands of stories identical to this on internet threads and forums.  I have read about anorexics, Olympians, dietitians, and weight trainers run into the SAME conundrum. They too have fallen into the same black pit as I have.  They put on weight when they take effexor even though there is no change in their exercise or diet.  In a way it made me feel more sane reading their stories. I truly felt like I was losing my mind not being able to lose weight when I worked harder than I have ever worked in my life.  However in the end I was depressed after reading their stories because a great deal of them turned out bad.  Most people were unable to take the weight off that they gained from the Effexor after they discontinued the drug.  It seems that it does long term damage to your system.  However I am hoping I will be one of the lucky few who either immediately lose weight after discontinuing or lose some weight after the effexor is completely out of my system (which will take up to a year).   It’s different for y so all I can do is wait.

To fill in the gap on the 6 months between gaining 50 pounds and then another 30 pounds after giving up I will describe every diet I used to try to lose the 50 pounds I gained.  The end result was maintaining my weight and losing nothing.  That is when I gave up and gained another 30 lbs.

Alternating 1-2 hours of Zumba (a super intense workout that burns 1000 calories each session) and Dance Dance Revolution on Hard core level a day for 5-7 days a week, as well as hour of walking every day, 40 minutes of weight lifting, sticking to weight watchers without deviating,  taking benefiber, Metamucil, or  fiber one for increased fiber intake, substituting nuts and beans for lean protein, replacing junk food with dark chocolate and flax seed omega 3 cookies for dessert in moderate proportions, cutting out processed foods and complex carbs, eating good carbs such as wheat, sweet potatoes, brown rice, oatmeal, going organic to eliminate toxins, increasing antioxidants by eating acai juice, eating ’superfoods’ such as papaya, flax seeds, and salmon, cooking with extra virgin olive oil, drinking a gallon of green tea every day, adding ginger, lemon, mint to water, apple cider vinegar in my water, drinking 12-16 glasses of water a day, cutting out dairy (dairy is bad because of all of the hormones that make you gain weight) and changing from soy to almond milk, taking probiotic, experimenting with caloric intake from 1400-2800 calories a day, cut out foods with high fructose corn syrup and aspartame, eating 6 small meals a day to speed my metabolism, cutting ALL Alcohol, trying slimfast, the red wine diet, taking vitamin C, etc. I’m sure there’s a lot I missed believe it or not.

After all that was said and done, my doctor said I was either eating too much or too little.  If I said I eat hardly nothing and exercise 2-3 hours a day, then she said I wasn’t eating enough to lose weight.  If I said I didn’t eat junk and ate the right amount, then I was eating too much.  It was always something ‘I did’ and not the effexor.  This was extremely frustrating as she wasn’t going to help me after not taking me seriously.  So after 9 years of not taking me seriously I have gone from a size 14 to a 20. (mind you a size 14 is perfect for me since I am 6 ft tall and have a large bone structure particularly in my rib cage. It is physically impossible for me to get smaller than a 14 unless I break my ribs! lol!)

I am so certain that there is nothing that can be done to lose weight while on this drug that I can bet I would fail miserably at the Biggest Loser.  What surprises me is that there’s no  public awareness of this problem. You never see articles in magazines, tv shows such as Dr. Oz or Dr. Phil that deal with this issue.  Instead they ALL say there is no excuse for not being able to lose weight. In fact I wouldn’t be surprised if some immature person (like my mother in law) commented on this article saying something to this effect “all you have to do is get off your fat ass” or “I don’t believe you.  All you have to do is diet and exercise.”  I have seen idiotic remarks like this all over the net.  Well unless you have taken this drug for more than a year,  you have no say or credibility to contradict my argument.  I would love to hear a successful story of someone who managed to keep their weight from ballooning out of control after being on this for as long as I have without taking extreme measures.

Currently I am still in a state of limbo.  I decided not to let the fear of gaining weight not rule my life.  I am not going to sit around all day and do nothing.  At the same time I am not going to go crazy and exercise 20 hours a week.  I’m sure that walking an hour a day while on a diet will just keep me around gaining 5 pounds a month.  When I am off this drug I have other plans to get my system going.  This site has truly inspired me to try a different approach.  http://www.theroadback.org/weight_loss.htm  Mind you I have no affiliations with this program.  This is just something different I am going to try and will tell you if there are results.  Long story short it involves taking Omega 3 fish oil, CLA, calcium, and vitamin E everyday to reduce inflammation and lose weight. Besides this I am going to try a hypothyroidism exercise plan.  (I might as well have hypothyroidism with the troubles I have.) The link to that plan I posted at the bottom. It involves 40 minutes of interval exercise 3-4 times a week.  Unfortunately I will not be able to have an immediate answer or a result. First I wont really find out if it works until I stop taking the effexor.  Even then I might not see results for a year depending on if my damage is non-reversable.

http://thyroid.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=thyroid&cdn=health&tm=414&f=21&su=p284.9.336.ip_p726.5.336.ip_&tt=2&bt=0&bts=0&zu=http%3A//www.thyroid-info.com/articles/exercise.htm

Since returning from London where I have been taking a semester of courses, I can now begin to work with some doctors on getting off this evil drug.  I have finally found a psychiatrist to work with who will not push pills on me or try to switch me to another drug.  Unfortunately I have been unable to make an appointment with him because he doesn’t push pills on his patients.  In other words he is high on demand and overbooked because hs is so good.

Well I finally took some initiative after waiting and waiting 4 months to get an appointment. I am still waiting for an appointment.  So instead I went to my family doctor and told her to give me smaller doses so I can begin tapering.  From literature that I have read it is the smaller doses that need the most care and doctor’s attention so I figured I can deal with getting down to 75 mg without a psychiatrist.  When I get to that point, I am certain I will need Prozac to extend the half-life so the side effects are not as gruesome.

Currently I have been tapering at 75 mg doses.  From 225 mg to 150 mg in two weeks.  I know this is too fast but I would rather suffer the side effects in a short period rather than tapering over the course of 9 months.  9 Months is would be the rule of thumb for me in particular that a doctor (who knows what they are talking about) would advise.  You are generally supposed to ween one month for each year you have been on it.  Since I have been on it for 9 years, then it should take me 9 months to get off this stuff. I want to get off it in two months.  I decided this is the best course because I don’t have a job and am finishing a graduate school project (thesis) and can afford to feel like crap for 2 months.  After May I think it would be more difficult to taper off this stuff since I would be losing health insurance and will have no idea where I will be living as I need to get out of my parent’s house and find a job.

To get to the point I am doing considerably better than I thought I would be doing after cutting my dose in half.  Week one I went down to 225 mg and felt absolutely no side effects.  That was far easier than taking the pill apart and counting beads.  That strategy I do not plan on implementing again until I lower my dose from 75 or (more likely) 37.5mg.  However depending on whether my psychiatrist prescribes Prozac at that time, I may not need to count beads.

Week two was much more difficult.  I could really feel the side effects.  They included the brain zaps and shivers, nausea, EXTREME fatigue (sleeping 14 hours a day and still tired) heart palpitations, loss of vertigo, the feeling that an alien is about to burst out of my chest like in the X-files movie, increased orthostatic hypotension (fainting and headaches after standing up), and feeling like crap.  The first few days were bad but manageable.  They were not as bad as it was when you miss a dose, however they were 70% as bad.  Being home makes this much easier. I cannot imagine trying to do any type of work while getting off this stuff.

The last two days I have taken 1000mg of Omega 3 fish oil . (This is recommended on http://www.theroadback.org/aaataper.htm).  This has improved the neurological side effects.  I am currently starting week 3.  This week I will continue on 150mg until I feel little to no side effects for a week.  This will mean my brain/body should be somewhat accustomed to this dose. Then I will taper down to 75mg.  I am expecting that to be much more difficult and painful.  I am certain my persistance will keep me motivated to stay on track.

On a side note I would like to note the literature I have read about effexor wearing off over time.  At some time I came across this information and completely agree with it at this point.  From my experience of being on this drug for 9 years I have been through several periods of depression and suicidal points (even recently).  I have also noted that my obsessive compulsive symptoms and thought processes are the same as before I went on this medicine.  This is something that slowly happened throughout the years.  I especially feel the effexor is no longer effective because I am feeling no difference in my mood since lowering my dose.  I cannot stress this enough.  I am not experiencing the normal depression that comes with tapering off this drug.  It only makes sense that this drug does not work anymore.  My hypothesis is that people who have been on effexor for a short period of time are more likely to feel suicidal and extremely depressed during the tapering process because the drug is still effective for them.

As I walked into the office, the main thing I noticed was the overwhelming number of magazine stands around the room. I mean, I understand wanting to have reading material around for patients to read while they wait to see the doctor, but there were literally magazine stands on each side of every chair in the office. I went up to reception, signed in to see Dr. Mefis, and grabbed a chair in the corner. Bored, I looked over at the stack to my left. All trade magazines for doctor’s offices, titles like WebDoc.com and Psychology Tomorrow, with giant smiles and unseen sticks up models’ butts. Not in the mood to be sold shit, I perused the rack to my right. Identical, down to the placement of the magazines in each row. I double checked – yep, the same exact corner was folded over on the corresponding gemini Pharmacology Monthly framing each side of my seat. Odd.

The sound of something heavy slamming on a desk grabbed my attention. A loud thud, followed by something similar to a ringing bell.

NEXT! My turn at intake.

Approaching the desk, I notice the source of the thud – an old school 1940s cash register being lifted to the counter and roughly thumped around by two scrawny and petite nurses. THUD. RING.

After being handed a few forms, I pick up a typical fat Pharmaceutical pen from the counter and a similar clipboard. The pen says “Scrotozome – Because everyone deserves normal-smelling genitals.” The clipboard just says “Liftor – From the Makers of Zoloft and Viagra.” I’d normally laugh, but I’m about to enter the ranks of the judged. The dependent. The medicated.

****

A week earlier and I’m golfing with my family for Father’s Day. I ride with my brother John, each of us providing commentary on the nature of the day. What surprised both of us by the 9^th hole was our other brother, Ian. He wasn’t doing exceptionally well this round. In fact, he’d already lost 4 balls to a stream and one bounced off a tree, whiffed –past his head and smacked into the cart before bouncing up to the ladies tee. Andy and I almost laughed, but bit our tongues. Christopher has a bit of a temper on the golf course.

But not today. He was having fun. He was reasonable. He took second and third tee shots and ACTUALLY COUNTED THEM. By the time the 18^th hole came around, he was downright pleasant to be with.

“What the hell’s with Ian?” I asked John.

“He didn’t tell you? Paxil. Amazing what modern science etc etc, eh?”

Amazing. And consequence free, bear in mind. No strings attached.

****

“Mr. ——-?”

For the record, that’s me. “That’s me.”

“This way,” says the nurse.

I can’t help but snicker at the two slight nurses still desperately trying to arrange the old fangled cash register at the out-take window. “What’s with the cash register?”

“Well, Dr. Mefis wants to create a feel in here, like a real classy 1940s feel. Patients wearing hats and dresses, better manners, no gum chewing – a real character to the place. Something to set us apart.”

“Really?” I mean … it’s a doctor’s office. A place to come when you’re sick. A place to get well.

“I dunno. You’re the one writing this elaborate setup…”

She leads me to the Doctor’s office. True to form, the door has a frosted window. Painted in gold letters, his name – Dr. Damien Mefis, MD.

“——-! Good to see you again!” No smoke, no mirrors, no smell of sulphur. Just a doctor, in a chair. “What brings you to need my services this time?”

I explain my situation – going through law school, tough finals, waiting to hear back about submissions to journals, no job for the summer, just got engaged, just put in a bid on a house. The usual. Stress. “And I was wondering if you thought maybe I might experience any benefits from trying out some…”

“Some Paxiiiiil, maybe?” He literally draws out the word. It sounds enticing. Seductive. He lures me in with his mouth.

“Yeah,” I say. “My brother has tried it out, and it’s really been doing wonders for him.”

“Well of course it has! It’s truly a miracle, in this modern age. A real godsend for those of us overwhelmed by the weight of life. You know something, ——? This I going to be good, I can tell!”

“Well, you’re the doctor!”

“I am, aren’t I? HAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!” He laughs for an uncomfortable amount of time. I try laughing with him for a few moments, but a hyperactive seizure shakes his body so violently I begin to worry. At any rate, I’m certainly not sure what’s so funny.

“KACHING!” he yells, and claps his hands.

“I’m sorry?” I ask, but just then an Asian nurse enters the room.

“Kaching, please get Mr. ——‘s paperwork together. He’s going to need a prescription for-“

“For PAXIL?!”

“Why yes, Dear. For Paxil.” He hands Kaching the paperwork and she exits the office. I get up to leave.

“Oh, and Mr. —–? Damien Mefis? Really? Like Mephistopheles? You don’t think very much of your readers, do you?”

“Not even a little, Doc. Wait for the cash register payoff.”

“Well, Mr. ——. Enjoy your prescription. And here, try some free samples! This one turns your tongue’s salt receptors off! Or how about this one? It supposedly turns your feces purple!”

I leave with pockets full of individually wrapped candies. Its like Pharmoween. Signing my paperwork, I hand over my credit card. “Oh, sorry,” says the nurse, “We only take cash now.”

I hand over my bills and the nurse hands me a prescription for Paxil. Its written on a prescription pad with a Paxil logo across the top. As I leave the office, the nurse finishing counting out my bills and presses a single button on the register.

KACHING!

*****

It’s the final day of my internship. It’s my first day on Paxil. I have had to leave the courtroom 3 times to run to the bathroom with the spits. I feel dizzy, nauseous, and about 5 steps behind myself in time. I feel numb, both physically and mentally. I feel nothing.

About a month ago I’d informed my boss that I was interested in working here full time at the end of school. This is, and remains, my dream job. A prestigious stepping-stone in a career. A leg-up in a competitive field. A real chance to learn and to make a name for myself. It was a long-shot, but I’d made my case over the course of the semester.

End of the day. I’ve puked three times, and I am leaving a bit early. They probably think I’m hungover. Right as I am leaving, my boss approaches my desk. She’s wearing the biggest smile I can remember seeing in years. From anyone.

“I just wanted to let you know, we’d love to have you come back when you finish school!”

I got it. I nailed it. My dream job, and the start of a fantastic career.

“Wow,” I say with as much enthusiasm as I can muster. It’s barely a drop in a desert of apathy and dizziness. “Hooray.” Without another word I slink off to find my car in the parking garage. I have no idea where I parked, and I won’t be getting home anytime soon.

ScienceDaily (Mar. 8, 2010) — Some anti-depressant drugs are associated with an increased chance of developing cataracts, according to a new statistical study by researchers at the University of British Columbia, Vancouver Coastal Health Research Institute and McGill University.

The study, based on a database of more than 200,000 Quebec residents aged 65 and older, showed statistical relationships between a diagnosis of cataracts or cataract surgery and the class of drugs called selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class.

Published online March 8 in the journal Ophthalmology, the study does not prove causation but only reveals an association between the use of SSRIs and the development of cataracts. The study could not account for the possibility of smoking — which is a risk factor for cataracts — and additional population-based studies are needed to confirm these findings, the researchers say.

This study of statistical relationships is the first to establish a link between this class of drugs and cataracts in humans. Previous studies in animal models had demonstrated that SSRIs could increase the likelihood of developing the condition.

“When you look at the trade-offs of these drugs, the benefits of treating depression — which can be life-threatening — still outweigh the risk of developing cataracts, which are treatable and relatively benign,” says Dr. Mahyar Etminan, lead author of the article, a scientist and clinical pharmacist at the Centre for Clinical Epidemiology at Vancouver Coastal Health Research Institute and an assistant professor in the Dept. of Medicine at UBC.

Researchers found patients taking SSRIs were overall 15 per cent more likely to be diagnosed with cataracts or to have cataract surgery.

The degree of risk among specific and different types of SSRIs varied considerably. Taking fluvoxamine (Luvox) led to a 51 per cent higher chance of having cataract surgery, and venlafaxine (Effexor) carried a 34 per cent higher risk. No connection could be made between fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) and having cataract surgery.

Co-author Dr. Frederick S. Mikelberg, professor and head of the Dept. of Ophthalmology and Visual Sciences at UBC and head of the Dept. of Ophthalmology at Vancouver General Hospital, notes that the average time to develop cataracts while taking SSRIs was almost two years.

“While these results are surprising, and might inform the choices of psychiatrists when prescribing SSRIs for their patients, they should not be cause for alarm among people taking these medications,” Mikelberg says.

SSRIs, the third most prescribed class of drugs in the world, block the uptake of the neurotransmitter serotonin by neurons in the brain, thereby stimulating more impulses between neurons. Cataracts, a clouding of the eye’s lens that usually occurs in older people, are routinely treated through surgery. More than 1.5 million people undergo surgery for the condition every year in North America, according to the Canadian Ophthalmological Society.

Co-author Dr. James M. Brophy, of the McGill University Dept. of Medicine, provided the database used for the study. The research was supported in part by the Canadian National Institute for the Blind, with Dr. Brophy receiving financial support from the Fonds de la Recherche en Santé du Québec.

For more information on eye and vision care issues visit youreyesite.com

“If you’re finding life to be the one thing that’s trying to kill you, I want you to stay alive to rise with the sun and fight back.”
–Henry Rollins

Update:

It’s been a dramatic 2 weeks. I snapped. I quit Chantix. I felt like crap the entire 2 1/2 weeks I was on it. Just not worth the side effects, in my opinion. My landlord set everything into motion by queening out on me over a financial issue that was partly his fault. His tantrum came on the same day I’d been released from the emergency room due to an upset gall bladder. He spoke to me in a very condescending, verbally abusive fashion.

Later in the week, both of my of contact lenses tore; they were my last remaining pair and I don’t own glasses. Being completely broke thanks to my deadbeat landlord further complicated matters. Meanwhile, I received a random carpet cleaning newsletter via email from the guy I used to be in love with but whom was never “available.” It is good to know his carpet cleaning company is #1 in DC. My boss caught me sneaking out two hours early. And State Farm cut off my life insurance because of an ensuing late payment. So I even had to worry about getting killed and being a burden to my family. Thanks a lot. All of you.

Anyway. After I snapped, full-blooded anger ensued. I imagined beating up my landlord on a street corner. Fantasy scenarios involving him failing at life occupied my mind for hours. I realized how much I miss aerobic kick-boxing. My beloved best friend and I resorted to juvenile tactics and it was wonderful. Landlord may have received an anonymous picture message on his IPhone of another man’s penis.

And on the 7th day, I visited my psychiatrist.
A chemical imbalance is a chemical imbalance. Genetics have given me a very special hand of cards in life. My only advice is, if almost everyone in your extended family takes antidepressants/anxiety medication, you may want to look into it when life just seems harder and harder. One cannot “talk” themselves out of an imbalance. And one shouldn’t have to.

It’s my first week on Effexor and I love feeling human again. I was able to climb out of bed for work before 7am for the first time in years. My tax returns come in this week, I’ve got new contact lenses, and tonight I see Henry Rollins live in Washington, DC. My landlord will always be a sub-human creature, but it was my choice to screw up the dynamics by sleeping with him. “Don’t shit where you eat” is right, boys and girls.

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