Effexor

[shepsmom]

Hi everyone,
I've been around the forums for a while but I don't post very often. I'm hiv+ since 1986. My husband of 20 yrs recently passed away. He didn't have hiv. He died of sudden cardiac arrest. We always thought that I would go before him so I wasn't prepared for this. I'm just devastated. Went to my doc today and he gave me effexor xr for depression. I guess anybody would be depressed in my situation. Anyway, I'm hesitant to start on these things. I don't want to get stuck HAVING to take them for the rest of my life. I'm also worried about an interaction with some of my other meds. I checked it on the check my meds part of this site. It says something about a seratonin syndrome. Its rare but it can really do some damage. I'm having some anxiety about it. Anyone else on viracept-combivir? I also take narcotics for neuropathy. If anyone is taking this combo along with effexor could you let me know how you're doing? Any other words of advice about effexor would also be appreciated.

[AlanBama]

hi s.m.

I don't know about the interactions of Effexor and the combination you are taking, but I have taken Effexor in the past and it worked well for me, for quite awhile.   I do seem to remember that I had a difficult time adjusting to it.

Right now, I am taking Cymbalta which seems to be working fine for me, and also helps with the neuropathy.   Its major drawback is a $60 co-pay with my Medicare Part D plan.....

Best of luck to you, and welcome to the forums!

hugs,
Alan

[Alain]

Welcome Shepsmom,

You might find some interest and answers to your question in the Cool Tool section of this website.

You can check interaction between medications.

take care. Alain.

[lydgate]

Hello shepsmom... First off, I wanted to say how sorry I am for your recent loss.

Second, my experience with HIV and depression is a bit different from yours, but here goes. I've been on Effexor XR for over 4 years now (it'll be 5 years in June). I had my first depressive episode, without discernible cause, at the age of 10. Then the second when I was 15, and the third when I was 21. That's when I decided to try and get psychiatric (as opposed to "only" psychological) help. I was put on Prozac then (this was 1995). Been on a number of anti-depressants since then, I won't bore you with the laundry list, but Effexor was the perfect fit for me. I'm currently on a pretty standard dose of 150 mg, though I have been up to 225 mg for a few months. (And I'm not on anti-retrovirals.)

What I'm trying to say is that I take anti-depressants for a kind of depression that is NOT dependent on external circumstances -- it just happens to be part of how my brain is hard-wired. Since I've had more than 5 depressive episodes, yes, in all likelihood I will take some kind of ADs (anti-depressants) for the rest of my life.

This is NOT necessarily the case with someone who takes a course of ADs in response to a tragic loss, such as you have experienced. It is entirely possible that you will need to take ADs for 6 to 12 months, and then you'll be tapered off, and won't have another episode of depression in your life. I know literally dozens of people who've taken a short course of ADs in resonse to a family member's death and not taken them again (including two cousins, an uncle, and my mother).

A few things to remember, though:

1. Not every AD works for everyone. Sometimes, through a process of trial-and-error, a second or even third pill has to be found. This can be excruciating for someone experiencing depression, but really really HANG IN THERE. It gets better, I promise. If a relapse does occur, there IS more help, AND more options.

2. Your doc probably told you this already, but the med can take a few weeks to start working. So don't lose hope or throw the pills away. Also, keep taking the med even once you start feeling better, and think about "quitting time" as something you decide with your doc.

3. Serotonin syndrome is pretty rare and would occur most likely if your doctor(s) have included an SSRI in your med combo, which would be unlikely. SSRIs are a class of antidepressants which work primarily on the chemical serotonin in the brain; Prozac, Zoloft, and Lexapro are examples. Effexor and Cymbalta work on two chemicals: serotonin and norepinephrine. Given that you're taking Effexor, I seriously doubt you'd also be prescribed an SSRI.

4. Sometimes, Effexor can cause an elevation in blood pressure. Usually not a problem at doses 150 or lower, but something to keep in mind. Mine has pretty much remained the same, except in times of great stress.

5. Which narcotics do you take for neuropathy? I can answer you better if I know that. I take a benzodiazepine (Klonopin) as well as another sleep med for insomnia; not a problem. I also took Vicodin, an opiod, when I fractured my hand; also not a problem.

6. Do NOT miss a dose of Effexor XR. It has a short-life and the withdrawal effect, even after one missed dose, is not pleasant. Sorry, but 'tis true. In my opinion, one of the (overcome-able) problems with this chemical is the tapering off when you're getting off it -- it's a lengthy process, but people do it every day!

7. Since you're taking a lot of meds, I'm assuming you're getting regular bloodwork done.

8. Finally, have you thought about -- eventually -- going to see a counselor? Or joining a bereavement group? Not for everyone I know, but it is something to think about. Studies pretty consistently show that ADs work best in conjunction with some form of psychotherapy.

Once again, I'm sorry, and let me (and us, the forums) know what we can do to help you through this. Depression really is an awful disease and state of mind. The good news is: we can fight it back.

Jay

Edited to add-- feel free to private message me if you'd rather ask questions privately.

Also:

1. What dose are you starting at and what's your dose eventually meant to be? Best to start low in my opinion and build up over a week or two, to avoid common transient side effects like upset stomach.

2. If the resource is available to you, you might want to get a specialist consult with a psychiatrist. Not saying that your family physician or ID doc is not competent; but can't hurt to have a second opinion if possible.

A lot on your plate, I know. Thinking of you!

[Tucsonwoody]

Hey Sheps -

I sure am sorry that you have lost your partner of all these years, it's always a terrible shock when the unexpected happens.  As for Effexor, I am not on the same meds you are and it seems everyone has a different reaction anyway.  But I can tell you my story... I started it while in the hospital last fall for treatment of PCP.  I didn't ask for it, my doctor put me on it because she thought I needed it.

I didn't feel any different taking it then I did before and over the past few months I continued to feel as I always did before so a couple of weeks ago I asked my doctor to let me start reducing the dose so I could stop taking it and she agreed.  So in a couple of weeks I will know if it was making a difference or not.

As far as I know I didn't have any side effects but then I am taking some other stuff so hard to sort out what's doing what.  Since so many people seem to benefit from some help like Effexor, you may want to give it a try and see if it or another AD med is for you.

Best of luck

[shepsmom]

Thanks for all your help.  Tucson,I'd be interested in what happens when you do stop taking them. I've had the same experience with a few different kinds of anti-d's. They don't seem to do anything. So it makes me wonder if my mood is just normal for me. I guess its okay to be sad when you lose your best friend and husband of 20 years. It wouldn't be normal NOT to be sad.  My life has been kind of tragic since I was born. I  think its meant to be for me to be unhappy. My husband was the one good thing in my life and now he's gone.

Alanbama, I hope they do work for me as well as they did for you.

[Christine]

Hello,
I have been on Effexor for depression, which I have had prior to hiv, and for me it worked great. Unfortunately, I was also on Norvir which can interact with Effexor.

My psyche, ID doctor, and myself were all aware of a possible interaction so the dose of Effexor was lowered to adjust for the boosting effects of the Norvir.

I was feeling really good on it, but then I noticed I was having some muscles twitches, felt like my skin was crawling, fever, and rash. It was diagnosed as Serotonin Syndrome and the Effexor was stopped.

Once the Serotonin Syndrome cleared up, which happend really fast, the psyche started me again on a very low dose of Effexor. I wanted to try a lower dose, to see if I could have the benefits of the Effexor without the side effects.

I did not work, so I had to stop it completely.

It also helps to see a psychiatrist who understands working with hiv meds and the depression meds.

As the other members have posted, have you gone to talk therapy? It can really help, along with the medications.

I am so sorry of the passing of your husband. I don't think you are meant to have an unhappy life. We all deserve to have peace and happiness in our world, sometimes it just seems that it is so far away.

Post here when you need support.
Christine

[shepsmom]

Hi Christine,
Thanks for your response. The info on what a seratonin syndrome might feel like will be helpful. At least I'll know what to look for. One of my hiv meds causes a slow metabolism of the effexor and the percocet could cause the seratonin syndrome so I got nervous about it. Its a low dose 37.5 mg. so I'm sure I'll be fine.

I did go to a psychologist at the request of my employer (USPS) and he told me I was resillient  and that I would be fine. He said he'd give me a call and check on me in a few weeks-he never did_ so that was the end of that. Then I got fired from my job because I had a fender bender in the post office parking lot so I don't think I qualify for the employee assistance program anymore anyway.