Category: Articles

Is Effexor An SSRI Or A MAO Inhibitor?

QUESTION:

Dear Dr. Heller,

I am a Chaplain.  I deal mostly in Critical Incidents counseling and the elderly through Adult Protective Services.  However, I do deal with a great number of people that have a biological disorder.  My wife is Bipolar, she is on 900 mg of Lithium a day and 225 mg of Effexor a day.  My question is this, is Effexor an SSRI drug or an MAOI?  She takes certain over the counter drugs for her sinus at times and they say do not take them if you are using Anti-depressants such as an MAOI.  I am not sure if Effexor is considered an MAOI or not, I thought it was an SSRI.  Now, if it is an MAOI, do you have a suggestion as to what over the counter drug she can take for colds and so forth?  I hope you can clear this up for me.

Thank you for your time.

 

ANSWER:

Effexor is not an MAO inhibitor.  It has different effects on the serotonin, noradrenaline and dopamine systems – depending upon the dose.  It’s not a typical SSRI like Prozac or Paxil however.  Unless high doses of Effexor are being used, there is rarely a problem taking cold medications.  The biggest risk is high blood pressure, since Effexor can raise the blood pressure and some people are sensitive to ephedrine and pseudoephedrine (Sudafed).  Monitoring the blood pressure can determine if a problem exists in this area.

Will Effexor Have Fewer Side Effects Than Paxil?

    Will Effexor Have Fewer Side Effects Than Paxil?

    QUESTION:

    Dear Dr. Heller,

    I am a 19 year old female suffering from panic disorder.  I have had panic attacks the past 5 years but it was only recently that I saw a doctor.  He put me on 20mg of Paxil a day.  I took Paxil for 2 weeks but the side effects were just too much.  Now he’s put me on Effexor.  Does Effexor have lesser side effects like insomnia, loss of appetite and headaches?  I have heard and read that Effexor is a drug used for depression, so will it help me with my panic attacks and agoraphobia?  Please reply back.

    Thanks.

     

    ANSWER:

    When Paxil has side effects it usually means the individual also has the cognitive generalized anxiety disorder (persistent worry).  This appears to be the case with you based on what you described.  The gene has been discovered for this diagnosis, and appears to be related to an elevated serotonin 1A receptor being elevated.  BuSpar is the most effective medication for altering how this gene works, and stopping the cognitive generalized anxiety disorder.  Once the BuSpar is in the system for a few weeks, SSRI medications like Paxil can usually be taken without side effects. Effexor works for some patients with the GAD, and might work for panic. Side effects are a problem with Effexor.

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Is Effexor Safe In Children?

Is Effexor Safe In Children?

QUESTION:

Dear Dr. Heller,

I would like to know if Effexor is safe to use in children under the age of eighteen.  It is being recommended to us to help my eight year old son and I’m not convinced it is safe to use at his age.

 

ANSWER:

It is not FDA approved for individuals under 18.  This is a persistent problem in treating children however, as there simply aren’t many studies in children.  It is not known to be safe, and it’s not known to be dangerous.  This is a topic you need to discuss with the physician.

Can You Answer Some Questions About Effexor?

QUESTION:

Dear Dr. Heller,

My 16 year old daughter has recently started suffering from depression and mood swings. She was put on Effexor/capsules and it has helped her with the depression. When we re-filled the prescription they gave us 75.mg tablets and she has thrown up and cried for days. Is there 2 different types of Effexor? Are the withdrawals from the Effexor as much trouble as reports say? I am very concerned about my daughter and need some answers.

Please help….

 

ANSWER:

Effexor can be a difficult medication for many people. Side effects limit their use, including blood pressure problems, profound fatigue, and withdrawal symptoms can be very difficult for lots of people. I’ve found it most successful for chronic pain, although some patients do well with Serzone combined with Effexor, and high doses of Effexor (300-450mg daily) has been shown to work for the BPD.

There are two forms with multiple doses: the regular dose and the sustained release form (“XR”). It could be she was given the short acting form, and it’s also possible the symptoms are completely unrelated to the Effexor – for example a stomach virus. Those with the BPD often have break through dysphoria (anxiety, rage, depression and despair) which also needs to be treated, and this could be the case.

I Have Lots Of Questions, Can You Help Me?

QUESTION:

Dear Dr. Heller,

I am 25 years old and have just recently been diagnosed with BPD.  Although I was in therapy for the past 8 years because of my symptoms I was never brave enough to be totally honest and get the diagnosis I needed until just a few weeks ago.  My first major symptom was very persistent, and sudden disassociation, then anxiety mixed in, and now for the last 3 years it has been intermingled with intense anger.  Of course my personal relationships are terrible, etc.  I fit all the categories except self mutilation and suicide attempts/threats.  My coping/self harming mechanism was sex.  I have recently been prescribed Neurontin for my anger and am waiting for the weekend to try it.

In your Website (and book) I read that my symptoms mentioned above are conducive to Epilepsy.  Is THAT really what has been wrong with me for 8 years?  Can you explain the connection to BPD a little better?  I also have a goiter, although my TSH levels are fine, I take Levoxyl to reduce the size – is it possible that a thyroid problem really is affecting me even though my TSH levels are fine?  Do you offer any workbooks for those of us who do not live near your practice??

I consider myself high functioning and have really wonderful qualities that get so masked by BPD – I have waited 8 years for a diagnosis and now that I have it I am so eager for a clear understanding and a “cure”.  I pray for the day that my “fog” disappears!!!!!!  I am eagerly waiting to get a grip on my professional career and it is so frustrating to know that I’m not at 100%, 100% of the time!

Also, I do not remember any sexual abuse in my past – although sex was my motive for control.  Does that imply sexual abuse?  Also, I lived with a step mother from the age of 11-15 that could so easily be defined with BPD – she was mean and I was terrified the whole time I lived with her – could that have been the cause??  Is it about finding the cause or as you say “reprogramming the brain”?  I understand that concept completely – I dealt with some pretty intense anxiety and learned to reprogram myself then, instead of dealing with side affects of medications (Prozac drove me absolutely crazy!!!)…is it the same concept??

I’m sorry to babble – I hope you have time to answer all of my questions.  I am grateful for your Website!  I hope someday to publish a book that I have written of my life and all the situations I found myself in.  I never could find a way to end it because it seemed to just continue in the same pattern no matter how aware I was.  Surprised as I was, it can end now with a diagnosis of BPD.  Although, I hope to add one more chapter called “Recovery”.  I had always thought it would end that I would find a wonderful man or win the lottery and my life would then be wonderful…I never would have guessed this disorder was at the root of all my evil!!

God Bless you!

 

ANSWER:

1)    Yes, I believe the BPD is primarily a form of epilepsy. 2)    The BPD is commonly associated with thyroid problems, although goiter isn’t one of them.  3)    I do not have any workbooks, but it’s an excellent suggestion.  4)    What you described doesn’t mean sexual abuse, although it doesn’t mean you weren’t.  5)    You need the right medications.  If Prozac made you ill, you likely also have the GAD and need BuSpar.  Please take a look at the screening test and the FAQ section in “Ask The Doctor”.

What Do You Treat Dysthymia With?

QUESTION:

Dear Dr. Heller,

What is your prescription for dysthymia?  A family member was diagnosed with it and on Effexor for a few months.  The Effexor worked effectively but the person will no longer take it.  Instead they are taking St.  John’s Wort.  I think a prescription is necessary to get the desired results, but they refuse.  Any suggestions?

Thanks for any information and your web site is very informative.

ANSWER:

To me Prozac has no equal for dysthymia.  It’s also crucial to make all the other diagnoses and treat them.  Anxiety and other problems can be somewhat depressing, which can trigger dysthymia.  The screening test I use for my patients may be of significant use to you.