Long term effectiveness of Effexor XR for PTSD

[Misty2222]

What can be done to prevent medications like Effexor XR from losing effectiveness with long term use?  

In 1995, I began with Paxil and praised God for the healing of this "miracle drug."  Paxil began losing effectiveness and after seven years, doctors tried new medications like Lexapro which was less helpful.  Finally I began Effexor, then Effexor XR, then increasing the dose last year.  Though depression bleeds through occassionally, (feels more like the blues than a dark suicidal hole), I think I'm doing very well on Effexor XR 150 mg.  But I can not help but wonder .... Will I eventually need 225mg?   What will it take after that?  Will new drugs be available if Effexor stops working?

I was off Paxil for three days in 1998 because of a pharmacy screw up - I never want to experience that again, it was a terrible reminder of the kind of depression and anxiety I experienced everyday, all day for years.  I've not been without medication since then, but I can tell when it seems to stop working well.

Misty

  

  

[Hensley258]

Antidepressant resistance varies widely depending on the persons individual biology and tolerance to medications in general.

I happen to build resistance rather fast to antidepressants. For example Zoloft was very effective for me for a full 4 years, then it slowly started to fade. Eventually I might as well been taking a sugar pill once this happened.

Then I switched to Effexor XR. First 2 years at 150Mgs a day, then the 3rd year at 300Mgs a day. After the 3rd year Effexor also started to poop out for me. That's when My P-doc added Eskalith which works great as a type of booster drug. This Eskalith gave me another 18 months of effectivness from Effexor XR.

After that I had to switch because it just was not working anymore. Enter the Tri-Cyclic Nortriptilyne at 75Mgs a day. again very effective, but only for 2 years and then it also faded.

Then to Remeron (had to stop that because the weight gain with Remeron is horrible)

Then my P-doc put me on both Lamictal and Pristiq. Wow! What a difference! I feel near my normal self again.

Not sure how long before I grow resistance to this combination, but I do know that I will savor every day of normalcy that it brings me.

There is no guarentee with these meds. Some people can take the same antidepressant for 10 years and never suffer a relaps. Others can only stay on the same one for a couple years before it's therapiutic effects fade.

One thing I do know for a fact is that tolerance build up with antidepressant medication is a VERY real thing. I see it happen to people like me all the time.

In many cases it can sneek up on you because it is a gradual thing. I have learned what the signs are and thus I am able to act with my P-doc before I hit rock bottom.

You will know it when a med starts to fail you because you will slowly start to feel as if you missed your dosages even though you did not.

In most cases once an antidepressant starts to fail for you, then increasing the dosage will only buy you a little time. By then it's too late because your body has found the key. Once you body has found this key to destroying the therapiutic effect of the drug, even larger dosages will fail in time.

In 17 years with this condition I have built up resistance to a total of 14 different antidepressant and mood stabilizing medications.

Any doctor that tells you that tolerance can not be built up with antidepressants is either ignorant or just not telling the truth.

The good news is that there are many different combinations you can fall back on should you build resistance. With creative combinations there are ways to trick the system back into a response again.

Also there are new medications being developed all the time. Two in particular that look very good are Valdoxan and Reboxitine. Set for approval sometime in 2009.

In the case of Valdoxan, It will be the worlds first Melotenergic Antidepressant ever. Thus far double blind controled studies are showing it be more effective than todays host of SSRI's and SNRI's and with less side effects.

Further down the road we may even see another new generation of antidepressants that are Opiate based but without the addiction properties of a real Opiate. As you may know Opium is probably the worlds most effective antidepressant, with one huge problem; It is far too addictive to be utilized as an antidepressant drug and will only result in massive addiction.

The drug company that figures out a way to make Opium completly non-addictive will be wealthy far beyond even Microsoft. It would be 100 times more effective than todays antidepressants and they would work for everyone, not just some people.

So you see there is reason to hang on because better treatments are coming. I firmly believe that in the next 10 years science will know more about clinical depression and anxiety than was discovered in the last 120 years. That is a huge leap foward and this science of the brain is moving very fast now.

[Mary_Lou]

Hi Misty,

That's a great question. I have been on Effexor for about 15 years! I was wondering if I should ask the Dr. if I should try something different or wean myself off the drug...I am feeling much better emotionally (except for the normal 'blues' every now and then.  Has anyone out there been on Effexor for this long?  I so, did you change, wean yourself off or decide to stick with it?

Thanks very much,
mary lou