Question:
On EffexorXR and still depressed.....

I'm 21 months post op rny, maintaining 120 lb weight loss and have had all reconstructive surgeries. Life was awesome then I had (out of the blue) a major panic attack and was put on EffexorXR 112.5mg daily. I'm terribly depressed now after 8 weeks on this medication. I was not depressed nor even sad prior to this medication. Can anybody shed light if they've experienced this? I almost feel like I may need MORE EffexorXR due to the malabsorbtion issue to completely block the panic as it does rear it's ugly head from time to time but I'm afraid it will also make me more blue. Suggestions appreciated.    — Vicki S. (posted on December 30, 2004)


December 29, 2004
I've always been told do not take extended or time release meds after RNY or DS as does not work right in us. So first I would start with some form of meds that are a "normal" release. I know nothing about Effexor, so I am not saying there is anything wrong with the medication. If they make a regular kind then try that. I have been on Celexa for about 5-6 years and when I was 9 mos PO I found I was having some depression flare up. So we increased it a small amount and that solved it. Basically I was malabsorbing some. So you may find even with a normal release drug that it may take extra meds now that you are PO. Also with depression and anxiety meds it is not uncommon that you don't hit the right medication the first trial. I was on 5 different meds over 4-5 years before we found the right one for me. I am on a very large dose but it works great and I do not have any side effects. If your PCP is prescribing the medication and cannot find something that works well for you then go to a psychiatrist. They are mental health medication experts. The dosage I am on my PCP used to cringe at, but since I was under a psychiatrists care, and one he respected, he went with the flow. He cannot argue with how I have been the last years. He now knows it is the right drug and dosage for me. He never would have put me on this dosage himself. There is nothing wrong with working with your PCP but realize they do have limitations in having the time to fully understand every kind of medication out there, and my internist is pretty savvy when it comes to recognizing and treating depression. Life can be great when you get the right med or combination of meds. Good Luck!
   — zoedogcbr

December 30, 2004
If it's time release, it probally won't work for you. It seems that 95% of us can't do time release post wls.
   — Danmark

December 30, 2004
Along with the SR not being well asorbed, the other thing is that this might not be the right med FOR YOU. I had terrible side effects from it, but take Wellbutrin (not SR) and have no ill effects at all. Everyone is so different with those types of meds
   — vitalady

December 30, 2004
hi, you wrote that you had a major panic attack and also hadn't experienced depression before you were on the medication. i believe effexor is generally prescribed for depression (and often after other meds are rxed like zoloft, welbutrin, paxil, lexapro, celexa and others). i wonder why you weren't rxed an anti-anxiety medication? if you had one panic attack and no prior history of depression, i'm not sure why you need a daily medication at all. did the doctor take a history, e.g., do you have sleep disturbances. i agree that if you did not get your prescription from a psychiatrist, that would be the best next move - they are specialists and aware of the latest meds and combinations. susan
   — susan S.

December 30, 2004
6 mos after rny depression hit me with a vengenance, my pcp started me on a low dose of Effexor ER, and for the next 6 weeks upped the dosage until I felt normal again, I take 150 mg. daily, and have for over a year now. It works great for me.
   — Donna Y.

December 30, 2004
We are told that post op you CANNOT take extended release meds. They aren't in your pouch long enough or some such thing. I would say check with your surgeon about taking an extended release med of any kind.
   — FaithMills

December 30, 2004
One panic attack doesn't seem to justify Effexor. Especially since you feel worse now than you did before. Please get a second opinion. Effexor is a serious med.
   — PattyL

December 30, 2004
I'm sorry to hear that you are having such a rough time with your panic attacks. As for your medication not working, you really need to let your prescribing doctor know that the medication is not doing it's job. It may just be that you do not respond to this particular medication, whereas someone else does. Also, it is true that we absorb very little in our pouches, it is in the intestines that the "extended release" medications are made to be released and absorbed. I would definitely discuss this issue with your doctor as soon as you can, there are many more alternative meds that you can take to help alleviate your panic attacks.
   — Marni

December 30, 2004
First of all, you need to see another doc or get your doc to give you something different. Are you sure about the dosage? Effexor usually comes in 75mg capsules. I took 2 every day prior to surgery for my Fibromyalgia, but don't need them now. There are so many other drugs you could take. The Paxil worked well on me too, but there were others I just could not handle. Don't get discouraged, just let the doc know you need something different. Good luck to you. I think you will be fine as soon as you get the right medicine and the right dosage.
   — debi327

December 30, 2004
My wife is now 3 months post-op, and is on Lexapro 10mg (Lexapro is the generic for Celexa), and is doing great on it. As a Ph.D. who works closely with a psychiatrist who prescribes these meds, I would urge you what I urge ALL my clients: call your prescribing physician immediately and ask to be switched to another medication! Also, if your primary physician is prescribing, I would also urge you to seek out a psychiatrist, since they are more adept in dealing with these meds than P.C.P.s. Hope this helps...
   — mom2sgw

December 30, 2004
Ok, here is what I was told, (I was on Effexor XR for fibromyalgia preop), I should NEVER take capsules or extended release because they don't absorb or digest correctly with the malabsorption part of this procedure. I was told take regular Effexor (which I don't, because every time I tried it made sick as a dog) in two doses daily. You may not be absorbing the Effexor XR correctly, and as with what most everyone else has told you.... get a 2nd opinion on taking it at all, or an antianxiety medication instead, just as needed for anxiety.
   — chelle_0608

December 31, 2004
Maria's Husband - Lexapro is not the generic for Celexa. It is a totally different drug. Celexa just went generic within the last 1-2 months and it is called citalproam (sp?). Lexapro has been out for at least a year or maybe even longer. From what I've hear Lexapro has been a great drug for many people as it has very little side effects and most don't even notice them. For me I'll stick with my Celexa (now generic - yeah!! Only a $5 co-pay now) as it's worked very well for me. But like I said I did have to eventually adjust the dose up by 10mg because I was malabsorbing some of it. That's all we can come up with because I had been maintained extremely well on the prior dose for about 3 years. So the malabsorption has to be the culprit.
   — zoedogcbr

January 2, 2005
I am only 6 days out and was on Effexor and Wellbutrin extended release prior and was told that all medications had to be switched to twice daily pills and not extended release because your body does not absorb. I agree with everything Lisa Lewis wrote back to you. I have tried restarting my pills crushed but have vomited because of the "nasty" taste and may have to wait a bit until I can eat some sort of "food" to mix the crushed meds with. Best of luck!-
   — D P.

January 4, 2005
Try switching to a non extended release Effexor, try that for at least 6 weeks and see if there is a difference. If it doesn't help consider switching to a diffrent drug. I like to give it at least a 6 week try before switching and trying a diffrent drug.
   — Kara J.




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