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Do not change your meds...
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Thomas L Schwartz, MD posted:
without consulting your prescriber. I am very concerned with many, many posts where folks are dropping, lowering, changing their meds without their doctor;s advice. We doctors know you patients do this a lot, no matter what our advice. May I suggest that if your med isn;t working or is giving you side effects call or make an appointment with your doc. I have at least 20 ways to treat depression with meds and probably 20 antidotes to side effects my meds give you all... As a doc, I'd like a call saying, 'hey this med is great but i have a side effect, what can i do to stay on the med and get my side effects to go away.??'
FINALLY, if you stop some meds cold turkey you can have anywhere from a mild withdrawal to a seizure and coma with others. In my career, I have had to put 2-3 patients in the hospital for medical emergencies due to withdrawal. If they would've called me, we could have lowered the meds safely and moved forward.
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irenne responded:
I understand where you come from, you are a good doctor but not all doctors think like you do. I was diagnosed with depression, anxiety, fibro., asthma and I also have psiorasis. The biggest problem for me at this time is depression/anxiety. I've been on so many meds and none of them work. The closest was Paxil and Selexa but the side effects were too overwhelming. Right now I'm stopping the Selexa very, very slowly and my doctor knows about this but I do not know what to do next, Change doctors again? Maybe see a Psychiatrist or who?????

I feel I'm living day by day just waiting for the end to come.
 
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Thomas L Schwartz, MD replied to irenne's response:
This is America and no one can make you take a med or stay on it. I think you can tell any doctor that you want to stop the medicine and I think they would be obligated to tell you how to safely do it. Your idea of a slow taper might be fine or might not be slow enough depending on the med. I may think someone stopping a med is a bad idea for certain reasons but if they say after informed consent they want off, then I teach them how to get off it safely. In your case ask your doctor what he/she suggests next. If you are not happy with your doctor find a new one? Do you have a counselor or a therapist? Meds do not work for everyone, so therapy is a good alternative too
 
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howtopayrx responded:
Dr. Schwartz,

I find myself in what may become a more common scenario. Have been on Effexor XR for 9 (?) years after many years of searching, trial and error. Clinical depression, ptsd and adhd.
My insurance just ran out after being laid off and the Effexor is incredibly expensive from an unemployment perpective. I have been trying to get a physician at the local county mental health center to prescribe something lower cost with similiar efficacy, but the timelines to get in are running 6-8 weeks. My regular physician will prescribe at no office charge but she does not feel she is qualified to replace antidepressants since she is a family practice doctor. how do I find someone who knows about mental health drugs before I find myself forced to withdraw? and -- is fluoxetine a possible substitute?
 
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warriorgal replied to howtopayrx's response:
Dear HowToPayRx,

I'm sorry about your employment situation. I'm not the good doctor , but have been in your situation many times; thus, I am somewhat qualified to give advice.

If the Effexor is working for you, have your primary care physician prescribe it for you, then contact the company that makes the drug (let your doctor know this, so they can prescribe your medication to last about 6-8 weeks). If I'm not mistaken, all drug companies have programs that supply samples to people who are out of work, or otherwise encountering a financial crisis.

As long as you continue to qualify, you may just wish to
"feed from the trough" of the drug company until your employment situation changes. Remember, too, that
you may not need to do this, now that a comprehensive health care bill has been signed into law. Although I'm not fond of some of its provisions, you unquestionably qualify as one of the truly needy, and now have an additional resource at your disposal.

Your drug can make the difference while transitioning to a new job.

Best Wishes,
WarriorGal
 
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mellowbrz54 responded:
Dr. Schwartz...such good advice. I was on Cymbalta and had been for years for fibromyalgia severe pain, and of course, related depression that seems to follow/be a part of fibro. The med had stopped helping, I had gained 35 plus pounds, and I asked my doc about it. He took me pretty much "cold turkey" off the Cymblata, gave me a pack to go on of Savella. He said it would "replace the Cymbalta" when I asked him about the withdrawals...HOWEVER...it did not!. I had MASSIVE withdrawals...literally thought I was going to die. I could write pages on what happened during the withdrawals...but...will spare everyone that...thank goodness for the blogs online about the withdrawals. During some of my "sane" hours, I would research and research...say "this is what is happening to me!!" My kids thought I was losing my mind. There was drama/trauma. I couldn't even communicate what was going on completely, the withdrawals were so, so bad...I had it all...brain zaps, memory lapses, etc., etc.
I called my doc, then went to see him...he actually didn't remember doing this until I told him...and of course...I still had the used Savella pack to show him, which didn't do what he thought. He said, "oh, I should never have done that"...duh! I also could not work during this time because of the many, many withdrawals (I am 55, and have worked all my life...I never duck my job...). Of course, my workplace did not really understand...so now I have that hanging over my head. Darn it!
Just going off the meds without reducing the amount over a period of time...is dangerous...as of course you know...but I want to shout it from the rooftops to other people...
God bless.....
 
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warriorgal replied to mellowbrz54's response:
I think going off a drug that affects one's brain "cold turkey" is counterintuitive to a layperson, to say nothing for a physician.

I am presently on 40 mg. of Celexa--small potatoes compared to what others take--but substantial withdrawal can occur
at any level, as I discovered. Indeed, if I miss my pill by as little as a few hours, I may experience increased anger and agitation. I don't think this is reflective of the state of my condition so much as it reflects the importance of gradually decreasing the dosage of the drug.

I imagine you went through hell, mate. Hope things are looking up for you.
 
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gl93705 replied to Thomas L Schwartz, MD's response:
DR.SCHWARTZ

I AM A 12 YEAR FIBROMYALGIA PATIENT I ALSO SUFFER FROM DEPRESSION/ANXIETY PANIC DISORDER/INSOMIA I AM ALSO ON ALOT OF MEDICATION,FOR DEPRESSION THEY HAVE ME ON /PAROXETINE 40MG DAILY. ,ABOUT 1 MONTH AGO HE TOOK ME OFF CLONAZAPEN 0.5MG AT BEDTIME. EVER SINCE THEN I HAVE DIFERENT MOODS SADNESS CRYING TO MUCH.WONDERING, ABOUT HOW WOULD IT BE IF I DIE WAT WILL IT BE LIKE LEAVING THIS WORLD AND I AM SCARED I HAD NEVER HAD THOUGH SO BAD ALSO FEARFUL BEING AROUND PEOPLE AT STORES.MY OTHER MEDS ARE BUSPIRONE 10MG/TWICE A DAY
ZOLPIDEM 10MG 1 AT BEDTIME-LOTREL10/20MG,HCTZ12.5MG MORNING-GLYBURIDE 5MG DAILY,EC ASPIRIN 81MG DAILY -PREVASTIN 40MG DAILY MOTRIN 800MG JOINT PAIN,TRMADOL 50MG FOR PAIN-HYDROXYZINE 10MG BEDTIME -DEXILANT60MG DAILY.AND THATS ALL THE MEDS I TAKE.
PLEASE I NEED ADVICE DOCTOR.
THANK YOU
 
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Caprice_WebMD_Staff replied to gl93705's response:
Hi Gl and welcome,

Until Dr. Schwartz has a chance to see and respond to your post....

Please tell your prescribing doctor(s) exactly how you are feeling. They need to know that you need more help than you are getting and that you are feeling suicidal.

Are you in regular therapy?

If you ever need help keeping yourself safe, please consider calling a crisis line and get the help you need and deserve.
 
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DonniiDani responded:
Dr. Schwartz what is a safe way to lower yourself on the dosage then? please answer a discussion I posted earlier.
 
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zephyrjude replied to DonniiDani's response:
Donni, You need to go to a doc that knows you and can help you according to your needs. Go to your Psychiatrist if you have one or your primary doctor for assistance. It is better if you not taper on your own. Really.

I have been on effexor and was off a couple days waiting for my meds through the mail. That was a MAJOR downer. Called my pdoc and he would have prescribed something until they came but they arrived. This is not anything to play with.
 
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ripcmw responded:
Dr
You are correct. I have not been on many medications, but the side effects I have experienced because I thought I would just quit them were horrible to deal with so I start back up. In the future, I WILL call my doctor and ask first. Thank you for your advice.
One Day At A Time Where There is a Will, There is a Way
 
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rsagakk responded:
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rufuspooch responded:
Wow! I wish that my doctors had ANY solutions for side effects except to "just try to get through it/ only you can decide if you can tolerate these meds."

Could you suggest a resource on coping with medication side effects???

I agree we should consult our physicians. Mine isn't available on Sundays; no emergency options. I can go to the local ER if I choose, or I can try to make an informed decision on my own.

If my doctors were like you, I'd gladly be more "compliant."
As it is, it is a constant gamble.
 
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Saiola replied to Caprice_WebMD_Staff's response:
That sure is a handy link to have, thank you Ms. Caprice in the WebMD staff!


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