my favorite commercial http://www.starterupsteve.com/swf/OVOID.html

I second that using Prozac as an adjunct when going off of Effexor helps tremendously.

I can't watch the Cymbalta ads because of the tone of them; the music, the colors, and the grainy quality of them...if I wasn't depressed already, looking at the damn ads would make me.

I went through withdrawals from Effexor (a very high dose). I wish I had known about using Prozac to ease the transiton. I didn't think the vomiting and diarrhea would ever end, not to mention what it did to my head. It was hell.

Just found this site. Have been hoping for a long time to get off effexor. Any good reasons why and how?

Look, what you've written about STAR*D is totally inaccurate. There were two measures of remission in this branch, and results in the two varied among the three drugs studied. Effexor actually was quite a bit better than the others at the primary endpoint, and lagged only slightly at the other.

Moreover -- and this is extremely important -- the differences in efficacy among the three drugs were not statistically significant. I.e., the differences perceived weren't great enough to assure us that they weren't due to random variations in the particular patients studied. You could run the whole protocol again with a new patient group, picked exactly as this one was, and get different results. This study did *not* show a difference in efficacy among the three drugs in this setting.

As to "stunningly poor performance": again, no difference was shown among the three, so there's no reason to single any of them out. And there was no placebo group here, so we don't know what the results would have been in a similar patient group treated with nothing at all. Without treatment, the remission rates might have been 0. And after previous treatment failure -- especially with depression as severe and treatment-resistant as that studied in STAR*D -- give me 25%. That's one patient our of four in remission, and we try something else for the other three.

What's just starting to appear in the literature is the idea that all depressions are not alike; each person's depression may reflect a unique imbalance in the neurotransmitters that regulate mood. So each antidepressant may have particular efficacy for a certain type of imbalance. This means it's possible that in this mix of depressions the three drugs -- which belong to different classes, with different mechanisms of action -- simply balanced themselves out. Recent preliminary work has suggested a way to characterize the imbalance for each patient, and choose an antidepressant accordingly. We'll start to see marked differences, and much better outcomes, once we've learned how to match drug to patient.

You should know that there's a whole system of people in place who check pharma ads for accuracy -- agency people, pharma people, government people. There was no deception here. You were right to read the study for yourself, but *please* read it carefully.

The practice of direct-to-consumer marketing by BigPharma is a deceptive and manipulative practice. So is the way the drug companies spend a great deal more on advertising than they do on R+D. So is the recent manipulation of Congress in the Medicare prescription drug plan so that Medicare wouldn't negotiate to bring down drug prices (the way the VA does). So is the tendency to make "me too" drugs that are sure to make money, rather than spending more effort developing new sorts of drugs. So is the slight manipulation of molecules (e.g. the s-isomer) to produce slight variations on a theme so that a new patent may be established and more money may be made on a drug that really isn't a new drug. And, most of all, so is the practice of fighting the production of generic AIDS drugs abroad (and more generally fighting to put profits above lives in the poorest countries).

Big Pharma is an insidious industry. Its hands are covered in blood. It's not as bad as Big Tobacco, or Big Oil; but it's in the same family. Do a Google Search on "Big Pharma" and have a look at how the drug companies behave. *Then*, with respect to this Wyeth ad on TV, ask yourself, "Now, are these the types of companies that would act in a deceptive manner?"

We all need to raise hell with our Congresspeople to reign in this industry.

Dr.D

p.s. Prozac has been used for Effexor discontinuation symptoms for 10 years now. It does a really nice job with them.

MD-great comment.

I am disgusted with the Pharma industry; and I am not so sure it can be considered a lesser evil re: Big Tobacco or Oil.

Psychiatric medications are far more dangerous than a drunk Captain creating a mammoth Exxon annihilation of Prudhoe bay.

Psychiatric medications can cause death, and permanent brain damage, alongside diabetes and other health concerns. They are prescribed to millions of people, and off-label uses are increasingly placing more people at risk.
Medicating of children on these potent chemicals is risking a complete annihilation of generations of people who could end up living as walking [or dead]examples of just how corrupt the Pharma industry is, and at the expense of our lives, to make a buck.