Hain Consult

For those of you interested in knowing, I asked Hain why Effexor works but other SSRIs don’t. (Effexor is an SSNRI but at 37.5 is an SSRI). He said “i don’t know.” He said he’s tried to find out, has asked other people. He said Cymbalta, which is also an SSNRI doesn’t work either. His assumption is that Effexor hits other neurotransmitters besides serotonin.

Those have been my thoughts also, nothing else makes any sense. There are a lot more neurotransmitters than the three big ones. Maybe some day we’ll make use of them. Maybe right now we are!

He also said that it’s okay to take ibuprofen 2-3 times a week but do NOT take it daily in order to avoid rebound. He said it is quite effective and many take it before menses.

Julie

Hi Juie,
I just seen Dr. Hain on 9/5/08 and he prescribed Effexor for me too, how long have you been taking it and have you noticed a decrease in your headaches? do you have dizziness or off balance feelings also that Effexor may help with? How many mg’s do you take daily? He prescribed 37.5 mgs but wants me to start out at 1/2 capsule for one week and then 2/3rd’s capsule for one week and then the full capsule there after… just wondering how it has worked for others?

He also prescribed SERC and I did just receive that from a canadian pharmacy, problem is that I haven’t been able to start the Effexor yet as my pharmacy is waiting for a pre-auth from my insurance before they can fill it and Dr. Hain wanted me to be on the Effexor for a month (if toleated) prior to starting SERC. have you tried SERC? full of questions I know but I would be very interested in getting some feedback. Thank you.
Gina

HI Gina,

37.5 of Effexor didn’t do a thing for me so he went up higher in the new improved form of Effexor = Pristiq, which is actually a metabolite of Effexor, meaning you get right to the middle man. I forget who manufactures Effexor but their claim is that it comes without all the Effexor problems, but i have the feeling that the real reason they came out with Pristiq (catchy name, right?) is because the Effexor patent is about to run out. Anyway, he gave me a slightly increased dose of Pristiq. I’ve been on it for a week and I will admit to some improvement. And any improvement is good, no matter how little.

At this point I’m on Neurontin, Topamax, Pristiq and Klonopin. Only three of those are preventatives and all three of them have been helpful, mostly the Topamax. His next move with me will be verapamil. Wouldn’t it be funny if, after all these ACs and ADs, little ole verap does the job? funny? not! :slight_smile:

Anyway, there have been members of this forum who have had success with Effexor in a short amount of time after reach 37.5, just like I did with Pristiq, within a few days, i felt the improvement.

Serc, no, that was never offered to me.

Good luck and keep in touch about how things go for you.

Julie

Julie, thank you for the information, I really appreciate it. Dr. Hain just prescribed me normal Effexor, he never said anything about an upgrade of effexor like Prestiq… interesting… but i imagine he would like me to start the regular Effexor and see how I do, and with him having me start it at such a low dose to make sure I don’t have side effects (sensitive to drugs) then I’m sure that is why he did it this way. I tried Topamax and although it helped with the headaches it did nothing for the every day constant off balance rocky boat dizzy feeling. After 6 weeks I had to go off of it because of added brain fog, i was a zombie. I now take Acetazolamide/Diamox, Klonopin, and allergy asthma meds so I’m not sure how I will do with the Effexor, he said to just add it to the drugs I am already taking, Acetazolamide is suppose to help with migraines too and I have noticed that it has but again… nothing with the other symptoms of dizziness, etc. He also wrote a script for the Verapamil and I guess he wanted me to try that if the Effexor didnt work? or maybe he wanted me to add that to the list too? I’m going to have to email him and ask again as I cannot remember.
I have the SERC but haven’t started it, we will see what happens once I get the Effexor filled if my insurance will get off their butts and decide whether or not they are going to cover it. I will keep you posted. …thanks again.
did you have daily dizziness/off balance or rocky boat feeling before meds? if so, do you still or do you think one of the meds are helping with that? if so, which one, hard to tell i imagine. take care
Gina

Gina,

The reason Hain decided to switch to Pristiq is because he thought my liver might not be metabolizing the Effexor to the metabolite that hits the MAV - thus Pristiq 50 mg instead of Effexor 37.5 mg. He started you out on Effexor 37.5 because he’s hoping to stay as low as possible. he would be thrilled if you found yourself well before you even hit the full 37.5 mg.

We have over-excitable brains - we’re all overly sensitive to medications - he titrates everybody up on Effexor that way.

I would email him about the verapamil but I would be real surprised if he wants you to try Effexor and verapamil at the same time. If you get well, how would you know know which one is working? He gave me two prescriptions also, but he gave me instructions to take the Pristiq for a month, then increase my Topamax and stay on that for a month (i’ve had great improvement with Topamax, just not enough, i’m at 100 and he really hates to go higher). Next he will add verapamil, but he wants to talk first.

Yes, the reason I’m taking preventatives is not because of migraine headaches, but because of MAV. Every one of my preventatives has helped some: Neurontin, Topamax and now Pristiq. Each one has given me some relief. It will be interesting what the verapamil will do, if i ever get to that point. But I’m still rocking. I still get too uncomfortable after driving to be able to do it except to go out to doc appts. So i’m basically home bound. I do go for a couple of long walks a day - about 45 minutes each.

Keep us posted,

Julie

Julie, thanks for responding… I do believe you are right that Dr. Hain wanted me to try the Effexor first before the verapamil to see if that worked, if so then great but if not then I imagine he would either have me add verapamil to the effexor and other drugs or have me d/c the effexor and try the verapamil and see what happens. I just can’t start the effexor yet as i still have been unable to fill it due to the insurance pre-auth. I emailed Dr. Hain’s office again today asking what is going on and to get back to me but I have not heard anything, then I emailed the receptionist and asked her to check also but again…nothing… I am getting so frustrated as I have been trying to fill the Effexor since 9/8/08 and it still isn’t filled yet.

I did receive my SERC but can’t start that either until I try the Effexor… but every day that goes by is another day that I have to live with this constant off balance, rocky boat feeling and I just want to try this medication to see if it will help me or not… I’m not sure if Effexor has the capability of helping with the dizziness and rocky boat feeling but I know Dr. Hain wanted me to try it for the migraines and then said to add the serc later as the serc is the one he thought could possibly help me with the rocky boat and dizziness i have each day. I don’t know what to do, I feel like I can’t get anything moving because I am tied up waiting on this effexor.

I know I asked you this but do you take serc? I can’t remember if you said you tried it or not… i’m sorry. thanks again
Gina

Gina,

I know how frustrating it is - you want relief SO BADLY and you want it now!

And insurance companies are outrageously impossible to work with and the decisions they make are insane. how could they NOT precert this? Well, they could not. It’s all in their hands. Let me tell you something, the Pristiq is working on my dizziness and it’s working really well!!! Probably better than even Topamax. So hang in there. I’m not going to tell you to be patient, but hang in there, because it just might be worth the wait.

No i don’t take Serc - it was never offered to me.

I really can’t imagine he would want you to try verapamil until you’ve given Effexor a good month, that doesn’t make sense to me, but you need to check with him. His front desk is incredibly disorganized. Email him directly. Do you have his email address? If you don’t, i’ll dig it out.

So when it comes to Hain’s front desk, the person you want to ask for is Monica. She’s the person who will get the job done.

And hang in there, i have the feeling you are going to get well.

Julie

Julie you are right and I just need to try to get that effexor filled. I emailed the front desk one more time demanding that someone takes care of this that it has been over 2 weeks that I have been trying to get a prescription filled and that it was unacceptable and Monica responded thank god. she said she has to give it to one of the medical assistants and was going to double check herself what is going on, I told her that I have spoke with Mark and he was handling the pre-auth but nothing was getting done and i’m sorry to say but Josette isn’t much help either… TOTALLY DISORGANIZED front desk ppl and Monica does seem to be the only one that can get anything done. It is a shame that a doctor as good as Dr. Hain has such poor staff running the front area, I wonder if he knows how patients feel about it and that it relfects on the whole office. I know this, if he wasn’t such a good doctor and knew his stuff I highly doubt I would return and i’m sure that is what keep his practice going because it certainly isn’t his staff up front.

i am so glad to hear the prestiq is helping with the dizziness… god i I could only have that! its terrible and i hate living like this… constant rocky boat feeling and off balance, it is so hard all the time.

well, I will let you know if I should hear back regarding getting the prescription filled, keep your fingers crossed! thanks again.
Gina

Heh, the most common (30-50%??) side effect of Pristiq seems to be nausea, which happens to be, by far, my main complaint. Guess that’s out. :stuck_out_tongue:
(It’s not approved over here anyway, in fact the substance wasn’t even listed in the official database (which is maintained by, pretty much, our FDA).)

Besides, I don’t think my body enjoys serotonin boosting very much. I actually had serotonin syndrome just last week (mostly over now) from adding a new med. :shock:
Slept 0 hours the first night, 3 hours the second, and felt like TOTAL crap with 120-130 heart rate, raised blood pressure (20-25 points), severe anxiety, nausea… etc, 24/7! Mostly Wed - Saturday, but it started last sunday and isn’t 100% over (or so I hope, since I want these last symptoms to go).
Damn horrible stuff!!! As if that wasn’t bad enough, I managed to get a benzo script (the preferred “treatment”) AFTER the worst was over. Arrrgh, damn slow doctors. For obvious reasons (MAV) I really didn’t want to go to the ER… And even if I managed to actually get there, there would be fluo lights everywhere and I can literally not stand those for 20 seconds.

Sorry for the OT, but hey, that’s the rule rather than the exception at this board anyway. :mrgreen:

Tran,

I’m sorry about your serotonin syndrome. Danger and hell all wrapped up in one lousy brain-zapping package. Glad you’re back here with us.

And you’re right OT is the way to go on this forum, hey?

Julie

— Begin quote from “Ginamc”

i am so glad to hear the prestiq is helping with the dizziness… god i I could only have that! Gina

— End quote

Gina, you do have “that!”

Pristiq is the major metabolite of Effexor. Hain gave it to me thinking that Effexor may not be doing anything for me IF my body wasn’t metabolizing it well enough. the other possibility could be that i just needed more, but he usually sees SOME improvement at the lower doses before going up. Who knows. All I know is that it is definitely helping because I’m needing less Klonopin, consistently. I’ve had days before where i’ve needed less, but i’m talking daily.

Does all that make sense Gina?

BTW, glad you got through to Monica. Always ask for Monica. and never hesitate to call Hain’s office over and over and over again. Never worry about considering yourself a pest. You’ll die waiting for them to do anything they said they were going to do.

Julie

HI Julie, the information you gave was very helpful… and guess what?? I got the Effexor filled and I started the low dose this morning, I am to take 1/3 capsule for a week, and then 2/3rd’s capsule for a week and then the full capsule of 37.5 mgs there after… I pray that this will help me and my migraines, would be nice if it would also help the constant dizziness and rocky boat feeling but I’m not sure if Effexor will do that… maybe the SERC will but I can’t start that for a month so I’m not starting two meds at once and getting side effects and not knowing which one is giving them.

I’m sorry to hear about Seratonin sp? syndrome that you went thru, I hear that is awful… what med did you start that had the drug interaction? I also take Replax for my migraines as a rescue med and was told that could have a severe side effect because of the increase in Seratonin… so I’m no sure what to take if I get a migraine again.I have a call to my Neurologist who prescribed the Relpax to ask them.

I’m really hoping I don’t have any bad side effects from the Effexor, I took the capsule at 10am this morning right after I ate and so far I’m fine but it’s the very low dose so I don’t know if I would have a side effect from that low of a dose or not. I guess we’ll see. Thanks again for the feedback, I’ll keep you posted… at least I got the effexor filled finally!!
Monica does do the job and she is the one I will deal with in the future. Hope you are feeling better.
Gina

Oh geez, I just realized that it was Tran that went thru the Serotonin syndrome… I’m sorry about that… my brain isn’t functioning!! TRAN - I’m sorry to hear about that, hope you are feeling better!!! thanks for the info too, I appreciate it!

Julie, thanks again and I look forward to any additional posts !
Gina - let me off this merry go round please!

— Begin quote from “Ginamc”

Oh geez, I just realized that it was Tran that went thru the Serotonin syndrome… I’m sorry about that… my brain isn’t functioning!! TRAN - I’m sorry to hear about that, hope you are feeling better!!! thanks for the info too, I appreciate it!

Julie, thanks again and I look forward to any additional posts !
Gina - let me off this merry go round please!

— End quote

Hi Gina :slight_smile:
I was on Remeron (mirtazapine) and amitriptyline, both at low doses, since long back; June 2007 and Feb 2008 respectively. Last week “I” (my doc) added metoclopramide (“trade names including Maxolon (Shire/Valeant), Reglan (Wyeth), Degan (Lek), Maxeran (Sanofi Aventis), Primperan (Sanofi Aventis), and Pylomid (Bosnalijek)” - wikipedia) prn for nausea due to migraine, which seems to have triggered it all. Incidentally, I think, I took my first dose of verapamil the same day it turned to hell, but I think that’s unrelated… still off that until I talk through this all completely with my doc next week, though.

Interestingly, by the way, my visual sensitivity symptom was off the scale during this all, which simply adds fuel to the fire regarding my idea that high serotonin causes all this crap for me. I really need to get off the meds and try another one!

Gina,

I don’t get headaches, it is the rocking that Effexor AKA Pristiq has helped rid me of ! :slight_smile:

Good luck! I started to feel relief after about 4 days, and each day just got better. I think i leveled off after about a week, well, it’s a week now, so who knows if i’ve leveled off :slight_smile:

Julie

PS Don’t worry about the mix-up. I can’t keep anything straight either.

Julie are you serious about the rocking sensation!!?? that would be wonderful if so! that is exactly what I am trying to get rid of, but I do get the migraines too so I thought he prescribed it for the migraines only and then the SERC was suppose to help with the dizziness??? but im not really sure.
I took such a low dose today that I really wont’ notice a difference yet, I really hope I can tolerate the effexor so it may help with my rocky boat feeling. ohhh i pray it works for me!!
Gina

Gina,

Hain also claims that some people get well at less than 37.5 mg, which is another reason he titrates so slowly. He wants to give you a chance to stay lower than the full dose. You’ll know if it happens :slight_smile: But you should know, i’m still rocking - i have not had completely relief - yet. It’s only been a week. He told me to give it a month. If i need more help, he’ll either increase my Topamax or add verapamil.

I think Joy said that Effexor helped with the dizziness but not the headaches. And others have said the same sort of thing. If so, he’ll just add something else. I’m glad for any improvement I get and then on to the next. One step at a time.

Julie

Julie, I sure hope it works for me! god would that be nice… I am on day two of 1/3 capsule of effexor and no side effects as of yet so I hope that I won’t get them as I increase the medication, I will start with 2/3rd’s capsule in a week and then the whole capsule after that.

I am just praying it will help the rocky sensation and/or the dizziness I have with these migraines! thanks again.
Gina

Gina,

You’re supposed to give Effexor a full month before doing anything else, correct?

Julie

Julie, yes as far as taking any other medications… I am to wait about a month to let this one get in my system and see how I do, and then start the SERC if needed, the SERC was to help with the dizziness, etc but we’ll see how I do on the Effexor. I have a headache today and I’m hoping it’s not the Effexor causing it as it is suppose to help with migraines and stuff but it could be an adjustment period that I am going through too. I will keep you posted… it’s such a low dose of Effexor right now that I’m not sure if I’ll get the rocking boat feeling to go away until I up the medication … we’ll see how I tolerate it as I go along.
Gina