Sorry I sold Effexor XR

[ARTICLE]

For the last four years, I had been on Effexor XR prescribed to help
with my anxiety disorder. Not only that, I sold Effexor XR for three years and rather successfully because I believed in the product. For the last
two and a half years, I have been displaying hypomania symptoms that have gradually increased such as extreme wrath, unable to let irritations go, nightmares every night for 2 years except for four nights, immobilization (would sit and would continually think, but failed to act), pathological lying- although no hypersexuality, violence, or stealing. All this time, I thought it was me; that somehow, in my thirties, I had some developmentally delayed bipolar/mania- I did not have any manic tendencies as a teenager, but I do have an addictive personality (genetic legacy, not abuse), OCD, and am ADHD.

I've noticed that articles comment on the .5% mania in phase II trials
of Effexor XR. But, having sold this drug, the study notes that it
"triggers" mania, not that it causes the disorder. Most people do not realize that
this terminology is specific to mania/hypomania already inherent in a person rather than chemically inducing the disorder. Only Wellbutrin has such a labeling within their package insert (dopamine). Also, there is no
related
labeling to increased drinking and/or drug abuse on Effexor XR
although, in my humble opinion, such usage is a patient's way to self medicate or counteract the manic symptoms of XR. I don't drink alcohol, except occasionally and within moderation due to my inherent addictive
personality, but I did receive a prescription for marijuana (for my panic attacks, a recent phenomenon, rather than the habit forming Xanax) and would smoke mj until the anger/wrath/irritability would diminish. If not, I would revolve in a suspended state of irrational emotions unable to do even the simpelist of tasks like eating, bathing, brushing my teeth, etc, never displayed such behaviors prior to Effexor XR- I'd stop for weeks and months, yet I would worsen.

If my "fight or flight" system was tiggered by fear or anger, my body
would feel the noradrenergic effects for not only hours, but days, weeks,
months and in some instances, years. Unfortunately, I thought, it was me. I was broken. That, this is it, I need to be checked into a mental
institute. How can I be so angry and irritable with everyone including myself when I've never held a grudge for more than 36 hours in my life? The tricky part was that most of these "symptoms" were traits that I already carried; on effexor, though, it was magnified with the exception of immobility and suicidal tendencies. It wasn't until my best friend of 12 years, who also has an addictive personality and ADHD, confided in me (she didn't tell me before because I sold XR and after Wyeth, my listening skills were below par) that when she was on Effexor XR, she stole (she's never stolen in her life), flunked out of college, pathologically lied, etc., but rationalized these behaviors. Because I've known her so long, I knew how counterindicative these behaviors were to the core of her personality. For the first time in 2.5 years, I clung to a new hope that maybe, this "mania" wasn't me.

I began to ask myself, "born hyperactive, I already produce extra
norepenephrine, which manifests my anxiety disorder. In addition,
every human produces extra norepenephrine when their 'fight, flight, or
freeze' syndrom is activated. So, if Effexor XR blocks my reuptake valve, which is the only means for the brain to rid itself of excess chemicals, then where are all these extra endorphines going?" Nowhere! that's the problem.

Needless to say, I began to wean from Effexor XR (225mg). However, at
75mg, I had to quit cold turkey. Why? Because, my mother, a psychologist and my best friend, was told that I had been smoking marijuana and cut me out of her life. That's what you do to addicts, but the addiction wasn't marijuana, per say, it was Effexor XR- note for the record, although I know marijuana is not physically addicting, it is mentally addicting so I confided in my friends and my sister about my usage as a form of monitoring,
when approached that my smoking was excessive, I stopped the next day.

Because of the mj revelation, my family refused to speak to me, which
is the first time ever. I fell into a serious state of despair and
loneliness. I have never attempted suicide in my life and even if I had a fleeting thought, it was for attention not for success, yet on June 4, 2007, I marked the date of my suicide. With forethought rather than impulse, I began making arrangements for a successful death, unbeknowst to all those around me. Fortunately, while waiting at a friend's house with my valuables to be placed in their safe the night of June 3, 2007, it occured to me that suicide is extremely common for those with mania/hypomania.

I began to pull up articles and behavior of suicide/mania within my memory (I have a photographic memory). That night, despite this utter desire to die, I returned home with my possessions and quit effexor xr right then and there in order to see if this desire stemmed from me or from Effexor XR.

I knew the withdrawals would be painful. I sold the drug and never
disputed the severity of the withdrawals. And, yes, they hurt, but not as much as that deep desire to die. On June 5, 2007, I awoke from a nap no longer yearning death, but also, for the first time in 2.5 years, I wanted to live.

I'm still undergoing extreme withdrawals: not just excessive
sweating, but sopping wet type of sweating, electrical shocks, bizarre tingling in my ears and all over my skin, most especially in the face/neck region, insomnia, weeping, etc.

On the flip side, I'm motivated, no longer wishing to die, wanting to
date (4 years since I last dated), my anger/wrath disappating, irritability
gone, actually lost close to 10 pounds(serotonin effect? Didn't gain weight
from Effexor XR, but dropped to one meal a day in order to maintain it),
bizarre ticks that developed about 3 years ago like peeling off my skin on my face and creating boils on the crux of my ear/neck evaporated, the desire to care for my appearance has returned, isolating myself has disappeared, no longer
rationalizing my lying- so embarrassed by this one, etc. After only a
week, I would rather have withdrawals the rest of my life rather than go back to that black pit of destitution for one moment. The thing is that if I
didn't quite June 3, 2007, I know unequivocally that I would have killed
myself, which I believe, personally and spiritually, is a complete cop out.
I'm so thankful that I didn't because it would have broken my parents' hearts and they have already beared my burdens long enough- I can't believe that I didn't/couldn't take their feelings into consideration.

I have so many amends to make with the people who were effected by my behavior. I feel a tremendous sense of guilt for my reactions to my
family and friends, even strangers who felt the brunt of my irrational wrath- so much negative energy. Nonetheless, I feel incredibly fortunate to have the support system that I do with my family and friends. I can't believe that they stood by me through these years. I never would have made it these last two years without them, especially considering that within seven hours of my mother not speaking to me, I had tactically planned my suicide. I can't even imagine all those souls who do not have my good fortune of such a remarkable support system.

I don't know if I will ever get back to the loving, kind, positive
person that I was, but at least, I know that I might. I'd rather have my
simple anxiety disorder than experience what I have over the last two years. My heart goes out to all those who are still enduring it- plus, I have a whole new empathy for those who have inherent, organic bipolar. My greatest fear is that my successful sales (transformed the territory from last in the region to first) may have caused doctors to prescribe Effexor XR to someone who is now enduring the same dark abyss that I was in for so long- may God forgive my ignorance.

The following is by no means an expert opinion; simply, nuances that
I've observed over the course of the last two years. Inherent organic
bipolar and this Effexor XR induced mania do appear similar, but there are some differences: one, unlike most bipolars, xr mania does allow
forethought, yet rationalized versus the dopamanergic effects that do not allow bipolars to even think about their actions much less rationalize them; two, there is cyclic behavior like bipolars, but XR mania will worsen situationally (noradrenergic) whereas, true bipolars are discernable because their behaviors do not always correlate with their situations (psychiatrist explained the bipolar's inconguity of behavior and environment); three, I never felt any "high," heightened enthusiasm like those with excess dopamine, simply a heightened intensity to my wrath/irritability; four, the low of the Effexor XR mania was regret/shame rather than sorrow and lethargy of "depression." As I'm to understand it, organic bipolars, for the most part, do not feel regret and apologetic for their actions until they are on a mood stabilizer- To boot, what I experienced as "immobilization" was not the same as lethargy; it would be more like the "freeze" aspect of norepinephrine like a suspended state of post traumatic stress; I would mull over what upset me for ridiculous lengths of time, in some instances, for years.

Of course, I'm not a professional doctor or a scientist, but I did take
detail notes several years ago (I've always kept journals) and began to
research bipolar when people remarked on the uncanny resemblence of my behavior to mania. These four nuances did suspend my state of
disbelief for the last 2.5 years and may help professionals discern between inherent bipolar and chemically induced mania. I know they are slight, but a psychiatrist/psychologist or a neurologist may be able to detect these differences in patients. Also noteworthy, Paxil is the only ssri that does block the norepenephrine reuptake inhibitor at high doses like Effexor XR, Cymbalta, and Wellbutrin and this is the drug that incited the "suicide risk" in antidepressant labeling.

I thought that my story and experience both personally and
professionally may help others like me. I have created a my space account, in which I will blog this experience, publically, which would be a success even if it helps only one other person. I seek your permission to add your web link to my blog posting so that others know that they are not alone, for I know without a doubt that they feel as isolated as I did- the cocktail for successful suicide.

Many thanks for being perceptive and concienctious enough to advocate
for all those poor souls! If there is any information that I may provide
about my personal or professional experience, I'm at your disposal. I must add that I'm not completely against the advocacy of antidepressants or even Effexor XR, yet I do believe that such prescriptions should only be prescribed by mood disorder specialist instead of family practice/general practitioners who prescribe 70% of the total prescriptions of antidepressants in the U.S.- Wyeth marketing and where I received my prescription.

Sincerely,

Jacqueline (Jacqueline has given us her full name but we felt it best to withhold it)

PS- my apologies if I'm not that articulate. I hope this makes sense,
but with the withdrawals, I've had incredible cloudiness with my thoughts.
Kind of embarrassing considering that I have an English Lit degree from
Berkeley.