Date:   3/16/2011 9:55:35 AM ( 13 y ago)
Hits:   5,675
URL:   https://www.curezone.org/forums/fm.asp?i=1784381

Good morning Tricia (everyone) -

Effexor withdrawal - yep, from everything you've posted, it appears that's what you're experiencing.  The first thing you want to do right now is to get stabilized and out of the 'withdrawal tsunami'.  The best/fastest way to do this (since the capsules aren't breaking down/assimilating) is to open the capsule/s*** and mix it/them with something like applesauce and eat it like that (do not chew the tiny pellets, as some of them may be time-released).

Your prescription of 300mg daily is very high.  And you've already reported seeing a few whole capsules in your stools...which means you're likely experiencing very harsh withdrawal symptoms right now.  So the first question you need to answer is (from ***):  how much do you want to take (and how much will it take) to stabilize you...or stabilize you to a point you can live with the symptoms?

Options:

--It's possible that taking less than the 150mg 2x daily would do the trick (now that you're in a major deficit situation), and stabilizing at a lesser dose thatn 300 mg would be great (if you could pull it off).  To do this, instead of mixing the contents of a full capsule with applesauce, you'd mix a measured percentage of the contents of the capsule (say 75%)...and take that 2x daily, rather than taking the full contents of the capsule twice daily.  From a case report shown here: http://www.antidepressantsfacts.com/effexor.htm  :

CASE REPORT - A 51-year-old male developed severe nausea, anorexia, dizziness, unsteady gait, tinnitus, and a bitemporal headache 72 hours after rapid reduction of venlafaxine therapy, 300 mg daily. The symptoms resolved completely after reintroducing venlafaxine at 75 mg daily. The dose was then tapered off slowly without any adverse effects (Macbeth & Rajagopalan, 1998).   ...so it's possible you might be able reinstate with much less than the 300mg daily (especially since with the 'open capsules' you'd be sure to be assimilating what you do take).

--On the other hand, since you are in a deficit situation, you may may need each every little pellet in those two 150 mg capsules to 'stabilize out' of the deficit/withdrawal.

Since I'm not experiencing what you're experiencing right now, I can't say (for sure) exactly what I would do.  But I do know that unless I was 'seriously in the red', I'd likely try the first option for 24 hours...and if that wasn't enough to 'get me out of the red' in 24 hours, I'd do the full amount the next day.

So my suggestion at this point would be to take either 3/4 of a capsule or full capsule (mixed with applesauce or some type of juice) as soon as you see this/in the am) and then take another in the evening...and continue taking the Effexor 'out of the capsules' for the duration of the withdrawal.  It is essential you regain (and consistently maintain) a stable plasma/blood level of the drug to withdrawal with the least amount of symptoms.

***

Withdrawing from Effexor 

'First thing on the "to do list", familiarize yourself with ALL the known adverse-effects of taking the drug and the various withdrawal effects & issues. As you read/scan through the data below, you will likely find that many of the issue/symptoms you are experiencing are not really "your body's"...they're the effects of taking Effexor (and especially taking

Now that you know that you likely haven't been assimilating the Effexor consistently, you can assume there have been many times when you've been experiencing symptoms of withdrawal that you may have erroneously assumed have been caused by something you ate, candida, or other issues.

Tricia, my computer is locking up (it's taking FOREVER just to type one sentence...I just need to close all these windows/tabs and reboot).  But, I've got towo other open posts to finish up real quick and then a couple of hours of pressing things I have to do around here.  Then I'll be back to finish up this information (about how to withdraw, the half-life issues, and the possibility of switching to Prozac).  Be back soon to finish - Uny

Switching to Prozac (from here: http://www.bipolarworld.net/Phelps/ph_2005/ph1354.htm )
Greetings Dr. Phelps!

I have been reading that antidepressants can cause rapid cycling in bipolar patients and additionally, that the medication Effexor XR has a difficult withdrawal effect upon its discontinuation.  My question therefore is:  What is the most best method of Effexor XR withdrawl and what is the most successful treatment program you have seen for those who suffer from BP II disorder?
Thank you

Dear Jonathon -- 
Effexor XR has definitely been the one that my patients seem to have the hardest time stopping.  It's almost as though their degree of bipolarity predicts how much trouble they're going to have, and women with bad mixed states and rapid cycling seem to have the most trouble. Looks like you have one thing going for you in that respect so far, if I'm right about any of that (i.e. being male). 

You may have heard or read about the so-called "Prozac bridging" strategy.  As I recall this is described in some detail in Joseph Glenmullen's book, Prozac Backlash (lots of accurate stuff in there, and lot's of overstating too, in my opinion). I think he has nearly a whole chapter on it, by the title of "Held Hostage", one of his frequent phrases therein. Here's a short version of this strategy (somewhat to my surprise, I cannot find a good link on this; there probably is one out there somewhere). But I've wanted to write this down where I can get at it, so here goes....

Serotonergic antidepressants all have been shown to have this problem of "withdrawal". To my knowledge, there is no well-researched explanation for it (plenty of guesses and hand-waving explanations regarding serotonin receptors). People get all sorts of strange symptoms, usually within 24-48 hours without a dose of one of these antidepressants.  Dizziness is one of the most common; others include pins-and-needles sensations in hands and arms; "electric shock" sensations (Glenmullen describes one patient who was convinced a loose wire had fallen into the swimming pool where she was working out, and yelled at everyone to get out quick!); flu-like symptoms such as nausea, headache, weakness, low energy, even runny nose; and emotionality, including easy tearfulness, depression, anxiety, and irritability; and sleep disturbance with unusual dreams. 

Most antidepressants, like most medications have "short half-lives".  This is the official term to describe how fast a medication leaves your bloodstream after you stop taking any further doses..  The time it takes for your blood level to drop by half is "one half-life". For example, consider a medication with a half-life of 24 hours (rather long; many are a little shorter, closer to 10 hours). If take your last dose Monday morning, by Tuesday morning your blood level is now half of what it was (say, measured at noon on each day).  Ah, but watch closely now, here's the important point:  each day after this, your blood level falls to 1/2 of what it was the previous day.  So, in this example, by Wednesday at noon you've dropped to half of Tuesday noon's level.  Note that you're now at 1/8th of where you started. Keep going with this math, and you can see that on Thursday you're at a sixteenth of your original dose, on Friday 1/32nd, and so forth. 

In general, we figure about "five half lives" and there will be so little left, we can call it zero. Why all this fuss about half-lives? Because it leads us to Prozac as a solution to "withdrawal" problems:  Prozac has a half-life of a week! (I'll be using the term Prozac here, because if you write it 20 times it sure is easier than "fluoxetine", the real name, that is, the generic name and the name under which you can get it mighty cheap, compared to brand name Prozac).  It is removed from the bloodstream very slowly -- so slowly, it takes a week to get rid of half of it!  Then, by using our "five half lives" rule, we can figure that Prozac will take over a month to go slowly away (5 weeks to get to 1/64th of the original). 

Thus, Prozac is generally assumed to "self-taper": it does not require careful dose reduction as we would do for Effexor, where I'll often take a month or often more to come down by 37.5 mg steps (the smallest practical step possible). So, the trick is to put these two strategies together. We lower Effexor to the point where one is taking only a single 37.5 mg XR pill per day.  From there, it's that last jump that usually causes all the trouble for people (if one goes slowly enough, getting down to that point is usually not too much trouble, although often people start to notice each step down once they get below 150 mg per day; those that do are more likely to have trouble when they make the last jump to zero). 

Instead of shaving some of those little beads out of the capsule and then trying to reassemble it; or dumping all but a small portion of it on applesauce and consuming them thus, which are alternative strategies for gradually lowering the dose from 37.5 mg and which have not generally worked very well for my patients (I'm not clear on whether that's because it's too much fuss, doing this over weeks; or because they get tired of it and jump to zero and end up getting the symptoms they were trying to avoid), we use the "Prozac Bridge" to zero. After at least a week on 37.5, longer if it's been rough getting there (and if the reason we're trying to take it out isn't too horrendous to force the whole thing to go faster), one stops the Effexor entirely and substitutes in its place one dose of Prozac at 20 mg. (Some doctors use two doses of 10 mg, one each day for two days; or two days of 20 mg for people who have had a lot of trouble and might need a longer bridge.) After that, no more antidepressant, and we just wait for the Prozac to gradually go away over the next several weeks. Since the "pile" of Prozac we built up in the bloodstream is much smaller than the levels one gets to after a month or more of 20 mg daily, this whole thing really does not take the 5 weeks to get to very low blood levels. You probably get there in a week or two, but some will still be lingering for weeks, just a tiny amount. 

Many of the folks I've tried this with (about 20 times total, I'd guess, over the last 5 years or more) have still had withdrawal effects but they were much milder than they had when they tried to jump to zero without the bridge. Two or 3 people have had such severe withdrawal symptoms, despite the bridge, that we ended up using 10 mg of Prozac every day for a few weeks. The, again using that long half-life to advantage, they gradually lowered it from there, by taking out one pill per week: first take it every day but Sunday; next week every day but Sunday and Wednesday; next week only Monday, Thursday and Saturday, and so forth each week until only taking it one day a week -- and then finally stop.  Everyone has been able to get off that way without too much struggle with withdrawal symptoms. 

There: that's the very long answer to your question.  Remember, don't try to do this on your own without your doctor knowing what's going on. I wrote this all out so that you'd know what the strategy looks like, not so you can do it yourself.  To do this on your own will seriously undermine your treatment, as your doctor will no longer be able to interpret your symptoms or give you proper guidance. And besides, she'd hate me.  So, please do not use this information to go around your doctor's intentions.  You'll be better off in the long run being up front with your plan, even if she doesn't agree with it: "I'm going to stop this stuff..."  Then she gets a chance to participate in the decision-making, which is both fair given the energy she is putting in to this, however minimal it may be if she is as busy as some doc's can get; and also a good way to get a good outcome in the long run, better than trying to run the show by yourself.  End of that little sermon.  

Good luck with your next step, Jonathan. (As for "treatment program", you'll see my general outline/recommendations on the Treatment page which you reach by starting  from here.). 

Dr. Phelps

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Another site with some decent info (although the recommendation of cutting 37.5mg per day/week wod be WAY too fast for most): http://www.crazymeds.us/effexor.html

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From the Effexor website, Physician's prescribing information (.pdf file) from here: http://www.effexorxr.com/medication-guide.aspx

DOSAGE AND ADMINISTRATION

Effexor XR should be administered in a single dose with food either in the morning or in the
evening at approximately the same time each day. Each capsule should be swallowed whole with
fluid and not divided, crushed, chewed, or placed in water, or it may be administered by carefully
opening the capsule and sprinkling the entire contents on a spoonful of applesauce. This
drug/food mixture should be swallowed immediately without chewing and followed with a glass
of water to ensure complete swallowing of the pellets.

Initial Treatment
Major Depressive Disorder

For most patients, the recommended starting dose for Effexor XR is 75 mg/day, administered in
a single dose. In the clinical trials establishing the efficacy of Effexor XR in moderately
depressed outpatients, the initial dose of venlafaxine was 75 mg/day. For some patients, it may
be desirable to start at 37.5 mg/day for 4 to 7 days, to allow new patients to adjust to the
medication before increasing to 75 mg/day. While the relationship between dose and
antidepressant response for Effexor XR has not been adequately explored, patients not
responding to the initial 75 mg/day dose may benefit from dose increases to a maximum of
approximately 225 mg/day. Dose increases should be in increments of up to 75 mg/day, as
needed, and should be made at intervals of not less than 4 days, since steady state plasma levels
of venlafaxine and its major metabolites are achieved in most patients by day 4. In the clinical
trials establishing efficacy, upward titration was permitted at intervals of 2 weeks or more; the
average doses were about 140 to 180 mg/day (see Clinical Trials under CLINICAL
PHARMACOLOGY).

It should be noted that, while the maximum recommended dose for moderately depressed
outpatients is also 225 mg/day for Effexor (immediate release), more severely depressed
inpatients in one study of the development program for that product responded to a mean dose of
350 mg/day (range of 150 to 375 mg/day). Whether or not higher doses of Effexor XR are
needed for more severely depressed patients is unknown; however, the experience with
Effexor XR doses higher than 225 mg/day is very limited. (See PRECAUTIONS-General-Use
in Patients with Concomitant Illness.)

On Mar, 16, 2011: 43,280 people who reported to have side effects when taking Effexor are studied

Top 100 overall Effexor side effects:

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From the site theroadback, is this compiled list of common adverse-effects from these kinds of drugs:

GENERAL BODY

Dry Mouth – Less moisture in the mouth than is usual.

Sweating Increased - A large quantity of perspiration that is medically caused.

Allergy - Extreme sensitivity of body tissues triggered by substances in the air, drugs, or foods causing a variety of reactions such as sneezing, itching, asthma, hay fever, skin rashes, nausea and/or vomiting.

Asthenia - A physically weak condition.

Chest Pains - Severe discomfort in the chest caused by not enough oxygen going to the heart because of narrowing of the blood vessels or spasms.

Chills - Appearing pale while cold and shivering; sometimes with a fever.

Edema of Extremities - Abnormal swelling of the body’s tissue caused by the collection of fluid.

Fall - To suddenly lose your normal standing upright position.

Fatigue - Loss of normal strength so as to not be able to do the usual physical and mental activities. 

Fever - Abnormally high body temperature, the normal being 98.6 degrees Fahrenheit or 37 degrees Centigrade in humans.  Fever is a symptom of disease or disorder in the body.  The body is affected by feeling hot, chilled, sweaty, weak and exhausted.  If the fever goes too high, or lasts too long, death can result.

Hot Flashes - Brief, abnormal enlargement of the blood vessels that causes a sudden heat sensation over the entire body.  Women in menopause will sometimes experience this.

Influenza (Flu)-like Symptoms - Demonstrating irritation of the respiratory tract (organs of breathing) such as a cold, sudden fever, aches and pains, as well as feeling weak and seeking bed rest, which is similar to having the flu.

Leg Pain - A hurtful sensation in the legs that is caused by excessive stimulation of the nerve endings in the legs and results in extreme discomfort.

Malaise - The somewhat unclear feeling of discomfort you get when you start to feel sick.

Pain in Limb - Sudden, sharp, and uncontrolled leg or arm discomfort.

Syncope - A short period of light-headedness or unconsciousness (black-out) also known as fainting, caused by lack of oxygen to the brain because of an interruption in blood flow to the brain.

Tightness of Chest - Mild or sharp discomfort, tightness or pressure in the chest area (anywhere between the throat and belly).  The causes can be mild or seriously life-threatening because they include the heart, lungs and surrounding muscles.

CARDIOVASCULAR (INVOLVING THE HEART AND THE BLOOD VESSELS)

Palpitation - Unusual and not normal (abnormal) heartbeat, that is sometimes irregular, but rapid, and forceful thumping or fluttering.  It can be brought on by shock, excitement, exertion, or medical stimulants.  A person is normally unaware of his/her heartbeat.

Hypertension - High blood pressure, a symptom of disease in the blood vessels leading away from the heart.  Hypertension is known as the “silent killer.”  The symptoms are usually not obvious; however, it can lead to damage to the heart, brain, kidneys and eyes, and can even lead to stroke and kidney failure.

Bradycardia - The heart rate is slowed from 72 beats per minute, which is normal, to below 60 beats per minute in an adult.

Tachycardia - The heart rate is sped up to above 100 beats per minute in an adult.  Normal adult heart rate is 72 beats per minute.

ECG Abnormal - A test called an electrocardiogram (ECG) records the activity of the heart.  It measures heartbeats as well as the position and size of the heart’s four chambers. It also measures if there is damage to the heart and the effects of drugs or mechanical devices like a pacemaker on the heart.  When the test is abnormal this means one or more of the following are present: heart disease, defects, beating too fast or too slow, disease of the blood vessels leading from the heart or the heart valves, and/or a past or impending heart attack. 

Flushing - The skin all over the body turns red.

Varicose Veins - Unusually swollen veins near the surface of the skin that sometimes appear twisted and knotted, but always enlarged.  They are called hemorrhoids when they appear around the rectum.  The cause is attributed to hereditary weakness in the veins aggravated by obesity, pregnancy, pressure from standing, aging, etc.  Severe cases may develop swelling in the legs, ankles and feet, eczema and/or ulcers in the affected areas.

GASTROINTESTINAL (INVOLVING THE STOMACH AND THE INTESTINES)

Abdominal Cramp/Pain - Sudden, severe, uncontrollable and painful shortening and thickening of the muscles in the belly.  The belly includes the stomach, as well as the intestines, liver, kidneys, pancreas, spleen, gall bladder, and urinary bladder.

Belching - Noisy release of gas from the stomach through the mouth; a burp.

Bloating - Swelling of the belly caused by excessive intestinal gas.

Constipation - Difficulty in having a bowel movement where the material in the bowels is hard due to a lack of exercise, fluid intake, and roughage in the diet, or due to certain drugs.

Diarrhea - Unusually frequent and excessive runny bowel movements that may result in severe dehydration and shock. 

Dyspepsia/Indigestion.  The discomfort one may experience after eating.  It can be heartburn, gas, nausea, a bellyache or bloating.

Flatulence - More gas than normal in the digestive organs. 

Gagging - Involuntary choking and/or involuntary vomiting.

Gastritis - A severe irritation of the mucus lining of the stomach, either short in duration or lasting for a long period of time.

Gastroenteritis  - A condition in which the membranes of the stomach and intestines are irritated.

Gastrointestinal Hemorrhage - Excessive internal bleeding in the stomach and intestines.

Gastro Esophageal Reflux - A continuous state where stomach juices flow back into the throat causing acid indigestion and heartburn and possibly injury to the throat. 

Heartburn - A burning pain in the area of the breastbone caused by stomach juices flowing back up into the throat.

Hemorrhoids - Small rounded purplish swollen veins that bleed, itch or are painful, and appear around the anus.

Increased Stool Frequency - see “Diarrhea.”  

Indigestion - Inability to properly consume and absorb food in the digestive tract, causing constipation, nausea, stomachache, gas, swollen belly, pain, and general discomfort or sickness.

Nausea - Stomach irritation with a queasy sensation similar to motion sickness and a feeling that one is going to vomit.

Polyposis Gastric - Tumors that grow on stems in the lining of the stomach, which usually become cancerous.

Swallowing Difficulty - A feeling that food is stuck in the throat or upper chest area and won’t go down, making it difficult to swallow.

Toothache - Pain in a tooth above and below the gum line.

Vomiting - Involuntarily throwing up the contents of the stomach, usually accompanied by a nauseated, sick feeling just prior to doing so.

HEMIC & LYMPHATIC  (INVOLVING THE BLOOD AND THE CLEAR FLUIDS IN THE TISSUES THAT CONTAIN WHITE BLOOD CELLS)

Anemia - A condition in which the blood is no longer carrying enough oxygen, so the person looks pale and easily gets dizzy, weak and tired.  More severely, a person can end up with an abnormal heart, as well as breathing and digestive difficulties.

Bruise - Damage to the skin resulting in a purple-green-yellow skin coloration that is   caused by breaking the blood vessels in the area without breaking the surface of the skin.

Nosebleed - Blood loss from the nose.

Hematoma - Broken blood vessels that cause a swelling in an area on the body.

Lymphadenopathy Cervical - The lymph nodes in the neck, part of the body’s immune system, become swollen and enlarged by reacting to the presence of a drug.  The swelling is the result of the white blood cells multiplying in order to fight the invasion of the drug.

METABOLIC & NUTRITIONAL  (ENERGY AND HEALTH)

Arthralgia - Sudden sharp nerve pain in one or more joints.

Arthropathy - Joint disease or abnormal joints.

Arthritis - Painfully inflamed and swollen joints.  The reddened and swollen condition is brought on by a serious injury or shock to the body either from physical or emotional causes.

Back Discomfort - Severe physical distress in the area from the neck to the pelvis along the backbone.

Bilirubin Increased - Bilirubin is a waste product of the breakdown of old blood cells.  Bilirubin is sent to the liver to be made water-soluble so it can be eliminated from the body through emptying the bladder.  A drug can interfere with or damage this normal liver function, creating liver disease.

Decreased Weight - Uncontrolled and measured loss of heaviness or weight.

Gout - A severe arthritis condition that is caused by the dumping of a waste product called uric acid into the tissues and joints.  It can become worse and cause the body to develop a deformity after going through stages of pain, inflammation, severe tenderness and stiffness.

Hepatic Enzymes Increased - An increase in the amount of paired liver proteins that regulate liver processes causing a condition in which the liver functions abnormally.

Hypercholesterolemia - Too much cholesterol in the blood cells.

Hyperglycemia - An unhealthy amount of sugar in the blood.

Increased Weight - A concentration and storage of fat in the body accumulating over a period of time caused by unhealthy eating patterns, a lack of physical activity, or an inability to process food correctly, that can predispose the body to many disorders and diseases.

Jaw Pain - The pain due to irritation and swelling of the nerves associated with the mouth area where it opens and closes just in front of the ear.  Some of the symptoms are: pain when chewing, headaches, losing your balance, stuffy ears or ringing in the ears, and teeth grinding.

Jaw Stiffness - The result of squeezing and grinding the teeth while asleep that can cause your teeth to deteriorate, as well as the muscles and joints of the jaw.

Joint Stiffness - A loss of free motion and easy flexibility where any two bones come together.

Muscle Cramp - When muscles contract uncontrollably without warning and do not relax.  The muscles of any body organs can cramp.

Muscle Stiffness - The tightening of muscles making it difficult to bend.

Muscle Weakness - Loss of physical strength.

Myalgia - A general widespread pain and tenderness of the muscles.

Thirst - A strong, unnatural craving for moisture/water in the mouth and throat. 

NERVOUS SYSTEM (SENSORY CHANNELS)

Carpal Tunnel Syndrome - A pinched nerve in the wrist that causes pain, tingling, and numbing.

Coordination Abnormal - A lack of normal, harmonious interaction of the parts of the body when it is in motion.

Dizziness - Losing one’s balance while feeling unsteady and lightheaded which may lead to fainting.

Disequilibrium - Lack of mental and emotional balance.

Faintness - A temporary condition in which one is likely to become unconscious and fall.                                            

Headache - A sharp or dull persistent pain in the head.

Hyperreflexia - A not normal (abnormal) and involuntary increased response in the tissues connecting the bones to the muscles.

Light-Headed Feeling – An uncontrolled and usually brief loss of consciousness usually caused by a lack of oxygen to the brain.

Migraine - Recurring severe head pain sometimes accompanied by nausea, vomiting, dizziness, flashes or spots before the eyes, and ringing in the ears.

Muscle Contractions Involuntary – A spontaneous and uncontrollable tightening reaction of the muscles caused by electrical impulses from the nervous system.

Muscular Tone Increased - Uncontrolled and exaggerated muscle tension.  Muscles are normally partially tensed and this is what gives us muscle tone. 

Paresthesia - Burning, prickly, itchy, or tingling skin with no obvious or understood physical cause.

Restless Legs - A need to move the legs without any apparent reason.  Sometimes there is pain, twitching, jerking, cramping, burning, or a creepy-crawly sensation associated with the movements.  It worsens when a person is inactive, and can interrupt sleep so one feels the need to move to gain some relief.

Shaking - Uncontrolled quivering and trembling as if one is cold and chilled.

Sluggishness - Lack of alertness and energy, as well as being slow to respond or perform in life.

Tics - A contraction of a muscle causing a repeated movement not under the control of the person, usually on the face or limbs.

Tremor - A nervous and involuntary vibrating or quivering of the body.

Twitching - Sharp, jerky and spastic motion, sometimes with a sharp sudden pain.

Vertigo - A sensation of dizziness with disorientation and confusion.

MENTAL AND EMOTIONAL

Aggravated Nervousness - A progressively worsening, irritated, and troubled state of mind.

Agitation – A suddenly violent and forceful emotionally disturbed state of mind.

Amnesia - Long term or short term, partial or full memory loss created by emotional or physical shock, severe illness, or a blow to the head where the person was caused pain and became unconscious.

Anxiety Attack - Sudden and intense feelings of fear, terror, and dread, physically creating shortness of breath, sweating, trembling and heart palpitations.

Apathy - Complete lack of concern or interest for things that ordinarily would be regarded as important or would normally cause concern.

Appetite Decreased - Having a lack of appetite despite the ordinary caloric demands of living, with a resulting unintentional loss of weight.

Appetite Increased - An unusual hunger causing one to overeat.

Auditory Hallucination - Hearing things without the voices or noises being present.

Bruxism - Grinding and clenching of teeth while sleeping.

Carbohydrate Craving - A drive or craving to eat foods rich in sugar and starches (sweets, snacks and junk foods) that intensifies as the diet becomes more and more unbalanced due to the unbalancing of the proper nutritional requirements of the body.

Concentration Impaired - Unable to easily focus your attention for long periods of time.

Confusion – An inability to think clearly or understand, preventing logical decision-making.

Crying (Abnormal) - Unusual and not normal (abnormal) fits of weeping for short or long periods of time for no apparent reason.

Depersonalization - A condition in which one has lost a normal sense of personal identity.

Depression - A hopeless feeling of failure, loss and sadness that can deteriorate into thoughts of death.  A very common reaction to or side effect of, psychiatric drugs.

Disorientation - A loss of sense of direction, place, time or surroundings, as well as mental confusion regarding one’s personal identity.

Dreaming (Abnormal) - Dreaming that leaves a very clear, detailed picture and impression when awake that can last for a long period of time and sometimes be unpleasant.

Emotional Lability - Suddenly breaking out in laughter or crying or doing both without being able to control the outburst of emotion.  These episodes are unstable as they are caused by experiences or events that normally would not have this effect on an individual.

Excitability - Uncontrollably responding to stimuli (one’s environment).

Feeling Unreal - The awareness that one has an undesirable emotion like fear, but can’t seem to shake off the irrational feeling.  For example, feeling like one is going crazy, but rationally knowing that it is not true.  The quality of this side effect resembles being in a bad dream and not being able to wake up. 

Forgetfulness - Unable to remember what one ordinarily would remember.

Insomnia - Sleeplessness caused by physical stress, mental stress or stimulants, such as coffee or medications; a condition of being abnormally awake when one would ordinarily be able to fall and remain asleep.

Irritability – An abnormal reaction of being annoyed or disturbed in response to a stimulus (the environment: that which is happening around one).

Jitteriness - Nervous fidgeting without apparent cause.

Lethargy - Mental and physical sluggishness and apathy (a feeling of hopelessness that “nothing can be done”) which can deteriorate into an unconscious state resembling deep sleep.  A numbed state of mind.

Libido Decreased - An abnormal loss of sexua| energy or desire.

Panic Reaction - A sudden, overpowering, chaotic and confused mental state of terror resulting in being doubt-ridden, often accompanied with hyperventilation and extreme anxiety.

Restlessness Aggravated - A constantly worsening troubled state of mind characterized by the person being increasingly nervous, unable to relax, and easily angered.

Somnolence - Feeling sleepy all the time or having a condition of semi-consciousness.

Suicide Attempt - An unsuccessful deliberate attack on one’s own life with the intention of ending it.

Suicidal Tendency - Most likely will attempt to kill oneself.

Tremulousness Nervous - Very jumpy, shaky, and uneasy, while feeling fearful and timid.  The condition is characterized by thoughts dreading the future, involuntary quivering, trembling, and feeling distressed and suddenly upset.

Yawning - Involuntary opening of the mouth with deep inhalation of air.

REPRODUCTIVE FEMALE

Breast Neoplasm - A tumor or cancer, of either of the two milk-secreting organs on the chest of a woman. 

Menorrhagia - Abnormally heavy menstrual period or a menstrual flow that has continued for an unusually long period of time.

Menstrual Cramps - Painful, involuntary uterus contractions that women experience around the time of their menstrual period, sometimes causing pain in the lower back and thighs.

Menstrual Disorder - A disturbance or derangement in the normal function of a woman’s menstrual period.

Pelvic Inflammation - The reaction of the body to infectious, allergic, or chemical irritation, which, in turn, causes tissue irritation, injury, or bacterial infection characterized by pain, redness, swelling, and sometimes loss of function. The reaction usually begins in the uterus and spreads to the fallopian tubes, ovaries, and other areas in the hipbone region of the body.

Premenstrual Syndrome - Various physical and mental symptoms commonly experienced by women of childbearing age usually 2 to 7 days before the start of their monthly period.  There are over 150 symptoms including eating binges, behavioral changes, moodiness, irritability, fatigue, fluid retention, breast tenderness, headaches, bloating, anxiety, and depression.  The symptoms cease shortly after the period begins, and disappear with menopause.

Spotting Between Menses - Abnormal bleeding between periods.  Unusual spotting between menstrual cycles.

RESPIRATORY SYSTEM (ORGANS INVOLVED IN BREATHING)

Asthma - A disease of the breathing system initiated by an allergic reaction or a chemical, with repeated attacks of coughing, sticky mucus, wheezing, shortness of breath, and a tight feeling in the chest.  The disease can reach a state where it stops a person from exhaling, leading to unconsciousness and death.

Breath Shortness - Unnatural breathing, using a lot of effort resulting in not enough air taken in by the body.

Bronchitis - Inflammation of the two main breathing tubes leading from the windpipe to the lungs.  The disease is marked by coughing, a low-grade fever, chest pain, and hoarseness, caused by an allergic reaction.

Coughing - A cough is the response to an irritation, such as mucus, that causes the muscles controlling the breathing process to expel air from the lungs suddenly and noisily to keep the air passages free from the irritating material.

Laryngitis - Inflammation of the voice box characterized by hoarseness, sore throat, and coughing.  It can be caused by straining the voice or exposure to infectious, allergic or chemical irritation.

Nasal Congestion - The presence of an abnormal amount of fluid in the nose.

 Pneumonia Tracheitis - Bacterial infection of the air passageways and lungs that causes redness, swelling and pain in the windpipe.  Other symptoms are high fever, chills, pain in the chest, difficulty breathing, and coughing with mucus discharge.

Rhinitis - Chemical irritation causing pain, redness and swelling in the mucus membranes of the nose.

Sinus Congestion - The mucus-lined areas of the bones in the face that are thought to help warm and moisten air to the nose.  These areas become clogged with excess fluid or become infected.

Sinus Headache - An abnormal amount of fluid in the hollows of the facial bone structure, especially around the nose.  This excess fluid creates pressure, causing pain in the head.

Sinusitis - The body reacting to chemical irritation causing redness, swelling and pain in the area of the hollows in the facial bones especially around the nose.

SKELETAL

Neck/Shoulder Pain - Hurtful sensations of the nerve endings caused by damage to the tissues in the neck and shoulder, signaling danger of disease.

SKIN AND APPENDAGES (SKIN, LEGS AND ARMS)

 Acne - Eruptions of the oil glands of the skin, especially on the face, marked by pimples, blackheads, whiteheads, bumps, and more severely, by cysts and scarring.

Alopecia - The loss of hair, baldness.

Angioedema - Intense itching and swelling welts on the skin called hives caused by an allergic reaction to internal or external agents.  The reaction is common to a food or a drug. Chronic cases can last for a long period of time. 

Dermatitis - Generally irritated skin that can be caused by any of a number of irritating conditions, such as parasites, fungus, bacteria, or foreign substances causing an allergic reaction.  It is a general inflammation of the skin.

Dry Lips - The lack of normal moisture in the fleshy folds that surround the mouth.

Dry Skin - The lack of normal moisture/oils in the surface layer of the body.  The skin is the body’s largest organ.

Epidermal Necrolysis - An abnormal condition in which a large portion of the skin becomes intensely red and peels off like a second-degree burn.  Often the symptoms include blistering.

Eczema - A severe or continuing skin disease marked by redness, crusting and scaling, with watery blisters and itching.  It is often difficult to treat and will sometimes go away only to reappear again.

Folliculitis  - Inflammation of a follicle (small body sac), especially a hair follicle.  A hair follicle contains the root of a hair.

Furunculosis - Skin boils that show up repeatedly.

Lipoma - A tumor of mostly fat cells that is not health endangering.

Pruritus - Extreme itching of often-undamaged skin.

Rash - A skin eruption or discoloration that may or may not be itching, tingling, burning, or painful.  It may be caused by an allergy, a skin irritation or a skin disease.

Skin Nodule - A bulge, knob, swelling or outgrowth in the skin that is a mass of tissue or cells.

RELATED TO THE  SENSES

Conjunctivitis - Infection of the membrane that covers the eyeball and lines the eyelid, caused by a virus, allergic reaction, or an irritating chemical.  It is characterized by redness, a discharge of fluid and itching.

Dry Eyes - Not enough moisture in the eyes.

Earache - Pain in the ear.

Eye Infection - The invasion of the eye tissue by a bacteria, virus, fungus, etc, causing damage to the tissue, with toxicity.  Infection spreading in the body progresses into disease.

Eye Irritation - An inflammation of the eye.

Metallic Taste - A range of taste impairment from distorted taste to a complete loss of taste.

Pupils Dilated - Abnormal expansion of the black circular opening in the center of the eye.

Taste Alteration - Abnormal flavor detection in food.

Tinnitus - A buzzing, ringing, or whistling sound in one or both ears occurring from the use of certain drugs.

Vision Abnormal - Normal images are seen differently by the viewer than by others.

Vision Blurred - Eyesight is dim or indistinct and hazy in outline or appearance.

Visual Disturbance - Eyesight is interfered with or interrupted.  Some disturbances are light sensitivity and the inability to easily distinguish colors.

URINARY SYSTEM

Blood in Urine - Blood is present when one empties the liquid waste product of the kidneys through the bladder by urinating in the toilet, turning the water pink to bright red.  Or you can see spots of blood in the water after urinating. 

Dysuria - Difficult or painful urination.

Kidney Stone - Small hard masses of salt deposits that the kidney forms.

Urinary Frequency - Having to urinate more often than usual or between unusually short time periods.

Urinary Tract Infection - An invasion of bacteria, viruses, fungi, etc., of the system in the body.  This starts with the kidneys, which eliminate urine from the body.  If the invasion goes unchecked, it can injure tissue and progress into disease.

Urinary Urgency - A sudden compelling urge to urinate, accompanied by discomfort in the bladder.

UROGENITAL (URINARY TRACT AND/OR GENITAL STRUCTURES OR FUNCTIONS)

Anorgasmia - Failure to experience an orgasm.

Ejaculation Disorder - Dysfunction of the discharge of semen during orgasm.

Menstrual Disorder - Dysfunction of the discharge during the monthly menstrual cycle.

VIOLENT OR PHYSICALLY DANGEROUS  SIDE EFFECTS:

Acute Renal Failure - The kidneys stop excreting waste products properly, leading to rapid poisoning (toxicity) in the body.

Anaphylaxis - A violent, sudden, and severe drop in blood pressure caused by a re-exposure to a foreign protein or a second dosage of a drug that may be fatal unless emergency treatment is given right away.

Grand Mal Seizures (or Convulsions) - A recurring sudden, violent and involuntary attack of muscle spasms with a loss of consciousness.

Neuroleptic Malignant Syndrome - A life threatening, rare reaction to an anti-psychotic drug marked by fever, muscular rigidity, changed mental status, and dysfunction of the autonomic nervous system.

Pancreatitis - Chemical irritation with redness, swelling, and pain in the pancreas where digestive enzymes and hormones are secreted.

QT Prolongation - A very fast heart rhythm disturbance that is too fast for the heart to beat effectively so the blood to the brain falls, causing a sudden loss of consciousness and may cause sudden cardiac death.

Rhabdomyolysis - The breakdown and release of muscle fibers into the circulatory system.  Some of the fibers are poisonous to the kidney and frequently result in kidney damage.

Serotonin Syndrome - A disorder brought on by excessive levels of serotonin. It is caused by drugs and can be fatal. Symptoms include euphoria, drowsiness, sustained and rapid eye movement, agitation, reflexes overreacting, rapid muscle contractions, abnormal movements of the foot, clumsiness, feeling drunk and dizzy without any intake of alcohol, jaw muscles contracting and relaxing excessively, muscle twitching, high body temperature, rigid body, rotating mental status - including confusion and excessive happiness - diarrhea and loss of consciousness.

Thrombocytopenia - An abnormal decrease in the number of blood platelets in the circulatory system. A decrease in platelets would cause a decrease in the ability of the blood to clot when necessary.

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