Here’s a list of compiled links providing information on Pristiq. These links include info from my blog and others.
I’ve compiled a list of my posts on Effexor (venlafaxine) withdrawal in chronological order. Do NOT take any of the information from these posts as official medical advice. This is based on my own experience; experiences may vary.
Funny the writers decided to add that. A year ago, that clause would have never been considered yet alone thought of.
Pfizer isn’t doing badly; in fact, despite the credit crunch, they’ve been able to snag $22.5 billion in loans since they also have $26 billion cash on hand. The NYTimes also reports that this merger would be the biggest since AT&T and BellSouth merged back in March 2006. But of course, with mergers always come layoffs. And what a time to have layoffs. Pfizer today announced that they’ll be cutting 8,000 jobs.
But as I said in a previous post, Pfizer’s biggest challenge is get some pipeline products out to market soon since some of the patents on their big names (ie, Lipitor) are expiring soon. Don’t hold me to this but I think Wyeth has a bit more sitting in their pipeline, hence why the merger would make sense. But I hope Wyeth can produce a new blockbuster drug for Pfizer otherwise Pfizer’s really going to be hurting for money. Especially since Wyeth’s best-selling drug, Effexor, is now generic and Pristiq isn’t completely cutting it.
justAna posted a comprehensive list of SSRI side/withdrawal effects that can be found on TheEffexorActivist.org. And it's freaking crazy. I've bolded the ones that I've experienced. (I've been pretty lucky, though.) Here we go:
1. Crying spells
2. Worsened mood
3. Low energy (fatigue, lethargy, malaise)
4. Trouble concentrating
5. Insomnia or trouble sleeping
6. Change in appetite
7. Suicidal thoughts
8. Suicide attempts
9. Anxious, nervous, tense
10. Panic attacks (racing heart, breathless)
11. Chest pain
12. Trembling, jittery,or shaking
14. Agitation (restlessness, hyperactivity)
18. Homicidal thoughts or urges
19. Confusion or cognitive difficulties
20. Memory problems or forgetfulness
21. Elevated mood (feeling high)
22. Mood swings
23. Manic-like reactions
24. Auditory hallucinations
25. Visual hallucinations
26. Feeling detached or unreal
27. Excessive or intense dreaming
29. Flu-like aches and pains
33. Runny nose
34. Sore eyes
38. Abdominal pain or cramps
39. Stomach bloating
41. Spinning, swaying, lightheaded
42. Hung over or waterlogged feeling
43. Unsteady gait, poor coordination
44. Motion sickness
47. Numbness, burning, or tingling
48. Electric zap-like sensations in the brain
49. Electric shock-like sensations in the body
50. Abnormal visual sensations
51. Ringing or other noises in the ears
52. Abnormal smells or tastes
53. Drooling or excessive saliva
54. Slurred speech
55. Blurred vision
56. Muscle cramps, stiffness, twitches
57. Feeling of restless legs
58. Uncontrollable twitching of mouth
I've also gotten rashes coming off of Effexor. I was also on Lamictal as well so I don't think it's common. Ana puts it best when she says:
Hoo boy, it sure doesn't.
Seeing the scale at 180 scared me into action somehow. I thought of my father who died of a heart attack and remembered that I had a history of high cholesterol running through my family. I decided I had to do something so I didn’t drop dead of a myocardial infarction at 23.
- Bob and I joined a gym. We went 1-2 times a week for about 30 minutes, which — for a variety of reasons — was a disaster so this consistency didn’t last long. But it helped short-term. We mostly did circuit training and about 20 minutes of cardio. We also had a
personal trainer for a while. It’s expensive and we haven’t been able to afford one since, but it was definitely worth the money. I dropped 5 lbs.
- I stopped drinking soda. Everyone in my family will tell you that I was ADDICTED to soda. However, I knew the carbonation made me bloated.
- I slowly weaned myself off of regular soda, forcing myself to like the significantly inferior diet products.
- In due time, I tired of diet drinks and became hooked on Crystal Light On-the-Go packets and forced myself to drink water regularly. This change resulted in an additional loss of 5 lbs. For whatever reason, the CL packets soon became too sweet for my sweet tooth and I stopped using them.
- While I drink mostly water, I somehow picked up a daily habit of drinking coffee and lattés along the way. I usually make my own coffee but often order my lattés at coffee shops or cafés. I initially didn’t care about drinking whole milk but I soon learned that the calories can quickly add up between the vanilla shots and 16 oz. of milk.
- Now, I ask for sugar-free vanilla lattés with skim milk. (These are called “skinny lattés” at Starbucks.) I always hated skim milk but forced myself to get used to it if I really wanted the pounds
to continue to peel off. I still get my caffeine fix but for significantly less calories. Depending on the size I get, my latté can vary from 90-175 calories. Not bad when a regular vanilla latté is easily 300.
- I began eating Lean Cuisine or Healthy Choice for lunch. This is something that’s since dropped out of my diet but I need to reincorporate because it’s offered me the most results. I limited myself to LC or HC only and fought off any other hunger urges if I could. These pre-made frozen meals led to another 5-lb weight loss. (NOTE: The sodium counts on some of these meals are ridiculous, negating the healthy benefits of the low-calorie count, and causing increased hunger. Check the Nutritional Information for products that contain — on average — 600 mg or less of sodium. I’ve found that more than that can be counterproductive. Healthy Choice is pretty good about keeping the sodium milligrams around 500 or less.)
- I began commuting to the city and walked from the train station to work for a total of 20-30 minutes round-trip. I skipped walking during severe heatwaves and rain. The bus to the train station from my job wasn’t very reliable so I often ended up walking for at least 10 minutes during the day. Or more if I walked somewhere (usually by myself at a faster pace) for lunch. I lost 5 more pounds.
- I ended up in the psych hospital. This is NOT recommended. I didn’t like much of the food so I hardly ate anything. I was also started on Effexor XR, of which weight loss was a side effect. I dropped a good 10 lbs in 7 days as a result of this. By this point, I was down to 150 — my “Freshman 15” weight.
- Since my body was getting used to the 20-30 minute work walks, I began working out at the gym at least 2-3 days a week for at least 30 minutes. I attempted to do a minimum of 20 minutes of cardio and 10 minutes of strength training or vice versa. I maintained a weight between 140-145 lbs for more than a year.
I haven’t been able to crack 139 on the scale for whatever reason and my goal is for a weight maintenance of 130-135 lbs. The BMI scale recommends that I weigh 110-125 lbs for my height. Considering that my 26-year-old body is significantly different than my 16-year-old body, I’m not going to shoot for anything less than 130. I think to do so at this point in my life would be unrealistic. Besides, I wouldn’t want to be that skinny again anyway. 110 lbs on a 16-year-old looks vastly different on a 26-year-old or a 36-year-old or a… you get the point. I’ve made 130 my minimum — a goal I’m sure I’ll be happy with if I’m able to attain it. Even if I bounced between 130 and 140 lbs, I wouldn’t mind as long as I didn’t regain my Freshman 15 weight. But I’m a work in progress.
I just learned that Wyeth produces two major menopause drugs, Premarin and Prempro, that allegedly has produced hormones causing cancer in more than 5,000 women. This added up to a loss of 40 million users and $1 billion annually.
With Effexor going generic in 2 years and the introduction of Pristiq to the market, Wyeth hopes to lure some of those customers back and net an annual $2 billion. However, serious questions linger about Pristiq’s side effects in menopausal women.
Why did two women in the study group taking Pristiq have heart attacks
and three need procedures to repair clogged arteries compared with none
taking placebo? How can Wyeth assure long term safety when 604 of the
2,158 test subjects took Pristiq for only six months and 318 for a year
or more? And what about serious liver complications seen in the studies?
Martha Rosenberg, reporting on Pristiq’s use as a menopausal drug, culled comments from CafePharma’s message boards and found one thread rife with mixed comments on the new drug. From an Anonymous commenter:
I’m aware that my blog has taken a significantly dark turn. This may alienate some of my readers who seek happier, brighter topics. I don’t think my posts have been negative; on the contrary, I think they’ve been positive. Positive and educational.
Dr. Grohol interviewed Dr. Phil Ninan, Wyeth’s VP of Medical Affairs on Pristiq, its efficacy, and surrounding issues. It was quite an interesting interview (and long) but here are some highlights that I chose to comment on. I’ll be making some comments in between Dr. Ninan’s answers due to the extensive length. Some parts of the answers have been truncated.
According to a Decision Resources (DR) press release, Lexapro (escitalopram), a SSRI, “retains leadership among first-line therapies in the treatment of major depression” despite the fact that physicians have increasingly moved toward the use of SNRIs, eg, Effexor (venlafaxine). However, the reason why SSRIs still retain their first-line status is due to
SSRIs have been out on the market for much longer than SNRIs so it’s what physicians are more comfortable with. As far as I know, there currently aren’t any generic SNRIs in the U.S.
As a result, SNRIs are likely pricier.
DR’s survey of psychiatrists found that the majority believe SNRIs work better in treating clinical depression than SSRIs and about 44 percent believe they have fewer sexual side effects. PCPs were also included in this survey and it seems that the majority of them believed the opposite despite DR’s spin that a lot of PCPs are on board with psychiatrists. From personal experience, four SSRIs were prescribed to me before I was shifted to a SNRI.
In the up-and-coming SNRI department, DR forecasts a bright future for Pristiq (desvenlafaxine).
Physicians are expected to move patients from Effexor to Pristiq-a newly approved SNRI- over the next two years. … Pristiq will begin to replace Wyeth’s Effexor XR and Lilly’s Cymbalta, especially in
This is an interesting analysis from DR considering that psychiatrists, health insurers, and even some investors seem less than impressed with the slight advantages the “me-too” drug has over Effexor.
As patents expire on a variety of drugmakers’ moneymakers, pharma companies have gone to great lengths to structurally reinvent the successful drugs then tout the benefits that differ from their predecessors.
Case in point — Johnson & Johnson’s Invega. Invega is the successor to the popular antipsychotic drug, Risperdal, and competitor to AstraZeneca’s widely used antipsychotic Seroquel. Scott Hensley at The Wall Street Journal’s Health Blog (WSJ) reports that Risperdal is going generic in June. Gianna at Beyond Meds recently said it will not. According to the Dow Jones Newswires (DJN), these “junior” drugs face skepticism from health insurers and doctors. California-based Kaiser Permanente and Minneapolis-based UnitedHealth Group Inc. (UNH) are example of companies that have somewhat discouraged use of the drug. Kaiser doesn’t cover Invega at all, and members of UNH are required to pay higher copays for the brand name. The wire reports New York-based psychiatrist Jeffrey Lieberman wasn’t “buying it” the difference between Invega and Risperdal.
Invega is “basically a me-too drug, and the company hasn’t done the studies that would be required to really distinguish it,” Lieberman, chairman of the psychiatry department at Columbia University’s medical school told Peter Loftus of Dow Jones Newswires.
The blog also quotes Daniel Carlat from the The Carlat Psychiatry Report.
Dan Carlat, a psychiatrist and a tough critic of Invega, wrote that J&J’s “marketing team apparently missed the fact that the word in the English language that sounds most like “Invega” is “inveigle,” meaning “to entice, lure, or ensnare by flattery or artful talk or inducements.’ ” He asked doctors: “Will you be doing your patients a favor by taking the plunge? Or will you simply be giving them the same wine in a fancier bottle?”
Even J&J’s Group Chairman of Pharmaceuticals, David Norton, admitted that Invega is a tough sell.
“We need to do a better job at drawing a differentiation in a difficult-to-treat population.”
So far, Invega sales have been incredibly disappointing compared to the Risperdal blockbuster.
Wyeth (antidepressant Effexor XR cum Pristiq) and Shire (ADHD drug Adderall XR cum Vyvanse) face the same uphill battle. Wyeth’s Effexor faces generic competition from Teva Pharmaceuticals despite efforts to halt generic sales of the drug and the patent on Shire’s Adderall is set to expire next year.
Hensley, in his analysis, raises a question in which the answer remains to be seen:
Cheap generics abound to treat a broad assortment of illnesses these days. What’s the point, the critics ask, of paying more for drugs that are at best only slight improvements over tried and true medicines available at bargain prices?
In an attempt to have the “me-too” drugs compete with its derivative, both Wyeth and Shire are slashing their prices, or as the DJN reported, “emphasizing improved dosing for the newer drugs.” Although Pristiq’s efficacy comes at higher doses, it’s being priced 20 percent lower than Effexor.
[Deutsche Bank pharmaceutical analyst Barbara Ryan] thinks the odds of
Pristiq’s success are slim because it appears to offer few benefits
beyond those of Effexor.
That remains to be seen. So far, a few patients have commented on my blog that Pristiq has already begun to help them. I haven’t seen any DTC ads for Pristiq so I can only assume that drug reps are doing a fine marketing job at selling the different benefits of the drug to doctors.
Vyvanse, on the other hand, is looking promising for Shire, already having 7 percent of U.S. ADHD drug prescriptions. Chief Executive Matthew Emmens says the drug is chemically different from Adderall (aren’t they all?) and has better pricing. Shire expects to beat Adderall’s 26 percent peak market share. Seems like a lofty goal to me.
As for Invega, J&J is currently seeking FDA approval to use the drug for bipolar disorder and not just treatment for schizophrenia. It is also l0oking to get approval for an injectable Invega XR.
(Invega logo from Janssen.com)