Should I help my beloved girlfriend out of Effexor, and how?
May 25, 2007 2:29 AM   Subscribe

Knowing that my girlfriend is taking Effexor (which has strong side effects), should I help her get off, and what should my role be?

I'm in my thirties and recently met a woman I trust is my perfect match. We are very much aligned on our personality, values and vision. Things are great, it's true love and we are moving in together in a few weeks.

That being said, I recently discovered a box of Effexor in the bathroom. She's never hidden that she was taking those, but out of curiosity I looked on MeFi to see if there was any information about this drug. I found this post that really worried me about how addictive it is. The page on Wikipedia also mentions side effects like high blood pressure that really worries me.

Bottom of this : now I'm starting to freak out... She indeed has high blood pressure and her doctor does not really know the cause. Maybe this is this damn drug... How can I approach her about it? And should I, actually?...

I'm not sure how she would react to me trying to help her. She went through a pretty strong depression a few years ago, that's why she is still on antidepressant. I have been through one myself, and I remember that I used to be pretty pissed off when my family tried to help me and ask I go to a doctor. Maybe it is going to be the same for her...

So now I have this dilemma : Effexor is maybe the cause of her high blood pressure, and it seems that she will have a very hard time coming clean. It's basically hurting the woman I love. Is that my role to talk to her about that?... Being her boyfriend, I feel like my role is to make her happy. If she keeps taking that drug long term, I would feel like I'm failing. Is that a fair feeling?...

Please help me clear out my mind, and make sure I do whatever is best for her.
posted by V-Turn to Human Relations (42 answers total) 6 users marked this as a favorite
Talk to her, but make it clear that you are coming from a place of love, not a place of meddling. Maybe mention your own depression, so she knows that you know what you are talking about.

Also, respect her decision, and make it clear that you will do that.
posted by Solomon at 2:36 AM on May 25, 2007

Best answer: Being her boyfriend, I feel like my role is to make her happy. If she keeps taking that drug long term, I would feel like I'm failing. Is that a fair feeling?...

Just to answer that part of your question - No, it's not a fair feeling at all - not fair to you, not fair to her. You're not there to "fix" her, you're there to love her.
posted by bunglin jones at 2:52 AM on May 25, 2007 [4 favorites]

Man, I hate to sound like a jerk, but your reaction seems a little nuts to me. I don't know how serious your relationship is, and frankly I would take your question differently if s/girlfriend/wife or if you were already living together. However, let's look at the facts - you found a box of something in the bathroom and you have come to these conclusions :

a) it's your business
b) she is actively taking it
c) it could be causing her high blood pressure
d) her doctor doesn't know she is on it, if she is on it
e) that she should probably be off of it

I have been on a few anti-depressants over the years, and for different reasons (sometimes for depression, sometimes for social anxiety when my job pushed me into a lot of public speaking). The fact that I relied on them was not something I was particularly proud of. She may have her reasons for not sharing this with you yet. Perhaps, high blood pressure is an excellent trade off against soul crushing depression or paralyzing social phobia.

On to the question! I took Effexor for almost a year. It fixed my fear of public speaking, but was negative for me in almost all other regards. The dial got turned down on just about all my emotions, I found I could operate more or less without a conscious, it goes without saying that that had some negative consequences. While it had zero impact on my blood pressure, it did pair very well with alcohol for me. In fact, one of the biggest complaints I have heard about that drug is that it turns people into alcoholics. If she seems to be handling booze ok I would cross one of the major concerns off the list. I have been off the drug now for about a year (and all others). I would not call it addictive, as I did not "miss it". However, I found the withdrawal symptoms to be brutal. Basically three weeks of feeling absolutely terrible in just about every way you can imagine, and that was getting off by slowly pairing down.

If I were you and it was bothering me, I would mention that you accidentally came across it. Ask her if she is still on it. Then I would casually remark, "Wow I've heard that's a really tough one to get off of, make sure you do your research if and when you decide it's time to stop taking it." That ought to give her plenty of openings for her to talk to you about it without you coming off judgmental or overly invested in her being off immediately.
posted by ill3 at 3:31 AM on May 25, 2007 [3 favorites]

Is she having any sort of therapy or is her doctor just renewing her prescription without any evaluation?

The simple answer is no, you shouldnt try to get her off the drug - you are not a doctor or psychiatrist (that you've mentioned anyway) she's been prescribed the drug for a reason, whilst high blood pressure is a risk to her long term health, forcing her off her medication before she's ready has much more serious immediate risks to her health and wellbeing.

How high is her blood pressure? What is her doctor doing about it? Is it just a little high that she should consider making some lifestyle changes to correct it or is it dangerously high and she's been given medication to lower it? Just because a possible side-effect of the drug is high blood pressure doesnt mean that it is the sole cause her your girlfriend's problem.
Does she smoke, drink, eat a lot of junk or have a sedentary lifestyle?

If [b]she[/b] is concerned about her blood pressure you might consider mentioning to her that you've read effexor could be the cause and at her next consultation she should ask her doctor about it and request that her medication be changed (if she still needs medicating)

If she's not having any sort of psych evaluation and they're just renewing her prescription then she should consider some sort of therapy in addition to the medication, it could help her get off the drugs.

Be supportive but remember you're not a doctor, leave the medical advice to the professionals.

Unless her blood pressure is truely dangerously high to the point where is it an immediate risk to her health then I think you're overreacting a little bit. I know you're just concerned for the woman you love but if she was in immediate danger, her doctor would be treating her.
posted by missmagenta at 3:38 AM on May 25, 2007

You should ask her about it, but calm down first lest you freak her out with 'I was snooping through your stuff and then I read on the internet that this drug is dangerous!'. Next time she mentions the high blood pressure problem, perhaps you could just ask, 'Oh, is that a side-effect of the Effexor you're taking?' and if she wonders how you know it's a potential side-effect, and you're worried that she might be put off by you taking too close an interest in something she feels is a private matter, fib that you researched various medications during your own past depression.

Also, I find it very, very hard to believe that her doctor 'does not really know the cause' of her high blood pressure if he's prescribing her Effexor - is it possible you've misunderstood the situation? When it comes to antidepressants, the list of side-effects on the label can be horrifying (I used to be on some that included 'sudden death' as a possible side-effect!) and, since most folk in this situation tend to go through a process of finding the medication that suits them best, I'm sure your girlfriend and her doctor will have weighed up the risks of high blood pressure against the benefits of the drug, and compared it to other anti-depressants and their side-effects.
posted by jack_mo at 4:01 AM on May 25, 2007 [1 favorite]

Wait, let me get this straight. You find a medication in her medicine cabinet, assume that she's currently taking it, get paranoid, find a post talking about withdrawl symptoms (symptoms, I should point out, that can happen with any number of drugs -- I had horrible withdrawl symptoms when I went off Xanax, and I was going off because it wasn't working for me), and now you're convinced that you need to 'help her off'?

Effexor is a prescription medication. If she is, in fact, actively taking it and isn't being secretive about it, she's almost certinaly doing so under a doctor's supervision. If she's on an antidepressant, it's because both she and her physician or psychiatrist feel that she still needs it. For many people, depression isn't something that you can just snap out of, and taking antidepressants indefinitely is not uncommon.

If you look long enough, (or, you know, more than a few seconds), you'll find horror stories about any medication. You are, in my opinion, totally overreacting, and if a boyfriend of mine came to me and said 'hey, these were in your cabinet and I think you shouldn't be taking them because the internet says they're bad' -- well, I can tell you that it wouldn't be a fun conversation, and if you didn't back off right quick, you wouldn't be my boyfriend at the end of it.

If you're really desperate to say something, mention you saw the pills in the cabinet and you wondered if she knew that they could cause high blood pressure. If she didn't, now she does, and she can mention it to her doctor. If she did, then you need to back off gracefully.

(Worth mentioning is that in the situation above, I'm assuming that you found these while you were in her medicine cabinet for some legitimate purpose, that you'd said 'hey, I need some asprin' and she said 'yeah, in the bathroom medicine cabinet'. If you were just snooping and you actually want to stay with this woman, shut your trap -- she and her doctor know more about her medical situation than you do, and especially if you've 'recently met' her, you need to stay out of it.)

Really, though, my advice is to give your girlfriend a little credit and assume that she's smart enough to fill in the 'current medications' box when she sees her doctor. She is (presumably) a big girl who can take care of herself; you butting in is unlikely to be appreciated.
posted by meghanmiller at 4:05 AM on May 25, 2007 [2 favorites]

I think you're treading close to being overbearing here. I understand your concern, and talking about the information you found is one thing, but asking her to change her medication because you don't like it is quite another. Unless you know the entire history of her depression and every piece of information her doctor has used in deciding to prescribe this particular drug, I would say that of the three people involved here (you, your GF, and her doctor), you are the least qualified to make any decisions regarding her health. Basically you're assuming that your GF doesn't have the forethought to read up on medication before she starts taking it, and you're assuming that her doctor doesn't know how to put 2 and 2 together. Be very careful with this; you know what happens when we assume. :)

Ultimately, how well your big plan goes over depends a lot on what kind of person your girlfriend is. If she's the type who wants a man to take care of her, she might think it's sweet that you're reading up on her medications in an effort ot be involved in her life. But if she's more independent and prefers doing her own thinking, she might be pissed and wonder if you're going to make a habit of meddling in other parts of her life too. You know her better than any of us, so it's your call to make.
posted by boomchicka at 4:17 AM on May 25, 2007 [3 favorites]

Response by poster: Thanks for all those comments. There are useful bits in all of them.

To clarify the situation, I did not skeak into her things : the drugs were in my bathroom not hidden at all, and she left them on purpose so that she did not forget them when she comes and sleep over (that's what she told me when I told her I've found those and ask her if I should bring those back to her place in case she forgot them). She's never hidden any of the antidepressants thing to me. My worry is just that she might not be completely aware of the pain she will have to go through when she stops taking it. And I can't be sure that her doctor has mentioned that to her (Reading the other comments on AskMeFi, she would not be the only one).
posted by V-Turn at 4:36 AM on May 25, 2007

Your presumption that she will stop taking Effexor is out of line. That medical decision is for her and her doctor to make. Many people take antidepressants for years, some for a lifetime. If she does go off Effexor, her doctor will likely taper her dosage down over quite a while. This is not your business.
posted by Carol Anne at 5:14 AM on May 25, 2007 [4 favorites]

People taking Effexor are supposed to get regular blood pressure monitoring. If your girlfriend is like most healthy 20-30somethings, her doctor visits are probably limited to a quick half-hour once a year at best. So I think it's extremely likely that Effexor is the cause and that her doctor doesn't realize it. I also think it's extremely likely that the doctor didn't talk to her about Effexor withdrawl. The list of side effects for most drugs is ridiculously huge, and its not reasonable to think your doctor is going to rattle off a list of fine print every time s/he prescribes something.

If she were the one asking this question I'd recommend talking to her doctor or pharmacist. The pharmacist is a good resource because they can often call the doctor and recommend a switch to a different medication for whatever reason, and get something changed right over the phone. That way you may not even have to make a doctor's appointment.

That brings me to my second point, tho. She's not the one asking the question. Dude. Chill.

Being her boyfriend, I feel like my role is to make her happy. If she keeps taking that drug long term, I would feel like I'm failing. Is that a fair feeling?...

No. Let me tell you as an old married lady that people need a certain degree of separateness. Reading your question I honestly wondered if you were from an abusive, alcoholic, or otherwise dysfunctional family and somehow have mixed up being in love with being enmeshed. I really got a lot out of "Codependent No More" by Melanie Beattie, but YMMV.

Or maybe it's just being in love that's making you overreact and poll a message board of strangers about your gf's medications. If that's the case let me say that she doesn't sound "addicted" or like she will have a hard time "coming clean." Addiction is dependence (need the drug to feel normal) plus tolerance (need more and more the get the same effect) plus psychological factors (continued use despite massive harm, such as losing jobs, friends, etc). She might have dependence, but that can be fixed by tapering off the drug when she wants to. That's all. Totally not a big deal.
posted by selfmedicating at 5:19 AM on May 25, 2007 [2 favorites]

Response by poster: selfmedicating, I'd consider my family background normal, and I think you're straight to the point when you say it's being in love that makes me over-caring. My goal is not to get her off medication she needs, but to protect her from something that may hurt her. I think I'll just let her know when the timing is appropriate, that I heard that some antidepressants cause high blood pressure. We'll see how that goes...
posted by V-Turn at 5:32 AM on May 25, 2007

I am not a doctor, but I have taken Effexor (and other antidepressants). Things I know:

1. Effexor indeed can cause elevated blood pressure in otherwise healthy people

2. It is possible that her doctor is not paying enough attention to that side effect. I experienced it, and I was the one that had to remind my (pretty good) docs that it was a side effect and we needed to monitor it. Ditto for a friend of mine.

3. Effexor withdrawal is not hellish for everyone.

4. Cymbalta is similar to Effexor in that they are both SSNRIs rather than SSRIs. (They affect norepinephrine in addition to serotonin.)

You don't know if she's tried other antidepressants (sometimes Effexor is pulled out as the "big guns"). You don't mention whether it's a GP or shrink prescribing the Effexor and whether they're monitoring her or just refilling the Rx. That's not our business, and may or may not be your business, but it matters and it's her business. I think it's OK for you to remind her about that.

I would gently bring up to her that you happened upon some intelligent online discussion about how Effexor can raise blood pressure and that sometimes doctors don't pay enough attention to that as a possible side effect. She may need to take a more active role in things with her doctor. Doctors have knowledge and training, but they're not perfect or infallible.
posted by needs more cowbell at 5:41 AM on May 25, 2007

V-turn, her meds are NONE OF YOUR BIZNESS. You can mention the blood pressure connection if you like, but if you were my boyfriend and I ran across this thread, I would not be a happy woman.

Are you this controlling in other areas of her life???
posted by konolia at 5:44 AM on May 25, 2007 [1 favorite]

On preview: I would emphasize to her that Effexor (specifically) can cause high blood pressure. I'm fairly certain this is a more common side effect with Effexor than other antidepressants.
posted by needs more cowbell at 5:45 AM on May 25, 2007

Best answer: Something I've not seen mentioned here yet: Effexor's interaction with other drugs can aggravate high blood pressure. I recall that while I was taking Effexor, I couldn't take anything like Sudafed. It made more sense to quit taking Sudafed than Effexor.

Being her boyfriend, I feel like my role is to make her happy. If she keeps taking that drug long term, I would feel like I'm failing.

You might want to take a look at some other AskMes about depression, like this one, to start understanding why this is a very unhelpful mindset to have.
posted by gnomeloaf at 6:00 AM on May 25, 2007

The big blood pressure problem here isn't hers, it's yours. Calm the hell down, get a firm grip on your brain, and take a deep breath. Or fifty. are freaking out, and it's going to ring nine different types of alarm bells in her head. As it should, frankly.

Everyone else has already addressed the blood pressure issue, so I will echo Konolia: are you normally this controlling? Really? Are you sure?

I have the distinct sense that there's something else going on here, and you would be well-advised to figure it out. I dunno if it's anxiety on your part or what, but this isn't just about Effexor.
posted by aramaic at 6:01 AM on May 25, 2007 [1 favorite]

They don't call this stuff 'side-Effexor' for nothing, and like all the other people who take it she's fully aware of those side effects because she suffered all of them when she was going on the drug in the first place.

Do not urge her to go off medication. You have no idea what you're messing with and your current position is somewhat analogous to suggesting someone adrift in the Pacific should take off his life jacket because it's giving him a rash on the neck.

There are far, far worse things in life than higher-than-normal blood pressure.

Seriously, WTF is it with some people and their aversion to mental health drugs? You never hear them whining about chaemotherapy.
posted by genghis at 6:04 AM on May 25, 2007

Being her boyfriend, I feel like my role is to make her happy. If she keeps taking that drug long term, I would feel like I'm failing.

Sorry, but this really twigged me. It is not your role to make her happy. It is her role to make her happy. You get to share in that happiness - one of the perks of being in a relationship - and you get to share in the bad times - also one of the "perks" of being in a relationship.

The only person responsible, in the end, for her mental health and happiness is her - and she's working on that, by taking Effexor. If she hasn't asked for your help on this, there is a limited number of things you can do - you love her, you're welcome to tell her you worry about her, but in the end the decision is hers and her doctors'.

Maybe you should consider worrying less about HER mental hangups and worrying more about your own? Understanding what relationships are, and aren't, is a good place to start. Her happiness is not your success, her despair not your failure.
posted by twiki at 6:12 AM on May 25, 2007 [4 favorites]

My worry is just that she might not be completely aware of the pain she will have to go through when she stops taking it.

I think this would be a much more valid concern if she was contemplating taking it, rather than already on it. As it stands now, she will either be on it forever or at some point potentially going through withdrawal symptoms. This leaves me with the impression you are wanting to use this information to express your concern/dislike over her being on the medicine in general.
posted by ill3 at 6:14 AM on May 25, 2007 [2 favorites]

Old married lady perspective again - one really common pitfall is getting into a parent-child style relationship with your significant other. It sounds like this has happened to you guys.

Parent-child stuff runs the gamut from me "correcting" the way my husband folds towels to the crazy guy who locks his wife in the basement and reads her email. We have no idea of where on the continuum you lie, so you are getting a lot of responses about being controlling, etc.

If you guys are in it for the long haul, this WILL come up again. It is really not good over the long term to have a parent-child way of interacting. Peers stay together long term. Children grow up, rebel, and move out.
posted by selfmedicating at 6:20 AM on May 25, 2007

Best answer: I have to say I'm surprised by some of the reactions on here, but that's coming from my own negative experience that really clouded my views of Effexor. I took Effexor about 8 years ago due to depression, and it was a few months after I started taking it that I began to have high blood pressure. I stopped taking it for that reason, and switched to a different medication. The blood pressure went down, but then started to creep back up again, and I have to take beta blockers for it now. I'm in my mid-thirties. I still suspect that Effexor may have triggered this permanently.

My doctors don't know why I have high blood pressure either, and it's pretty unusual in a young woman. But there's not always an obvious cause. I don't think there's anything suspicious in the fact that her doctors don't know why, but I do think it's pretty clear that Effexor is a weird choice of antidepressant for someone with high blood pressure when there are so many other antidepressants to choose from.

Therefore I'd say, talk to her. Tell her, as Solomon says, making sure she knows you're coming from a place of love rather than meddling. If you're worried, it's always better to talk things through, anyway. She'll probably appreciate the fact that you care so much about her to be concerned about her health like this. Just be totally prepared to accept whatever answer she gives you, as it's of course her ultimate choice whether to do anything about this or not.
posted by hazyjane at 6:20 AM on May 25, 2007

Effexor is maybe the cause of her high blood pressure, and it seems that she will have a very hard time coming clean.

First, are you a doctor? Are you her doctor? Do you have her medical & family's medical backgrounds? If the answer is "no" to any of those questions, I think the most you can do is suggest to her that maybe she should speak with her doctor about the side effects of Effexor. SSNRIs/SSRIs are often taken for some time after the depression has lifted.

Second, what do you mean by "coming clean"? When I read that, it sounds to me like you think she is an addict -lying about her addiction, hiding it, and having a difficult time. The use of antidepressants is not something you need to "come clean" from. I hope I am reading more in to this statement than there actually is. If someone said that about me, I would seriously reconsider my relationship with that person.
posted by kellyblah at 6:22 AM on May 25, 2007 [1 favorite]

So now I have this dilemma : Effexor is maybe the cause of her high blood pressure, and it seems that she will have a very hard time coming clean. It's basically hurting the woman I love. Is that my role to talk to her about that?...

Coming clean? Are you fucking kidding me? It's not heroin. She's not taking it for kicks. It's a prescription medication for a medical condition. The fact that it has side effects (like most medications) and that tapering-off is necessary when stopping does not make it "addictive." Your assertion that Effexor is hurting your girlfriend is bizarre.
posted by desuetude at 6:23 AM on May 25, 2007 [1 favorite]

Best answer: I know the comments on this thread may sound harsh, but they're coming from a very real place.

A warning from a depression sufferer who has been in situations like these: I have had boyfriends who thought their job was to "save" me or to make me happy. The relationships failed, because the men in question couldn't understand that my happiness or lack thereof was a chemical and situational reaction that had absolutely nothing to do with them.

Seriously, it's much more harmful for the relationship for you to continue thinking her depression is somehow your fault than it is for her to take the antidepressants she has been prescribed.

I would absolutely mention the high blood pressure thing. But do it tactfully, and absolutely do not suggest that she stop taking Effexor. If she comes home from a doctor's appointment and announces she has been switched to another drug, realize you're in for a bumpy road and be there for her.

That is all you can do. You can hold her hand, you can get her a glass of water, you can give her space when she needs it or cuddles when she needs them. You can comfort her, but you can't change the way her brain works.
posted by brina at 6:32 AM on May 25, 2007 [1 favorite]

Dude, do you look up the side-effects of all her drugs? I mean, I bet she's probably taking a hormonal birth control so she can have sex with you- they can cause potentially fatal blood clots, are you going to help her come clean from that?

Seriously, if you do look up all her drugs- back off. If you're just wound up about this particular drug- back off. You're her boyfriend, not her daddy. How do you know she doesn't already know about the side effects? Why do you assume she has no idea how to get off of it, if she chooses to?

In short, treat her like an adult since presumably, she is one. She can handle her own medical treatment.
posted by headspace at 6:34 AM on May 25, 2007

An ex-boyfriend of mine took medication for depression. We dated for about four months before he told me. He was embarrassed and clearly had a lot of shame about needing the medication to “function like a person”, as he described it. Our talking about it improved our communication and intimacy – it allowed me to share with him my own experience with depression, explained a lot of things (certain sexual dysfunction, days when he was particularly glum because his prescription had run out and he hadn’t had time to get to the pharmacy for a re-fill, etc.), and allayed some of his own fears about being somehow abnormal or flawed in the eyes of his SO.

In my experience, his being on the drug and having me support him and listen to him without offering any opinion or judgment on the matter made him feel more in control. That, in and of itself, improved his self-esteem. Were I you, I would trust that your gf is taking active steps to improve her life or else she wouldn’t be on the drug in the first place. Wait and see if there are any serious complications with her drug regimen before you make it an issue – after all, she’s attempting by taking the drugs to feel more empowered when it comes to her illness, and your insinuating yourself prematurely into her health issues might make her feel more helpless. High blood pressure can be managed; over-stepping boundaries and questioning someone’s judgment might not be managed as easily in the long run.

Good luck. You clearly care about this woman and your relationship very much.
posted by TryTheTilapia at 6:42 AM on May 25, 2007 [1 favorite]

You are not her doctor.
posted by Tacos Are Pretty Great at 7:42 AM on May 25, 2007 [1 favorite]

At this point, there's just not much you have any right to say to her. Sorry. You don't get to tell her how to run her medical life, and you don't even get any input on it unless the two of you are contemplating having kids.

Stopping Effexor wasn't hard for me. However, the effects of my not taking the Effexor - i.e., the return of depression, lack of ability to concentrate and extreme reactions to stress - were very hard on the boyfriend who had encouraged me to stop, and we are no longer together.

In other words, be careful what you ask for. Your girlfriend is taking this medication for a reason, not just for fun. You say you're worried that Effexor is hurting her; have you thought about how much it is benefitting her? (And for God's sake, it's not an addiction!)

Depression isn't something I "have" and then recover from. It isn't about being unhappy because of a certain event or any kind of unfulfilled need in my life. It's been with me as long as I can remember, and I fully expect it to be there until I die.

Personally, I'm glad I stopped the Effexor because it wasn't helping me as much as it should have, and I am now on a med that works better for me. But do I resent the guy who suggested it and then didn't stick around for the consequences? Hell yes. DON'T GET INVOLVED in this, and if your girlfriend's taking antidepressants is going to be this big a deal for you, either come to terms with it or end the relationship, because this is something she can't change to suit you.
posted by Jaie at 8:01 AM on May 25, 2007 [3 favorites]

You seem to be making this an all-or-nothing proposition, and you seem to have made up your mind that she must get completely off Effexor. It is certainly possible that it is causing the high blood pressure, but that doesn't mean she has to stop taking it entirely. She may be able to lower her dosage and get her blood pressure in a reasonable range while still getting the positive benefits of the medication. As for the 'addictive' effects, I can tell you that it is unpleasant to come off Effexor but it's not addictive in the sense that you're sitting around jonesing for your next fix and robbing liquor stores to get it. Essentially you just need to gradually wean off it if you lower your dose or you'll feel pretty crappy for a while.
posted by mattholomew at 8:09 AM on May 25, 2007

Best answer: If she keeps taking that drug long term, I would feel like I'm failing. Is that a fair feeling?...

If she were diabetic, and taking insulin long term, would that make you feel like you were failing? Would you urge her to stop?

Some people don't need lifelong medication for mental health issues, but some do. Accept it, it's got nothing to do your suitability or performance as a boyfriend, move on.
posted by stevis23 at 8:19 AM on May 25, 2007

The most - the most - it makes any sense to do is say "Hey, I heard this stuff can affect your blood pressure, have you and your doctor discussed that?"

- "Potential side effects" doesn't mean "side effects that she will certainly get." If you read down the full potential side effects list of any drug, you'll find some bizarre stuff, but presence on a side effects list doesn't mean that those side effects will actually show up in everyone who takes the drug. Everyone's biochemistry is a little different. [Given the side effects list of a recent medication, for example, you'd think I'd be fat, libido-less, with high blood pressure, and, improbably, lactating. Thankfully, none of the above are true...]

- Effexor may or may not be implicated in her high blood pressure. There are other things that affect blood pressure. Other medications [like birth control pills], lifestyle [food, exercise, recreational substances], genetics, etc. all can and do play a role. It's possible that your girlfriend's high blood pressure, for example, showed up way before or after she started taking Effexor, and that's why her doctor doesn't think they're connected. The doctor's in a position to be able to see this, but you aren't - you don't know your girlfriend's intimate medical history. Again, bringing it up as a possibility is OK, but anything more means you're leaping to a whole bunch of conclusions.

- She may be on "that damn drug" because the alternatives are worse. It's not usually the first drug people try for depression, but people often end up trying a few different ones before they find one that's effective and not intolerable, side-effect-wise. No ond wants to have to go on meds, deal with side-effects, etc., but when the alternative is severe depression... Seriously, give your girlfriend and her doctor a little credit here. Maybe your girlfriend's ignorant and lazy and didn't bother to read up on the medications, and maybe her doctor's incompetent and lazy as well, but that's a crappy set of assumptions to make, particularly when you're the one who's least apt to know the details of the situation. Depression can be damn serious, and having been through a brief episode of depression yourself doesn't mean that you really understand how it was affecting your girlfriend's life.

- "Coming clean" is not the right way to think of it. She's not an addict. She's taking a medication that is hopefully helping her stay sane and functional. She may have a few nasty symptoms if she stops cold turkey, so if/when she gets off of the medication, she'll want to taper it under the directions of her doctor. But thinking of it in terms of addiction really won't help you or her.

- You're not her doctor. You're not her psychiatrist. And you're not her. It's the job of people who have medical training and who have access to her whole medical/psychological history to figure out what's appropriate. You can suggest that they take another look at the blood pressure, but in the end, it's not your decision. Similarly, you can do things to try to make your girlfriend happy, but she's an adult - in the end, her happiness is her own business. Trying to take responsibility for the emotions of another person - well, that way lies madness. Doubly so if you get her off of the Effexor, and she ends up severely depressed.

So sure, bring up the possibility that the blood pressure's somehow related to the Effexor, but that's all that's reasonable for you to do. You're leaping to a lot of conclusions and acting pretty overbearing over your girlfriend's medication when you're the person who's least likely to know the reasoning behind the prescription. And you're trying to take responsibility for her own happiness, which is both intrusive and likely to lead only to stress and pain for you. Calm down, take a deep breath, and realize that in the end, this is your girlfriend's business and not yours.
posted by ubersturm at 8:29 AM on May 25, 2007 [2 favorites]

I'm a bit worried for your GF, in that you'll be pressuring her to change her medications, which may well be working for her.

I think you need to really accept deep in your heart that she's voluntarily using this medication, with the approval of her doctor. If you can't do this, then I'd rethink the idea of moving in together.
posted by DarkForest at 8:42 AM on May 25, 2007

Best answer: I'm really happy about the comments I received, here. I'm not sure my intent was always properly understood (or explained), but Thank you all of you who posted something here, even the harsh ones... It's a sensitive subject and it was very good to receive some feedback from a crowd who experienced that.

The thing is, this morning I had no idea about how much I should be involved here, and I think I do now.

I'll support her in her choices, and should not feel like I'm the superhero that must save her (from that specific drug, and from depression at the first place). Love can't fix chemical imbalance in the brain...

posted by V-Turn at 8:53 AM on May 25, 2007

i just wanted to chime in about effexor.

i'm 23 and physically healthy. i've been on effexor since I was 15 or 16, very very gradually moving up to 150mg over those 8 years. my blood pressure is low-normal and always has been. i have never felt a single side effect from taking effexor, and i know i'm on kind of a high dose of it right now. in fact, i'm shocked to hear all of this about this drug, because it's never caused a problem for me. in fact, it's been a lifesaver.

the only problem i see with it is that the withdrawal symptoms are pretty brutal. however, since i am on it for life, this is only an issue when i forget to take a dose, and easily rectified. if i ever wanted to stop, i would wean myself off by taking smaller and smaller doses over the course of several weeks. that's how it's done.

my point here is this: if i'm not experiencing any side effects that i'm aware of, it's not unlikely that lots of other people are in the same boat. why focus on the bad? if she's on the drug, it's probably indefinite, and she's probably totally fine on it. relax.
posted by timory at 9:17 AM on May 25, 2007

Seconding: you are not her doctor, so back off.
posted by spitbull at 9:22 AM on May 25, 2007

I have a close friend who is dealing with depression and who is on an anti-depressant. I have been really stunned by how unaware her doctors are of side effects. She finally bought a paperback book on medications from CVS so she could educate herself rather than relying on her doctors to tell her about the drugs she's taking.
posted by mingshan at 10:30 AM on May 25, 2007

For those who are interested in learning more about antidepressant side effects I cannot recommend CrazyMeds highly enough. It will give you an understanding of side effects in English, not medical terms.
posted by Serena at 11:42 AM on May 25, 2007

In fact, one of the biggest complaints I have heard about that drug is that it turns people into alcoholics.

Wow. Effexor saved my life. But a year later I found myself drinking EVERY NIGHT.

Why? Well, aside from the fact that what was causing me depression was external and had been straightened out, I discovered that Effexor eliminates hangovers.

Aside from a decreased sex drive, the only negative I found with Effexor was it affected my balance. I slowly decreased my dosage to get off (because I was enjoying it!) I had the much-referenced "brain flashes," FYI.

But two weeks later, all was well. Brain flashes gone, and drinking which had been fun ceased to be, and that was done, too.
posted by humannaire at 12:33 PM on May 25, 2007

When I first read your question, I thought, cool, this guy is asking what his role ought to be. After reading through the answers, I'm thinking you wouldn't be at all out of line to say, Hey, I saw your Effexor. What does it do for you? Or, How do you like it? Just open the subject and see what she wants to say. I think your question here shows that you care, and that you know that one's first inclination isn't always the best choice. In this case, she's the one with the mood problem, the one who's talked with a doctor, and the one who's choosing to take Effexor; she may know quite a lot about it, while you know very little.

Even if she should one day say, "I'm not sure about this drug," you need to center your response on how she feels and what she thinks. Her mental health is a big part of her life, and of course you're interested. It's a big cliche and maybe not true for you, but many women say that many men like to give advice and fix things, when it would be better just to listen. But you don't have to leave the subject untouched -- it's okay to ask.
posted by wryly at 12:47 PM on May 25, 2007

FWIW, I have high bp and am on Effexor. Thing is, Effexor helps my moods so much that my doctors decided it's ok for me to stay on it, and that it's probably not the main cause of my high bp anyways.
posted by IndigoRain at 2:06 PM on May 25, 2007

Just for another data point, I took Effexor for several years, up to a fairly high dose (225mg iirc) and the side-effects were pretty minimal (minor shock sensations, bit of dry mouth, some sweating, anorgasmia, and some anxiety which was eased by beta blockers) -- certainly nothing compared to the depression it helped lift.

When I did come off it (and I've been on/off it several times), I tapered off over a few months and didn't really experience much beyond the odd slightly stronger shock sensation (though doing it too early didn't exactly help my remission). Not much worse than any other antidepressant I've taken.

So don't go all panicy because some websites told you it was terrible; most experiences are going to be closer to mine than theirs. If you think high blood pressure is bad, try feeling like there's a 3ft layer of plexiglass between you and the world.
posted by Freaky at 3:19 PM on May 25, 2007

Best answer: While I agree with everyone who has suggested here that it is not your role to either make you gf happy or to strive for a significant impact on her medical choices, I do think that part of evaluating a potential longterm partner is discussing mental health issues, especially when there has already been a history of treatment. It's not at all out of line to want to understand why she's taking the meds, how she understands their effects, how she thinks about them in the long-term...all as part of a more general discussion about her (and your) mental health experiences and hopes.
posted by OmieWise at 7:29 AM on May 29, 2007

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