I've been talking Pristiq for months and it doesn't seem to be doing much, but honestly, the withdrawal is so bad I didn't want to attempt getting off of it. As you might know, Pristiq is a metabolite of Effexor and Effexor is also a nightmare to get off of. If I would miss a Pristiq dose by even a few hours I would become suicidally depressed. Really. No joke.
So getting off of it wasn't on my short list. There is no taper strategy for this drug as it only comes in 50 and 100mg tablets and you cannot cut them. But I seem to be successfully getting off of it with minimal impact and withdrawal. Here's how:
1. I started taking half the Pristiq (I was on 2 - 50mg pills) later and later in the day, one hour at a time. This takes a long time, but the withdrawal was so bad I was prepared to take as long as necessary to try to reduce/get off safely.
2. I started taking some Welbutrin which is a similar type of antidepressant (a serotonin norepinephrine reuptake inhibitor, SNRI).
3. Eventually, I was taking one tablet in the morning, and one at night, so I just stopped taking the one at night. This meant the worst of the withdrawal would happen at night, when I was asleep.
4. Now I'm taking the second pill later and later in the day until I can eventually get off that one too.
Now, no doctor suggested this to me, I simply used my knowledge of psychopharmacology to do it. This means, it is in no way recommended. You should talk to your doctor. But I wanted to share, for anyone who has lived the hell I did trying to get off of this medication before.
Good luck.
Effexor was awful for me! I literally could hear people breathing from across the room...it heightened all of my senses and not in a good way. It also made me feel like my heart was going to explode. I wouldn't give it to a dog...I didn't like!
ReplyDeleteI've heard a lot of horror stories about Effexor. I can't say being _on_ Pristiq is a nightmare, but trying to get off of it sure is.
ReplyDeleteI have my own horror drugs. Geodon was the_worst_one_ever. But that's me.
Effexor is awful, I would literally start vomiting if I was one hour off my time to take it. Somehow, my (formerly evil) psychiatrist switched drugs on me on miraculously, no side effects when I changed. I wonder if there's something similar for you and Pristiq?
ReplyDeleteKansasSunflower - like I said, this method I've invented seems to be working, so I'm OK for now.
ReplyDeleteI love Pristiq I dont want to stop taking it. Plus you can't beat the side effect of weight loss! :)
ReplyDeleteI have been taking Pristiq 50mg for anxiety and hot flashes...been taking it for a year now. It has raised my LDL and Trigycerides both by as much as 60 pts. It has also caused hypertension....I have gained 10 pds in a year. although it has helped a little with my anxiety it is making me depressed...I am tired all of the time but not the "good" type of tired, have difficulty sleeping. I see my dr. next Tuesday. i have been on seroquel which was the best but also raised HDL and triglycerides...lamactil which almost drove me crazy and only 10 mg of Prozac which made me nuts. years ago I took Paxil and gained 35 pds...any advice? I also take .50 mg of clonezepam at bedtime...
ReplyDeleteHi Carol,
ReplyDeleteI have to say, if the Pristiq is all you are taking (such a small amount of clonazepam isn't really a factor), those are very unusual side-effects to get. What you are describing sounds more like any antipsychotic. However, if you and your doctor agree it's the medication, then I suppose it must be.
If Seroquel was the best for you, then you might try another antipsychotic. While they do all carry metabolic risk, some carry less than others, and you might react differently to a different one. People seem to have a good response to Abilify, but talk to your doctor about the right med for you.
If you don't want to go the antipsychotic route, another antidepressant is also a reasonable choice. It sounds like you've tried a few but some antidepressants manipulate different neurotransmittors than Paxil and Prozac so you might want to ask your doctor about that. Welbutrin is fairly unique, but again, talk to your doctor about which one is right for you.
If all you are experiencing is anxiety and hot flashes I wonder if a benzodiazapine might do the trick. Again, that's something to talk to your doctor about.
All that being said I must stress that I am not familiar with treatments for hot flashes, so that may complicate things for you in ways I don't know.
My best advice is to sit down with your doctor, be very clear about what you symptoms are, what your side-effects are, and specifically what you want in a treatment.
For example, "I want a treatment that will reduce my anxiety by 50% and will not cause hypertension."
I know that seems obvious, but the more you tell the doctor what you need, the better his treatment is likely to be. He's the only one (and you) who know your medical history so he's the right person to discuss options with.
Good luck.
- N
thanks N....yes, I'm almost positive it is the Pristiq raising my bp and triglycerides..if you look at the literature it is a side effect...and in between the seroquel and Pristiq my blood work was normal.
ReplyDeletei see the dr. on tues...when i was in my 20's I was on valium for anxiety...on it for 10 years with no problems...i was taken off of it because it was "addictive". that is so funny to me because when I was weaned off of it there was NOTHING like the joy of "discontinuation sydrome" which is NOT addiction. I'll take addiction any day of the week. there was a time I was depressed right before I retired from teaching...that's when i took the Paxil which did absolutely nothing for me but make me fat. I am going to come right out and ask him to put me on more clonezepam or valium at a higher dose until I am withdrawn from Pristiq...then I can start to taper til I'm at a low dose...I did very well on just 5 mg a day years ago...so what if you're addicted???? As long as you do not have to increase and I did not. The dr. told me I was psychologically addicted to valium...so what? i was happy.
I do not understand why dr's today are so happy to give you an antidepressant but not a benzo...I have had doseage increases for every antidepressant I've taken...just in a few months...Anxiety disorders run in my family...I am just so tired of all this crap...I have had such miserable withdrawals from seroquel, paxil and even prozac. I HATE going through this again...the sickness...
anyway thanks for your advice...I will update after I see the dr. Tues and see what he has to say...
Carol,
ReplyDeleteYou bring up a very good point about benzos. You see, it went like this:
- barbituates were famously addictive drugs that housewives and partiers liked to take in the 60's and 70's.
- These drugs were given out far too easily and got a bad rap. Probably rightfully so.
- people who killed themselves often used barbituates, at least as part of the cocktail
- benzos came in and they have similar effects to barbituates but are "lighter" (they act on fewer neurotransmitters)
- due to the backlash from the barbituates, benzos got a bad name too
That's my theory anyway. I have never seen a study that proves that benzos are addictive (of course, benzos due vary). (Also, the possibility of addiction is greater in those with other addictions.) Of course addiction is a slippery term and can be tough to prove.
People become _reliant_ on benzos but as you've mentioned, it's not the same thing.
If your anxiety was successfully controlled on a benzo I would make a strong case for trying it again, and if the doctor says no, then ask to see some research. There's really no reason why you should be in pain just because your doctor isn't up on the latest literature.
You are exactly correct - some people can't live without their antidepressants and some people can't live without their benzos. I would be very pointed in asking the doctor what the difference is.
(FYI, part of the definition of addiction is that it must be harming your life or the lives of others in some way. If this was not the case for you, I would challenge the doctor on that also.)
Actually, I could go on this topic for ages, so I'll just stop, but yes, be proactive with your doctor. If something works then it works damnit! (Most of us don't even get that lucky.)
- N
Ok, I saw the psychiatrist on Tuesday and this is the plan...when i come back from vacation on the 24th I am to quit taking Pristiq. I will take Prozac as needed to help with w/drawal and I will take another antiseizure med, zonisamide, which the dr. says will help me w/w/drawal, but he intends for me to stay on it...supposed to help with anxiety/depression..also prescribed for binge eating and studies are being done to see how this drug can help people w/alcohol abuse problems...lamactil stimulated me too much but he said the zonisamide will not necessarily behave in the same way...my mother says I should go some place to detox... i can also continue on .5 clonezepam per day and ambien as needed, we have agreed not more than twice a week except on vacation...
ReplyDeleteIf this does not work i will go back on a low dose of seroquel about 150mg and then take a statin...I think with all of the meds you eventually reach a tolerance with them...absolutely NO to any increase in benzo's...he believes they are too dangerous in the long run. And of course as "downers" can lead to depression.
this is the first time a dr. has helped w/ the w/drawal so i'm hoping for the best and will see him the 2nd week of November...but I had symptoms from 10 mg of Prozac before...and i opened the capsules and poured some on food to get about 5 mg...constant nausea...no more antidepressants I can say that for sure.
I think once you are on any of these meds for any length of time they rewire your brain...when i am off meds even for months I am so nervous and panic stricken and depressed I do not enjoy my life...
Hi Carol,
ReplyDeleteWell, I'm glad you talked to your doctor and made a plan. Hopefully this works for you.
Watch coming off of the Pristiq, as I've mentioned, it can be pretty nasty. If I were you I'd put plans in place, like friends and family, just in case things go wrong. But maybe you'll be lucky and it'll be easy for you. You never know.
Meds don't actually "rewire" anything. Meds manipulate neurotransmitters which effects how often a synapse fires. It's a bit complicated but it's sort of like throwing pebbles in a glass of water - the water level goes up but the amount of water stays the same. When you remove the rocks, you're back to where you started. (This is according to everything we know about meds and the brain thus far.)
I wish you the best of luck with this plan. Just try to follow it and don't be afraid to call your doctor if you need to.
- N
N,
ReplyDeleteThanks for your comments...rewire or chemistry it is all the same. I believe once you start on antidpressants your brain is NEVER the same. Anyway I am on my new plan...started on Monday...a few brain zaps...feels like my head is a Morton salt box about half full and then every so often it's being shaken. Not bad, very mild, I had intestinal difficulties until yesterday...now I just feel like I have a mild hangover...dont like it but I do not feel nervous and am allowed my .5 klonopin and 10mg ambien at bedtime...will start cutting back on the ambien...I have opened the 10 mg capsules of Prozac and sprinkle about half on food, will end that in a day or two and then soon I double the zonisamide. I have done a lot of reading on it and it is used "off label" for the treatment of anxiety for those of us who do not respond to traditional treatment (antidepressants)..in case you think there is anyone who might want to know this...after a week off Pristiq my bp dropped from 160/90 to 119/63 on average. My dr. agrees that I will NEVER be on an antidepressant again...I have been on Prozac before and even doing what I'm doing now I had w/drawal even though that is not typical..my youngist brother is on Prozac and Wellbutrin...and a big busy businesman who cannot take a day off..he told me his dr. told him he is ok to start cutting back on Prozac first..he complains of nausea...so I guess we are "ultra" sensitive. I wish this was all over...I am so sick of this...take one drug it doesn't work so w/draw...but I will tell you this ..after having w/drawn from Paxil and then much later Prozac on my own I think you need a dr....this time at least maybe due to the zonisimide I am not nervous and can sleep..gives me strength for the day and the "sick" feeling...I can function.
I've been taking 50 mg Pristiq for about a year now for anxiety. I can't even explain how huge of a help it has been. After some seriously traumatic events in '09, I began to have debilitating anxiety. Before I started taking the Pristiq last year I was in the E.R over six times in the course of two months because of panic attacks. I originally started with Xanax, combined with Abilify (I think). The Abilify did nothing to help with the anxiety so I was put on Celexa which only very slightly took the edge off of things. After another bout of panic attacks, my doctor put me on Pristiq, and I have to say from the very first day I started taking it, I began to feel normal again. Within a month I was completely off of the Xanax and like I said, I've been taking Pristiq for a year now and it's done wonders. The worst side-effects I experienced were night sweats, vivid dreams, and (unfortunatley) a reduced sex drive. Overall though I don't experience any of those things any more and I feel pretty normal.
ReplyDeleteI've been through a lot of counseling and believe I'm ready to ween off of it, but I have to admit, I'm scared I won't be able to without falling back into panic mode. I don't want to start taking other medications to help with the withdrawl effects because I'm afraid I'll end up being reliant on them (vicious cycle).
I tried about six months ago to take my dose every other day and for about two weeks I seemed to do OK until I started getting excruciating headaches, dizziness, night sweats, and I noticed the anxiety starting to come back. My counselor said most people should give Pristiq at least a year to 18 months before trying to ween off of it. Well, it's been a year and I don't want it anymore. So, my question is: Any advice for getting off this stuff?
Hi N,
ReplyDeleteIn your initial post, when you say you halved your pristiq, did you go from 200mg to 100 mg and take them later and later in the day until you were taking one at night and one in the morning and then stopped the night one?
I need to get off Pristiq. I've just gone up to 250 mg a day and I know in the past when I tried to come off the last 50 mg (from 200 mg reducing 50 mg / 2 weeks) it nearly killed me. I've heard taking another SSRI or SSNRI canbreducebside effects, but I also like your plan, if you could just clarify for me exactly how you did it?
Hi,
ReplyDeleteI'm not really monitoring this blog as I've moved it to http://natashatracy.com
However, to answer your question, I was on 100mg of Pristiq so that is two 50mg tablets. I took the first one in the morning and moved the second one later and later until I was taking one in the morning and one at night and then stopped the one at night.
You may wish to decrease you Pristiqu more slowly, that may help.
Yes, it's the last 50mg that are a bitch, and of course, you can try the above, but it didn't work for me for the last 50mg.
Yes, recommended practice is to switch to another medication when you come off the last 50mg of Pristiq and then slowly taper off the medication. Prozac is one of the medications they switch you to as it has a long half-life. (Long half-life is good. Pristiqu has an extremely short half-time.)
Discuss options with your dr, but for the last 50mg, you may have to do the switching technique, some people can't withstand the withdrawal any other way.
Good luck.
- Natasha
i also had difficulty coming off of Pristiq. My Dr originally said I had to "suck it up". It was awful - nauseous, headache, shaking, hot sweats, clammy, etc. Finally, I got the Dr to prescribe a way to wean off of Pristiq without any withdrawal. I was told to immediately stop the Pristiq, then take 25 mg of Effexor for one week, then 12.5 mg of Effexor the following week and finally, 6.25 the third week. It worked like a charm! No side effects and no withdrawal!
ReplyDeleteI just wanted to give my experience about Pristiq. I am currently on 50 mg a day for depression and frustration in general with life & people. I really love the fact that it takes off the "edge". My kids and husband are much happier living with me now & I like them a lot more too!! It increased my sex drive by at least 80% (which had been completely gone for years). Problems I have with it is #1 COST!!! So freakin' expensive! Also, night sweats especially during pms week, SEVERE! I'm talking waking up having to change clothes and sheets!! Tiredness(lazy unproductive kind) is so extreme also! I can't seem to light a fire under my tail! It has definately increased my procrastinator personality default! Also I by force, not choice (doctor's office is rediculously inefficiant) got cut off of it cold turkey for 5 days at Christmas time. Absolute HELL!!! I wanted to kill myself I had panic attacks (which I've NEVER had before) I cried non stop and felt the whole world was against me! I honestly & literally thought my body was shutting down & I was dieing! Now after reading all of this, I know I'm not alone! I am now seriously terrified about getting off of it!
ReplyDeleteI missed my docs appointmemt to get my pristiq refilled...havent had it for 3 days now and Im going nuts....extremely irritated and no patience....Have decided to lock myself in the room for the evening until I can call my doc in the morning.....I love my pristiq I felt about %80 better than I did before I started taking it.
ReplyDeleteI have only been on Pristiq for about a month for anxiety but the main side effect I was having was it was making me depressed. I was on Effexor previously so the transition was not a problem. Now I am switching over to Cipralex and that is going ok. The problem is weaning off of the pristiq. I was down to 50 and making some head way until about day 3. I had a terrible time concentrating at work and really bad chest pain/tightness. All I could think of was getting home and taking a dose of Pristiq. about 1.5 hours afterwards I was feeling better. How else can one taper on a med you can't cut or split. Or can you? Has anyone tried this with Pristiq?
ReplyDeleteEffexor and Pristiq are a nightmare for me. If I miss a dose by a few hours, I get jittery and flu-like symptoms as well as irritable. I would love to stay on the Pristiq as it has seemed to work okay for me in conjuction with Depakote. BUT it is a nightmare to pay for as well as getting it with my insurance company. I have to get three months at a time through mail order and EVERY SINGLE TIME a refill is due (every 3 months) I have to get Prior Authorization. It stresses me out to no end on top of the fact that we can barely afford to pay for it on top of several other meds I am on. I HATED effexor, but it has a generic, so I am going to have to go back to that.
ReplyDeleteRight now, I am going through withdrawl because lo and behold I ran out of my meds and couldn't get the prior auth in time for the refill and we didn't have the money for 3 months worth anyway. So I am sick as a dog. Anyone know any OTC stuff that helps? If so, PLEASE email me rubyred77@gamil.com