Nate: Pristiq

[Nate]

Hi everyone,

 

I take 50mg/day of Pristiq and am looking into eventually tapering off. I've read about switching to Effexor, tapering by going a day without it in a certain time frame reducing more, etc. Just looking at ways to do this and advice. I've been taking it regularly for about 7 years I think and it's kept me stable and generally in a good place. But some side effects like excess sweating and difficulty losing weight are getting me to research different ways to come off of it

Edited May 27, 2017 by scallywag
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[MollyN]

Hi Nate! So glad you're here - there's a wealth of knowledge here regarding these drugs, their interactions and safe ways to withdraw from them... a moderator will pop in shortly to post lots of helpful links for you and also to recommend a way forward for you. (I only really know about paxil, so can't help you myself sorry) .

 

xxxmollyn

[ChessieCat]

Hi Nate, and welcome to SA,

 

I'm tapering Pristiq.  I can't respond fully at the moment but I'll come back later to chat about my experience.  I get my tablets compounded.

 

As for alternating days/doses.  This is not a good idea.

[ChessieCat]

Hi Nate,

 

Yes some people do switch to Effexor to taper.  I'll give you some links to check out.  This is your own Intro topic where you can ask any questions you have about your own situation and journal your progress.  If you click "Follow" top right you will be notified when someone responds.

 

It is best to take the same dose every day at a similar time.  Please see Skipping Days vs Every Day Dosing Graph

 

Please create a drug signature Create Your Signature.  Please include details for the last 12-18 months of  all drugs, dates, doses and discontinuations & reinstatements.  If you can't remember dates, please write it as "early March" or "mid-August".  Please provide a summary of any drugs prior to that which can just be listed with start and stop years. Please include all prescription, non-prescription drugs and supplements you are currently taking. Phone Instructions:  Withdrawal History Signature. Please also remember to update it with date and dose whenever make a change so that it remains current. Thank you.

 

Before you begin tapering what you need to know

Why taper by 10% of my dosage?

 

Tips for tapering off Pristiq (desvenlafaxine)

 

Tips for tapering off Effexor (venlafaxine)

 

baroquep is a member who has switched from Pristiq to Effexor to taper.  When she changed we think she may have used too low a dose as the exchange amount so she switched and lowered at the same time.  It is better to make one change at a time.  However her taper seems to be going well now.  I personally decided not to risk changing over and stuck with Pristiq.  In Australia we can only get 100mg & 50mg tablets but some countries can get 25mg.  The link to my Intro is in my signature.

 

And this topic is helpful:  How do you talk to a doctor about tapering and withdrawal?

 

These really helped me to understand SA's recommended tapering of no more than 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug:

 

One Theory of Antidepressant Withdrawal Syndrome

What is Withdrawal Syndrome?

[baroquep]

Hi Nate, Thought I should post this on your profile as well just in case you don't see the answer to your questions on my own profile ...

I won't lie, the switch from Pristiq to Effexor XR was pretty intense.  Though once my body/mind adjusted, withdrawal has been fairly tolerable except for a couple of rough spots after my tapers in January/February when I tried to shorten the holds.  My doctor switched me from 50mg Pristiq to 75 mg Effexor XR and from my experience, I can only assume that a switch from 50mg Pristiq to 100mg Effexor XR would have probably made it a lot easier.  

I have the Effexor XR compounded and chose this route, because Pristiq has a time-release coating and the pharmacist said I would have to either dose Pristiq twice a day to keep a steady stream of the drug in my system or she could add a time-release mechanism to the compounded Pristiq but she couldn't guarantee that it would work as intended.  Because I was worried about either a dose dump or having to take it twice a day, I decided it might be easier to switch to the Effexor XR.  I know that there are a few people on this site (ChessieCat for one) who have their Pristiq compounded and didn't seem to have any issues but we are all different.  

If I had to do it again, am not 100% sure, but may have just stuck to having the Pristiq (devil you know) compounded with a time-release mechanism and taken my chances.  It's anyone's guess whether doing that or switching to the Effexor XR would have been a better or worse approach as these drugs are so unpredictable.  What works well for one person, doesn't work well for another, so it's a crap shoot.  

All I can say is to go slow, no more than 10% at a time, Effexor (any version) and Pristiq are notoriously difficult to withdrawal from so be prepared for it to take you many years to get this drug out of your system safely.  In the long run, it really doesn't matter how long it takes, the most important thing, as far as I'm concerned, is to get it out of your system as gently and carefully as humanly possible and we are the only ones that can ultimately make that wise decision.  

Good luck in your journey, after everything that I have gone through so far, the benefits are most definitely worth it.  I feel a lot more engaged in life and hopeful that it can only get better as I slowly get this drug out of my system.  Best of luck

[Nana]

I tapered off Pristique 2 years and 2 months ago. I followed the recommendations on this forum for a slow taper; 10% every four to six weeks. It can be done by crushing and weighing the meds.

 

I don't take any other meds. I don't drink at all, (but I used to). I feel great.

 

If I ever wake up feeling a bit panicy, (and that hasn't happened for over a year), I take some deep breaths before getting out of bed. Exercise is hugely beneficial.

 

I haven't looked at this forum for a year or so; I am not sure why I did today. But I hope this helps you!

[Nate]

Thanks for the input Nana and Baroquep!

I think now I may be leaning towards sticking with Pristiq and either the crushing method or look into compounding.

Nana can you tell me what you used to crush and weigh the Pristiq?

 

 It can be done by crushing and weighing the meds.

 

 

[Nate]

Also, since you crushed it yourself, did you just swallow the powder or put it in water or a capsule?

[Nana]

I used a mortar and pestle from my kitchen, typically used to crush herbs. I weighed the med on a digital kitchen scale. It only goes down to 1/10 of a gram, but that was close enough for me. I scraped the powder into my hand and popped it into my mouth.

 

I think the key is the slow taper. Don't get impatient. A good method is to make the 1st day of the month the day you cut back by 10% of your previous dose.

 

I did have "weepy" days,  or maybe just weepy episodes, after I came off completely. But they became more and more infrequent.

 

Life is good.

 

Good luck!

[Nate]

Just started a taper today from 50 mg/day of Pristiq to 45/mg. I spoke to my dr and he prescribed 60 tablets of 25mg a month for me. Insurance approved for 2 months so far. Took 1 25mg pill and crushed and weighed a 2nd to equal 20mg.

 

Whoo baby, felt a bit of a rush for 15/20 minutes but normalizing now I think. Doctor recommended taking all at once not to interfere with my sleep. Might talk to him about separating doses, but I'll see how it goes these first few days.

[mammaP]

Hi Nate, I have moved your latest post to your original topic, it is one topic per person in the introductions forum. 

 

I'm glad your doctor is on board with your taper.  If you decide to space the dose you might be best just spacing the 20mg of broken tablet to twice a day, early morning and early evening so not too close to bedtime. 

[Nate]

Thanks for the tip Mamma I'm trying it out. I do still get a bit of a head rush when I take the crushed portions but it goes away within 45 min/1 hour.

It seems its easier for me to sweat after I take the crushed portions, my body feels a little warmer....which is the side effect I'm hoping goes away as I slowly taper. Sometimes a little lethargic after the crushed portions as well. My guess is that since its entering my blood stream faster, any side effects are coming faster too. But other than that - so far so good!

[Nate]

Some sleeping issues, I have had a few nights where I wake up after 4 hours and can't go back to sleep for at least 2 or more hours. Feeling tired today but I'll get by. I'm still dividing the crushed part in 2, taking half when I wake up and half maybe 3-5 hours later. I'm wondering if the sleeping breakup is because of the half life of Pristiq, not sure. I may try taking it all at once rather than dividing it up, but any suggestions are welcome. Trazadone used to keep me asleep all night for the most part, I'd rather not increase that but I guess that's an option to discuss with my psychiatrist as well.

A few times I've been easily irritable at night after this decrease but nothing too bad

[Nate]

Still trying different times during the day/evening to take the crushed parts to help with sleeping and finding that if I can take the 2nd half between 6-8 pm it works out better in keeping me asleep, probably because the half life is 11 hours. Sleeping is the biggest issue for me right now and I'm hoping to find those best times to take it, and then stick with them. I'm also finding irritability or frustrating feelings for a day or two maybe a few days into the reductions. But I'm aware of it that this is likely to arise when I reduce and am doing ok.