Rhino: Pristiq / desvenlafaxine

[Rhino]

I've been a lurker on this thread for a long time now.

 

Was on Pristiq 100mg for 5+ years. Was experiencing all sorts of side effects.

I started by cutting a small amount of the tablet off. DO NOT do this. It caused very severe symptoms, cold shivers, paranoia were some of them.

 

I went straight from 100mg to 50mg. This was very hard. It took a good two weeks for the withdrawals to soften. These included severe anxiety, OCD like symptoms, brain zaps to name a few. Very nasty. I was impressed how quickly I managed to survive that- so I thought the next reasonable step was to go cold turkey. Surely - 2 weeks of awful stuff and then happy ever after? I was so wrong.

I lasted for 2 weeks cold turkey. It was truly harrowing. My existing depression and anxiety symptoms spiraled out of control. This was accompanied by extreme brain zaps, paranioa, OCD like symptoms and cold sweats/shivering. I also experienced awful sexual side effects that were very embarrassing and hard to deal with (premature ejaculation - barely lasting 2 seconds). The severity of all of this peaked at the 2 week mark. It just got too much so I took 50 mg. 

 

Within the space of 45 minutes I was totally back to 'normal' again. It was the most bizzare feeling.

 

Since this I have been taking compounded pristiq tablets. 

I have tapered as follows:

• 50mg
• 37.5mg
• 30mg
• 25mg
• 20mg

Currently I'm on 20mg. The compounded tablets work very well. They have the "E4M" sustained release additive. The next reduction will be 15mg. I am holding off as I have a few stressful life circumstances to deal with in the near-ish future and would like to wait until things have calmed down a bit. The cost for 100 tablets is $90. I am in Australia by the way.

 

Currently feeling pretty good - my anxiety is a constant battle - the higher dose of Pristiq certainly curbed my anxiety.

 

I thought I should share my experience this site to help anyone else thinking of doing this. It's going to be probably at least a year until I'm actually Pristiq "free". 

 

 

[ChessieCat]

Hi Rhino and welcome to SA,

 

I moved your post from the Tips for Tapering Pristiq topic and created your own Intro topic where you can ask questions and journal your progress and be supported by other SA members.

 

I am tapering Pristiq and I am concerned that you may be tapering too quickly.  I am currently on 17mg and don't expect to be off until at least the middle of 2020.  I also experienced difficulties going from 100mg to 50mg Pristiq.  After 3 weeks of extreme cog fog I was unable to type (I am a professional typist).  I had joined SA a few days prior to this and they had suggested increasing my dose.  When I couldn't type I took extra Pristiq and after about 4 hours I was about to type again.  Since then I have been tapering successfully with minimal withdrawal symptoms and will be reducing to 16mg tomorrow.  I would much rather go slower and allow my brain to adapt as I taper than to go too quickly and experience worse withdrawal symptoms.

 

We ask all members to create a drug which will appear below every post you make.  This makes it easy for everyone to see your history at a glance.  Please follow these directions to create a signature in the preferred format.  Please also remember to update whenever you make a change so it remains current.  Thank you.

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
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Why taper by 10% of my dosage?

 

Tapering Calculator - Online (this can be saved)

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Tips for tapering off Pristiq (desvenlafaxine)

 

Windows and Waves Pattern of Stabilization

 

Stabilising - What Does That Mean?

Withdrawal Normal Description

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Many members find that the lower they get they slower they need to go:

 

Why taper paper: dose-occupancy curves

 

These helped me to understand SA's recommendations:

 

Video:  Healing From Antidepressants - Patterns of Recovery

What is Happening in Your Brain

[Rhino]

Hi ChessieCat ,

 

Thank you for your reply and help in getting me set up on the forum. 

I do admit I have weaned off quicker than I necessarily should have. It's been very hard at times. 

There's not a huge amount of info out there about weaning from Pristiq. My GP suggested taking tablets every 'other' day, gradually increasing the time between doses. Obviously this doesn't work. It was my girlfriend that actually found out that I could get the medication compounded. She's been very supportive of me through this ordeal. One of the side effects I noticed when I am weaning is that I become overly clingy and paranoid. Not fun for her at all, or for me. 

What I have noticed so far is that the lower the dose you are currently adjusted to, the slower you need to wean off.  Going from 50mg to 37.5 for example wasn't too bad, at least not as bad as going from 100mg to 50mg for example. However going from 25mg to 20mg was tougher than expected. The journey from 20mg is going to take a long time I suspect. 2.5mg at a time is pretty much the most I can handle without major withdrawal effects, however that amount will decrease the lower my dose becomes. The other thing that happens that I neglected to mention was that I lose weight when I wean. My normal weight is about 72 kg- I lose nearly 5-6 kg when I am weaning. My partner notices that I look gaunt. 

 

I do (for the most part) feel better with less Pristiq. The main issue I encounter now is occasional bouts of severe anxiety and some mild OCD like symptoms. There are being managed with counselling mostly. Some days are good, others are not so good (today has been very bad unfortunately).

 

Once I am weaned properly off Pristiq I may well need to start on another medication, mainly for the anxiety, but I will be very mindful of how easy/difficult it is to stop taking. I don't want to be in this situation again where I am stuck taking something I don't want anymore.

 

I wrote a journal at the time of weaning and if wanted I can share it here so people can see what they might experience during weaning of Pristiq. 

Thank you again

 

Rhino

 

 

 

[baroquep]

Hi Rhino, Welcome from Surviving Antidepressants from me as well.  I am another member that was initially on Pristiq but decided to switch to Effexor to help me to taper off of antidepressants.  If I had to start my taper over again, I would have probably just had a time-release mechanism added to the compounded Pristiq and tapered directly off of that ... but hindsight is 20/20.  A few people, including ChessieCat, have had very good success tapering directly from compounded Pristiq and now wish that I had gone that route.  

 

Seeing as you have been tapering fairly aggressively, I would suggest that maybe you do a good hold and maybe stay at your current dose until the new year to let your central nervous system catch up to all the changes you've made.  Please also remember that Surviving Antidepressants recommends tapering by 10% of your current dose with at least a four week hold in-between decreases.  But for now, I think it might be a very good idea for you to take a break from tapering and allow your central nervous system to rest and heal so that your tapering going forward will have much more tolerable withdrawal symptoms than what you've had to deal with in the past.

In any event, I thought that I'd include a few links to help you look for non-drug techniques for managing withdrawal symptoms.  Many of our members have had good success using various techniques to deal with anxiety and stress, among others.  Many members have also found that supplementing with magnesium and omega 3 help calm and relax the central nervous system and thought I'd include those links as well.  Please do make sure that you read the cautions regarding other supplements as they have oftentimes exasperated symptoms rather than helped and Surviving Antidepressants generally only endorses magnesium and omega 3 during withdrawal.    Good to hear that you are seeing a counsellor as they will be a good source of support as you go through withdrawal.  

 

Non-drug techniques to cope with emotional symptoms

Symptoms and Self Care Forum

 

Magnesium

Omega-3 Fish Oil

Sensitivity to medications and supplements

 

Feel free to connection with other members by posting in their introduction threads, they are a supportive group, know what you are going through and are here to help.

Edited November 17, 2017 by baroquep

[ChessieCat]

48 minutes ago, baroquep said:

Seeing as you have been tapering fairly aggressively, I would suggest that maybe you do a good hold and maybe stay at your current dose until the new year to let your central nervous system catch up to all the changes you've made.

 

I agree with this.

 

Rhino, thank you for completing a drug signature.  It will be more helpful if you would add dates and doses so that we know exactly how you have been tapering.

 

"ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly"

[Rhino]

Hi ChessieCat

 

I have updated my signature with a bit more detail.

You'll probably see how hastily I weaned off the Pristiq initially. This was not sustainable. Caused me to lose a lot of weight - I'm a nearly 6ft male, weight had dropped down to about 65kg at times. Normal weight is about 72-73kg. It really punishes the body.

 

One thing I have noticed is that my spectrum of emotions/feelings I experience is much wider without being on such a high dose of Pristiq. Is this something you have experienced? I feel happier than ever before at times, but also more sad sometimes, and I am often very anxious. Pristiq definitely helped with my anxiety.

 

Starting early next year I wish to start further weaning off Pristiq. Thinking 17.5mg might be the next dose I step down to. Going from 22.5 to 20 wasn't too distressing. Just felt slightly 'off' for a week or so. 

 

 

 

 

 

 

 

[ChessieCat]

Yes, I found that the lower my dose got the more I realised how numb I had been.  Back in May I was on 25mg and bought a new car.  It wasn't until recently, on 19mg, that I got really excited a few times over more minor things that I realised that when I got my car it was a dulled excitement.  I've been on an AD for 25 years and it nice to be finally feeling more like I did before them.

 

I would like to caution you against trying to go from 20mg to 17.5mg.  SA's recommended taper is no more than 10% of the previous dose with a hold of about 4 weeks which allows the brain to adapt to not getting as much of the drug.  Many members find that the lower their dose gets the slower they need to go.  This topic is interesting Why taper paper: dose-occupancy curves

 

There are some members on this site who have tried to go faster then 10% and because they have had to updose or hold for longer it is taking them longer to get off the drug than if they had followed the SA taper.

 

I did a 7 week hold on 20mg because I had plenty of capsules and wanted to allow time for my brain to do any catching up that it may have needed.  The way I am reducing from 20mg is with 10mg, 5mg, 2mg & 1mg capsules.  So far I have done 19mg, 18mg, 17mg each for 3 weeks (because it is lower than the 10%)  and I am hoping to continue reducing by 1mg every 3 weeks till I get down to 13mg or 12mg.  I will then hold for 4 weeks.  Once I get under 10mg I will do the same thing but with 0.5mg reductions for 3 weeks instead of 1mg.

 

This is what an ideal 10% x 4 week hold taper looks like.  You will notice that the curve is very similar to the dose-occupancy curves in the link I provided above.