Mattie: tapering off Pristiq

[manymoretodays]

Hugs.

[Mattie]

I was supposed to take my 1st dose at 1:30 today but realized I took it at 830 with my vit d and b12 (feeling bad all day) what now? Hope I didn’t mess myself up ! What time take it tomorrow? I have to get me a separate pill box because my brain is mush 😩

[Altostrata]

@Mattie every time you make a change in Pristiq, it will take about a week to settle out. This could be the change in form or change in schedule. If you take a dose off-schedule, it will take about a week for that to settle out, too.

 

Were you always prone to health anxiety?

 

 

[Mattie]

@Altostrata, in my experience, every time I switched a med or went up or down, it took around 2 months to settle and still never felt better only partially, like settling with so many side effects, I’ve never felt good since I initially went off Prozac in 2020 , I don’t think this nightmare will end for me , not living only surviving, sorry if I’m so negative, it’s 530 am and despair is all I feel, please don’t give up on me , I have no hope or trust in doctors ,I do have anxiety but not as far as thinking of my health, I just don’t feel good, no courage, I’m always  exhausted in the am till around after 10 or 11 at least, the depression and lack of modivation renders me useless till thankfully getting a window where I feel almost normal every evening but since I switched to double dose I haven’t had. I did call the PCCA and they directed me to a compounding pharmacy in there group, do you think it is wise at this point to switch to their meds?

[Mattie]

Date: sat Oct 7

 

530 am woke up full of anxiety and 

               despair sat in recliner 

630 am  no motivation, made coffee 

               crying spell, feel a little less   
               anxiety now that I cried 

830am    accidentally took meds, 

                should have taken them at

                2:30 pm

930 am.   upset stomach, feel drugged 

                 and spaced out, drained

                 hopeless ,headache 

 

1230pm.   ate lunch, feel a little less 

                  over medicated , 

                  depression up and down 

300pm      don’t feel as drugged, 

                  stomachache went away 

                   feel a little stronger

                   psychically, depression up 

                   and down, headache gone

5:30pm.      ate supper, mood starting

                    to lift a little but not like

                     usual since starting

                     double dosing

7:00 pm        finally starting to get a

                      slight window

7:30 pm         took 2nd dose meds

830 pm          Very sleepy, went to bed

330 am          toss and turned, anxiety,

          
4:00am          fell back asleep 

5:30am          woke up , doom and 

                       gloom, anxiety, 

                        extremely sleepy but 

                        can’t sleep 

 

[manymoretodays]

4 hours ago, Mattie said:

I’m always  exhausted in the am till around after 10 or 11 at least, the depression and lack of modivation renders me useless till thankfully getting a window where I feel almost normal every evening but since I switched to double dose I haven’t had. I did call the PCCA and they directed me to a compounding pharmacy in there group, do you think it is wise at this point to switch to their meds?

 

Hi Mattie,

Maybe there is some non-drug coping that might help with the morning blah/depression?  That too, is a cortisol response.  Is it like a early morning dread?

Early morning waking-managing the cortisol spike

you'll see the dread mentioned in the first post, and then reading down you'll see that many others have suffered the same, and then look at how they managed it.

That it lasts all day now without change may be temporary.  You know that.  I don't think it will take 2 months for you to adjust to split doses.

 

I did find a little more on the Methocel.  Apparently it is the E4M in it that gives it a more slow release quality.  We don't really know how much longer it would extend the usual 11 hours half life of the pure drug Pristiq(before being altered in any way).

  

On 3/22/2016 at 5:50 PM, Fresh said:

About the "slow-release additive"  (necessary for pristiq and some other meds.):

""We are PCCA (Professional Compounding Center of America) approved pharmacy and we use PCCA ingredients for our compounds. PCCA has approved us to use Methocel (E4M) as the only ingredient for slow released formulated compounds. 

 

 PCCA approved pharmacies use Methocel (E4M) as their slow-released ingredient, however, we will have no access to other independent pharmacies's medical data on what slow-released ingredients would they use. "

18 hours ago, ChessieCat said:

https://compoundingpharmacy.com.au/slow-release-t3/

"The ability to make “slow or controlled-release” capsules is vital, if all the T3 is released immediately the effect would be too great and potentially dangerous. It is important that these capsules are made by a pharmacy with experience and expertise in this area. The choice of controlled release agent matters. We use a slow releasing agent called Methocel E4M Premium CR is used. The Premium means it meets the USP standard and the CR means it is control released grade. It is considered the gold standard. "

And then Ccat found this ^ about another medication but mentioning the Methocel(E4M) formulation.

 

Are you thinking of switching to the PCAA group approved pharmacy to go back to dosing once a day?

I hate to see you abandon the split doses, while you are still moving them, and after only a weeks trial so far.  You haven't even gotten to the target times yet with them. 

Yes, I agree you are sensitive...... and did not do well with changes in the last 2 years.  It's only been a week though.......now........since you've begun splitting doses, and slowly shifting them.  And then you've had 2 mishaps with your dosing now.......doubling your dose once, and more recently taking an early morning dose instead of taking it at the later hour it was scheduled for.

 

This all confuses your nervous system and definitely takes more than a day to recover and then adapt again to new stable doses, at stable times. 

 

Just saying, as it isn't always as quick as we'd like it to be.  That illusive more manageable stability.

Here's a good link to what brassmonkey says about stability, or WD stability:

Stability

 

When was the last time you felt better than now?  I mean is it fear/anxiety?  Or just part of the dread and not being able to believe, or have hope that you will ever recover, and be able to taper off your drug?

You will recover, you will feel better Mattie.  I know it's hard to believe after several bad days but hang on to that.  Use imagery too, or your imagination a little bit.  Try, try to recall your last good day or a good experience and picture it in your head, and remember what that felt like.  I know that can help me, many a time to get through hard things.  Just knowing that the easier things do exist, have existed and will come again.

We often say this whole experience makes us more resilient in the future, I mean any of us who have been through a tough WD experience.  We just know we gain skills to help us in our present and future lives that likely could not have been gained any other way.

 

Yes, you could switch to the PCAA group approved pharmacy if that is affordable and doable. 

I might, if I were in your shoes now, also give it at least another week before abandoning split doses.

 

I'm glad you got some pill boxes to separate out your 2 doses each day now, to prevent further errors in dosing.  You might feel a bit off from that error made for another week.  I would hope that you'll soon have a better day.

 

Crying often helps me too, to shift out of either anger or hopelessness,........let those tears rip.

Laughter too, can you find anything humorous to help you cope now?  Dumb movies that make you laugh?

Try some of the psychotherapeutic techniques in the indexed list of the first post of this link(they are down at the bottom):

Non-drug techniques to cope with emotional symptoms

 

Okay, and thanks for the Notes.  Do a couple more days for us please.  They might even help you to keep your doses at the right times......act as a reminder.  You could set an alarm on your phone too, for the times your doses are due each day.  That might help.

And above all hang in there.  Despair is tough, but you are tougher. 

Explore some of the other forums, like Finding Meaning, and Off Topic too.  Visit with some of the other members too.......that can help,..... to offer others support during your time of need. 

 

L, P, H, and G,

mmt

Edited October 8, 2022 by manymoretodays
additional

[Altostrata]

Hang in there, @Mattie

 

When you post your daily notes, please specify which drugs you took at what time and at what dosages.

 

If you take your drugs off-schedule, this could cause odd symptoms later. The disruption in your symptom pattern could take a week or so to settle out.

[Mattie]

@Altostrata, thanks for your response, I didn’t know what to do about the time to take my morning dose today since I accidentally took it yesterday at 830 am instead of 230 pm, so I went ahead and took it at 730 this morning and will continue from here on at 730 am and 730 pm, hope it won’t mess me up too bad , I definitely won’t be making any more mistakes from here on, I’ll do another day’s symptoms tomorrow and I’ll put the drug name etc, thanks again 

[Mattie]

@manymoretodaysand cheesiecat, thanks for the encouragement and information, as for as the PPCA,compounding pharmacy, I’m just wondering maybe if they have a better quality med since they went the extra mile and uses only ppca chemicals. My intention is to still take it twice daily. Thanks again, I’ll read everything y’all found and I won’t be making any more mistakes, I’m suffering enough as it is. Again thank you both for your continued support, you have no idea how much I am grateful for you both and alto. I keep you all in my prayers every night ❤️

[Mattie]

Sat Oct 8

 

5:30am. Woke up, doom and gloom 

               feeling,depressed, drained   

               so sleepy but can’t sleep 

6:00am.  Sat in recliner with mood 

                lamp

6:30am.  Made coffee, 

7:30am.   Took 9mg pristiq 

                 Compounded, ate breakfast

                 low appetite 

8:30am.  upset stomach,over 

                medicated,spaced out 

                feeling , headache 

                depression, anxiety 

9:00am.  sat outside in sun, then 

                In shade 

10:30am. Drove around in my car, 

                 listened to motivational 

                 tapes , driving is my best     
                 tool I’ve found, helps me 

                 with mindfulness, still low

                 mood, spacey feeling 

12:00pm.  Lunch, low appetite, feeling.    
                  the same 

   1:30pm.  Crying spell,sobbing,does

                   make me feel a little better

                   anxiety wise

   3:pm.      spacey but mood starting 

                   to go up and down 

   5:pm.      took shower by the hardest   

   6:pm.      Dinner, low appetite, mood

                   slight windows ,stomach

                   upset , took pepto

   730 pm.   9mg pristiq  

   9:00 pm.  bed fell asleep 9:45 pm

   4:15 am.   up, toss and turn, anxiety,

                    doom and gloom, can’t 

                    take another day like this

                    but the good Lord gave it    
                    for a reason 

   5:30 am.   Got out of bed

 

 

Edited October 9, 2022 by ChessieCat
removed white space at bottom of post

[Altostrata]

Please include your sleep pattern in your daily notes.

 

How much caffeine do you drink every day?

[Mattie]

@Altostrata Not quite sure what you mean by sleep pattern . I put the time I went to bed and the time I woke . Maybe I wasn’t detailed enough or worded wrong? Also, I drink 1 cup coffee (black) but I also drink a drink every day that has about 75mg caffeine so probably a total of 150 mg daily, sometimes chocolate which has caffeine (almost every day)

[Altostrata]

Caffeine can cause sleep difficulty, even hours later, especially if your system has been sensitized by going on and off psychiatric drugs. Too improve your sleep, you may wish to gradually replace caffeinated drinks with decaf.

 

Any alcohol?

 

When did you start taking Pristiq on this schedule?

[Mattie]

@Altostrata, I’ll have to get off of caffeine, I don’t drink any alcohol, and I started double dose 

sat Oct 1.  6:30 pm & 7:30 pm

sun oct 2. 6:30 pm & 7:30 pm

mon Oct 3 5:30 pm & 7:30 pm

tues oct. 4 4:30 pm & 7:30 pm

wed oct  5. 3:30 pm & 7:30 pm

thurs oct 6  2:30 pm & 7:30pm

fri.     Oct  7. 8:30 am & 7:30 pm

sat.    Oct. 8. 7:30 am & 7:30 pm

sun.   Oct. 9.  7:30 am & 7:30 pm

[Mattie]

Sun Oct 9-2022

 

5:30am   Woke up, immediately upon 

                eyes opening, fear , doom, 

                hopeless, I’ll be like this 

                forever , panicky, stomach in 

                 knots

6:00am   Coffee (1cup) , mood lamp 

                 30 min

6:30 am.   Feel only slightly better, not 

                  as much anxiety, very low 

                  mood 

7:00 am.   Breakfast, low appetite 

7:30 am.   9mg pristiq (morn dose)

8:30. am.  upset stomach,anxiety,

                  depressed,spacey feeling 

9:00. am.  so sleepy but can’t sleep,

                  want to sleep my life away 

10:00. am.  took pepto for upset 

                    stomach

11:00. am.  depression, restlessness,

                   took ride in car listening to

                   spiritual, motivation tapes,

12:00. Pm.  Lunch, low appetite,spacy

                    feeling

1:30   pm.  crying spell, sobbing,

                   hopelessness,extremely

3:00. Pm    still depressed, a little

                   more energy

5:00. pm.    still no windows, still

                    depressed

6:00  pm.    dinner, low appetite

7:30 pm.     9mg pristiq (second dose)

8:30 pm.    slight window, depression    
                   starting to lift 

9:30 pm.    went to sleep

Mon Oct 10

5:15. am.   woke up, upon opening my 

                  eyes panic sets in, extreme 

                   anxiety, hopelessness, I’ll 

                   be like this forever

                   extremely drained, want to    
                   sleep my life away but 

                    cant sleep no matter 

                   how hard I try so I get

                   Out of bed with dread and 

                  also feeling physically I’ll,

                   no motivation 

          

Edited October 10, 2022 by ChessieCat
removed white space at bottom of post

[Mattie]

So extremely hard not to get evening windows, depression non stop, anxiety bad also, is it ok to take magnesium  tonight 

[Altostrata]

You can take magnesium any time. It's best to take it in small doses throughout the day.

 

Do any thoughts accompany your low mood feelings?

 

If you remove the mood symptoms from your symptom pattern, do you feel better or worse since you split the Pristiq dose on this schedule?

 

Something seems to upset your stomach after breakfast. Has this happened for a long time? Aside from coffee, is there something you eat every day for breakfast?

[Mattie]

I definitely feel worse, depression aside, and the stomach upset only started since I’m taking meds in the morning, but the depression is worse also, perhaps after I reach steady state it will ease off ? I’ve felt all these things before when switching doses or up or down, in my experience it lasts a few months and only settles to a degree, I hope this will be different 

[Mattie]

Also, what magnesium do you recommend for daytime and at bedtime 

[Altostrata]

It's possible you're still stabilizing from the drug changes. You started on this split dose schedule 10 days ago. How has your symptom pattern changed over the last week?

 

Does your stomach get upset after the evening dose?

 

See this about magnesium.

 

[Mattie]

My stomach gets upset after morning dose but the severity of it is lessening, I would normally have good windows every day around 4-5 pm but only slight windows now starting around 7 or later if any and I feel kinda spaced out or intoxicated since morning dose. In the past I always had to take my meds at night 

[Altostrata]

This sounds like it's going to settle out. Hang in there.

[Mattie]

@Altostrata, thanks, I’ll hang in there, that’s all I can do for now, thanks again, 

[Mattie]

Is there anything I can take for my mood with pristiq. My depression is horrible! Is this part of withdrawals ? I’ve taken antidepressants for over 25 years and had no depression before taking them but have debilitating depression now 

[ChessieCat]

Have you looked at the list of possible withdrawal symptoms?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Edited October 11, 2022 by ChessieCat

[Mattie]

Wow I have all but 1 that mimics depression. I also have a bunch that mimics others 

[Altostrata]

Please explain more about how you feel depression. Are there any thoughts that often accompany this feeling?

[Mattie]

I feel like I’m trapped in a body that can’t function, any thoughts of doing any normal task, completely drains and overwhelms me, So much fear I’ll stay like this, I’m so drained yet full of anxiety, crying spells and thoughts of not wanting to live through this, it’s so intense, example; I slept at my daughters house last night and she has a 8 month old, it’s 6:am and she’s crying in her room and I want to go get her but I can’t will myself to do it because I feel so drained,  and overwhelmed by the thought of having to do it,so all I can do is cry, it’s like my brain shuts down, later in the day my energy level starts improving but my mind doesn’t,I’ll drive around or sit outside in sun or sit in my recliner with my eyes closed desperately trying to sleep but can’t,this intense feeling (which I can’t explain) doesn’t go away, I try to use mindfulness as much as I can. Usually every evening it all lifts (I can’t understand it but the relief and normalcy I feel keeps me hanging on)

[Mattie]

It’s day 6 of transitioning my meds from single to divided dose 7:30 am and 7:30 pm, no positive change yet, please encourage me please, I’m hanging by a thread 😞I want to believe I will heal , I’ve been suffering for so long. I’m sorry for being so negative, please don’t abandon me,I know it’s just my sick brain talking 

[Altostrata]

10 hours ago, Mattie said:

So much fear I’ll stay like this, I’m so drained yet full of anxiety, crying spells and thoughts of not wanting to live through this, it’s so intense,

 

Withdrawal can bring up very uncomfortable sensations and feelings, but it sounds like you are also blaming yourself, which makes it worse. Please forgive yourself every time you have thoughts like this, and remind yourself you will slowly feel better.

 

Please read

 

 

Neuro-emotions

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Ways to cope with daily anxiety

 

Dealing With Emotional Spirals

 

Shame, guilt, regret, and self-criticism

 

 

Overwhelmed, demotivated, apathetic? Cannot get going on interest or action

 

Withdrawal dialogues and encouragement

 

"Is it always going to be like this?"

[Mattie]

@Altostrata, yes I do get discouraged because I’m so helpless these days and always feel sick like I’m getting over the flu and it won’t go away and the meds make me feel bad on top of the depression . Thanks for the info. I did have slight windows off and on today, not like usual but am grateful, I’ll take what I can get, thanks again I’ll read the info you supplied me.

[Altostrata]

In that case, read The importance of recognizing you're feeling good Make a note of it, on your calendar or with your phone!

 

[Mattie]

@Altostrata, I will and also when my depression lifts somewhat my anxiety kicks into high gear, very nervous feeling 

[manymoretodays]

Hi Mattie,

Sounds pretty typical and like you are working on the non-drug coping.  So good, good.

Any improvements at all yet? 

My fingers are crossed for that we will be hearing of improvements very soon.

 

L, P, H, and G,

mmt

[Mattie]

Since switching doses my anxiety is through the roof, didn’t sleep last night, anxiety through my body, nervous, I took magnesium but didn’t help, still stomach upset after morning meds, my depression is a tiny bit better but still bad, I’m getting evening windows but soo nervous, and panicky feeling, my evening windows are different now, they use to be calming but now anxiety. Is there anything else I can try to help me sleep. I hope my compounding pharmacy knows what they doing, this poison scares me, 

[ChessieCat]

9 hours ago, Mattie said:

I took magnesium but didn’t help, still stomach upset after morning meds,

 

How much magnesium are you taking?  Do you take it every night?  If yes, then the upset stomach might be because you are taking too much magnesium.

 

  

On 10/8/2011 at 6:22 AM, Altostrata said:

Don't overdo taking magnesium -- too much will give you diarrhea.