Tasart: New side effects after 6 months on Pristiq, want to go back to sertaline

[Tasart]

Im New to this forum. For many years I took 100-150mg sertaline and the only side effect was weight gain. My depression was moderated but not completely gone. Got a New doctor who recommended Pristiq. I've been taking 50mg for about 6 months. It was going fine. Suddenly I'm noticing frequent headaches, trouble remembering and nausea. Also increased anxiety. I'm not functioning and can barely get to the grocery store. I live alone and am scared.
I've read about the symptoms of withdrawal and I seem to have all of them, except I have not changed my dose or time of day (night) that I take it.
Has anyone else had this happen? I can't get in touch with my doc until 4 days from now.

Edited December 10, 2016 by Shep
added username to title

[Shep]

Hi, Tasart.

 

Welcome to Surviving Antidepressants (SA).

 

I'm a bit confused by the title of your thread. Are you interested in coming off antidepressants or switching back to sertraline and staying on antidepressants?

 

Please note we are a forum dedicated to helping people come off their antidepressant, not in switching to other ones. For that, you'll need to work with your doctor.

 

What may have happened is not that Pristiq by itself is causing all of these symptoms, but you very well may be suffering from withdrawal from sertraline. Please note that antidepressants are well known for causing a delayed withdrawal syndrome. So even several months after coming off sertraline, you may be experiencing withdrawal from it now.  

 

Here is some basic information on antidepressant withdrawal:

 

What is withdrawal syndrome? 

 

The Windows and Waves Pattern of Stabilization

 

Brain Remodelling

 

 

Here is information specific to coming off Pristiq in case you are interested:

 

Tips for tapering off Pristiq (desvenlafaxine)

 

Why taper by 10% of my dosage?

 

Please be so kind as to fill in your drug signature. Here's how:

 

Please put your withdrawal history in signature

 

This is your thread to list your symptoms and to ask plenty of questions. I'm glad you found us for information and support. 

 

 

[Tasart]

Thanks for your reply. I updated my signature/history but can't remember exact dosages and dates. I want to go off antidepressants all together. Pristiq is not helping and I have new, strange symptoms even though I haven't changed my dose. New symptoms include frequent headaches, nausea with diarrhea, memory loss, anxiety, dizziness, brain shocks, and bad insomnia. This all started about 6 weeks ago. These new symptoms are ruining my life. I note what you said about possiby having delayed withdrawal symptoms from the sertaline.

I'm wondering if anyone has switched from pristiq back to sertaline? and then tapered off sertaline? Would that even make sense? Pristiq seems to be far more problematic than sertaline ever was for me. I'm scared that pristiq has done some permanent damage and want to go off it as quickly and easily as possible. Is it possible to switch back to sertaline as a bridge to becoming AD free?

[Shep]

Hi, Tasart.

 

Thanks for filling out your signature and for the additional information.

 

There's something the drug companies call "poop out", which is really "hitting tolerance". Alto, SA's founder, gives a good explanation and links to research in this post here. 

 

So it could be that you've hit tolerance on Pristiq or that you're getting withdrawal from Sertraline, or a combination of both. 

 

I've asked the other moderators to weigh in, as I'm not sure switching AD's is the answer, but it would be best to have wiser minds check in with you.

 

 

 

 

[ChessieCat]

Hi Tasart, and welcome to SA,

 

Are you taking any other prescription, non-prescription drugs or supplements?

 

If so, please include these in your signature.  It's important for us to have the full picture so that we can make suggestions.

[JanCarol]

Also, Tasart, what were the dates of these changes?

 

"two weeks later" etc. doesn't help me understand the time frames here - please update your signature to include

 

"Month 2016 started Pristiq

Month 2016 tapered sertraline to 150 mg

etc

Month 2016 took last dose of 12 mg sertraline"

 

I'm sorry to ask you to do this, but until we have dates, we are struggling to help you.

[Tasart]

I read about "hitting tolerance" but don't fully understand how that actually manifests when using Pristiq (SNRI) or an SSRI. The subject threads and terminology on the various forums are confusing to a newbie. (What the heck is Benzo?)

New symptoms I have are similar to symptoms described in "serotonin syndrome" but also similar to symptoms described in "withdrawal syndrome." The past 2 months I've been having increasing episodes of headaches with nausea, diarrhea, insomnia (recently), terrible memory problems, brain fog, tiredness, anxiety and feelings of hopelessness, wooziness/mild dizziness, increased hand tremors, increased hypergogic hallucinations, increased hot flashes and night sweats. I don't get brain zaps unless I'm a few hours late taking a dose of Pristiq. I never had these symptoms when I was taking sertaline.

After reading about how horrible Pristiq is, and given my recent symptoms, I want to go off Pristiq as it seems to harm me more than help me. I don't know if it would be beneficial to taper off the SNRI (Pristiq) and taper back on to an SSRI again. Then I want to taper off the SSRI as it seems to be far less horrible to get off of sertaline than Pristiq.  Has anyone on the forum ever tried this method?  I'll be meeting with my psych doc in the next week or so but I don't entirely trust him.

[Shep]

Hi, Tasart.

 

You asked what a "benzo" is - a benzo is a benzodiazepine, which includes drugs like Valium, Xanax, Klonopin, Ativan, etc. Do you have any of these in her history? Sometimes they are used to help get people off of antidepressants, but they are very dangerous and can cause a severe dependency in as little as two weeks.

 

 

 

I don't get brain zaps unless I'm a few hours late taking a dose of Pristiq. 

 

It's important to take your drug consistently each day. Inconsistent dosing can cause other symptoms that may not show up right away, so please do try to be as consistent as possible.

 

According to the Tips for Tapering off Pristiq there are a number of problems with getting off this drug. Pristiq cannot be made into a liquid and technically, should not be cut up although people have come off that way (please read the entire  Tips for Tapering off Pristiq thread for full details of problems when cutting up Pristiq).

 

Switching to Effexor may be an option, as according to that that thread:  "Pristiq is a drug made of Effexor's (venlafaxine) active metabolite, O-desvenlafaxine. Pristiq is to Effexor as Lexapro is to Celexa -- a tweaked and more powerful isomer molecule. In effect, Pristiq is concentrated Effexor."

 

Switching back to sertraline may be problematic, as you mentioned, it's an SSRI, which is different than the SNRI, Pristiq. And, unfortunately, it won't solve the problem of how to get off Pristiq. 

 

The main benefits to switching to Effexor are its chemical similarity to Pristiq and the ability to come off it much easier by counting beads. 

 

Here's the thread to coming off Effexor, as that may also provide some background information as you do your research:

 

Tips for tapering off Effexor (venlafaxine)

 

Please read over this two "Tips" threads carefully and let us know if you have questions. 

[Tasart]

After bad withdrawal symptoms (after 7 months on 50mg of Pristiq), I tried 10mg of Prozac (fluoxetine) but became suicidal after 2 weeks of feeling good. Doc prescribed 25mg Lamictal and 450mg Trileptal while reducing Prozac to 10mg every other day. I feel stabile, but am wondering if the two new drugs will be problematic to reduce once I'm weaned off of Prozac. Does anyone have experience using lamictal (lamotragene) or Trileptal (oxcarbazene) while tapering off Prozac? I wake up in the middle of the night for 1-2 hours and my essential tremor has gotten worse, but am OK mood wise.

[Petunia]

Hi Tasart,

I'm sorry to hear that your initial prescription of Sertraline has now increased to 3 drugs. Unfortunately, this often happens. Drugs cause side effects, and withdrawal symptoms when they are stopped, so more drugs are given to 'treat' those symptoms, leading to people ending up on multiple medications, often feeling worse than when they started, and still no no relief of the original symptoms.

 

If Prozac was making you feel suicidal, it would have been better to reduce the dose, rather than add 2 more drugs.

 

How long have you been taking 25mg Lamictal and 450mg Trileptal? Please would you add dates to your signature.

 

We don't recommend skipping doses as a method of tapering, this can be quite destabilizing to the nervous system. We would suggest cutting the tablet in half and taking 5mg every day at the same time, this will help to keep your nervous system stable as you continue to taper.

 

How long have you been taking 10mg every second day? If you have only just started this regime, it would be wise to go back to taking it daily and tapering using the 10% method.

 

We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising. Please read through this which will explain why:

  

Why taper by 10% of my dosage?

 

Here are some links with the information you will need for your tapers:

 

Tips for tapering off Prozac (fluoxetine)

 

Tips for tapering off Lamictal (lamotrigine)

 

Tips for tapering off oxcarbazepine (Trileptal)

[Tasart]

Thanks for the reply. I started with 300mg Trileptal on 3/30/17. I started on 25mg Lamital at the same time. I'm now up to 600mg Trileptal and 50mg Lamictal as of 4/13/17. I still take 10mg Prozac every other day.

I have to say that my anxiety level has improved and my mood is more stable. My memory is coming back slowly with less brain fog. I am also sleeping better at night. My essential tremor is still the same,  I'm going to maintain this dosage for awhile.

 

My psych doc suggested taking 10mg Prozac every 3rd day instead of every other day. I am against this idea and suggested using the liquid fluoxetine instead to titrate slowly downward. Doctor is resistant to this idea. It is not easy to find a new psych doc on my insurance plan and I have complained about this to the insurance company. So changing doctors again is not an option.

Does anyone have experience with convincing their doctor to prescribe liquid fluoxetine to slowly reduce dosage? What should I say?