Andie: tapering off Pristiq

[elbee]

Hi Andie . . . I just wanted to chime in say you've been doing so awesome with your slow taper! You are getting some great suggestions from ChessieCat, and showing some really great self-care when you hit the rough spots. Well done

 

 

[Andie]

3 hours ago, elbee said:

Hi Andie . . . I just wanted to chime in say you've been doing so awesome with your slow taper! You are getting some great suggestions from ChessieCat, and showing some really great self-care when you hit the rough spots. Well done

 

 

Hi Elbee

Thanks so much! 

 

I have had a relatively easy taper, mostly because of  what I have learned here! 

 

The last 6 weeks have been really rough but I think I am finally turning a corner. 

 

ChessieCat is amazing. 

[Andie]

Hi Everyone 

 

My Doctor is asking me to consider making a switch to Prozac as I am struggling on ‘low’ doses of Pristiq. He has used the bridging method with some of his other patients trying to come off Effexor and Cymbalta. 

 

I am currently on 12mg. I have had my Pristiq compounded and the Pharmacist can only guarantee a sustained release of 4 to 8 hours dependant on my own body’s rate of metabolisation as well as the size of the dosage. 

 

 Basically the Pharmacist has explained that it is hit and miss with compounded Pristiq as the sustained release is definitely different to that of the original. How else Pristiq changes when it is compounded is a mystery as it has never been studied. Anecdotally some patients are fine on one daily dose and some struggle depending on their own level of sensitivity. Ideally I should have been taking divided doses right from the beginning of the Taper. The Pharmacy I use work exclusively with compunded formations, so I trust their opinion. 

 

My doctor has now instructed me to divide the doses up during the day and that the dosages should remain as equal and evenly spaced as possible to ensure even levels of Pristiq in the body. I am going to see if dividing the dose makes things easier. 

 

I have an appointment with my doctor next week and I would like to be prepared. 

 

With 149.4mg of Venlafaxine = 40mg Prozac and 100mg of Venlafaxine= 50mg Pristiq.

 

I have calculated I need about 6.5mg of Prozac to equal 12mg of  Prozac Pristiq. Does this sound right? 

 

I wouldn’t ever consider a cold swap, so I am wondering how I would dovetail the Pristiq and Prozac together before dropping the Pristiq. 

 

Swapping over is really a final option and it’s not something I can do immediately or that I take lightly. I would  like to be prepared for my appointment next week. I believe I can have the Prozac compounded into a liquid in a 100ml to 100gm solution. 

 

I’ll post here about the outcome of my next appointment. 

 

 

[Andie]

So far so good shifting the 12mg across to three doses. 

 

1mg 7am

1mg 3pm 

10mg 4pm

 

Still having muscle spasms but morning anxiety and vivid dreams markedly reduced. Brain sharpness is slowly returning. This could be due to increasing dose to 12mg as suggested by Dr.  12mg easier to divide across 3 doses. 

[Andie]

Note to self. 

 

I have now heard Methocel releases dosage over anywhere between 4-10 hours and this is highly dependent on the individual. Different Pharmacists have different opinions on how long the slow release works for but the consensus is to listen to my body and adjust accordingly. 

[Andie]

Finally able to start doing my art activities again.  My hands and arms have been too unsteady and weak so I didn’t have good control over my pen and ink.

 

I was able to make it though the day without napping even though I was feeling quite tired. 

 

Allergies have been much better with the recent change in weather. It’s very mild over here and not as hot and dry. I’m staying away from the antihistamines and have been using nasal sprays and saline only with good results. 

 

[Andie]

Steadily improving. Had some funny dreams before waking and felt a bit anxious. 

 

Managed to go out to shops and then attend small fundraiser. 

 

Teleconference with Psychiatrist and Pharmacist bookers for Thursday. 

[Andie]

Starting vitamin D 5000iu work with K2 as results came back very low. 

[ChessieCat]

1 hour ago, Andie said:

Hi Chessie 

 

I will investigate this further with the Pharmacy. They say it may be worth trying the enteric coated capsules and see how it goes. If I do go this route I will have to have a whole new batch made up. I think anything is worth trying before switching over to Prozac.

 

I will also see what doc suggests. We have a teleconference organised  for Thursday with myself, my Psychiatrist and the Pharmacist. 

 

 

 

 

Yes, I agree that trying to stay with Pristiq would be better.

 

You say above that you are steadily improving.  You might not need to try the enteric coated.

[Andie]

4 hours ago, ChessieCat said:

 

Yes, I agree that trying to stay with Pristiq would be better.

 

You say above that you are steadily improving.  You might not need to try the enteric coated.

Yes definitely improving. I was tired so took a nap and actually woke up feeling refreshed. No weird anxiety on waking. Thank you 🙏Jesus! I feel my brain is still a little fogged up and I’m still have spasms all over, but everything is so much less intense. 

 

Fingers crossed I won’t need to try the enteric capsules, but I’m happy there is a plan b and a plan c in place if things go pear shaped. 

 

[elbee]

16 hours ago, Andie said:

Starting vitamin D 5000iu work with K2 as results came back very low. 

 

Hey Andie, good to see you feeling some steady improvement. I'll suggest you note that you started to take the vitamin D today (in your signature, or at least in your own notes). I took D3 5,000 IU for a while because a blood test showed I was low. This was during a time when things were really bad and I wasn't getting out into the sun much, so it made sense to me that I might be low. It seemed to be fine for me, and I eventually discontinued taking it as I was able to spend more time outside. But I do know of others that have had bad reactions to taking even something seemingly as simple as a vitamin. Again, during this withdrawal / discontinuation process our bodies can be extra sensitive and raw to many things, so it's important to note these types of changes we make.

 

 

[ChessieCat]

16 hours ago, Andie said:

Starting vitamin D 5000iu work with K2 as results came back very low. 

 

It's better to start with a small amount and increase it gradually.  Keep it Simple, Slow and Stable

[Andie]

On 11/25/2018 at 5:07 AM, elbee said:

 

Hey Andie, good to see you feeling some steady improvement. I'll suggest you note that you started to take the vitamin D today (in your signature, or at least in your own notes). I took D3 5,000 IU for a while because a blood test showed I was low. This was during a time when things were really bad and I wasn't getting out into the sun much, so it made sense to me that I might be low. It seemed to be fine for me, and I eventually discontinued taking it as I was able to spend more time outside. But I do know of others that have had bad reactions to taking even something seemingly as simple as a vitamin. Again, during this withdrawal / discontinuation process our bodies can be extra sensitive and raw to many things, so it's important to note these types of changes we make.

 

 

Hi Elbee 

 

Thanks for the heads up. I’d been taking vitamin D3 4000iu with K2 up until the Time I got really sick so it’s not a huge increase to the 5000iu thank goodness. I should really be on about 10000iu but we (my Dr and I) are slowly working up to that.  

[Andie]

Woke up this morning with no anxiety. Lots of spasms and jerkiness but  become less intense. 

 

I think I’ve been paying way too much for my compounding, but happy with the service I get.  At the time, the Pharmacy I chose was the most competitive in my area. I’m ringing around for quotes to satisfy my curiosity. 

 

Bought a cute and functional diary from Kiki K to keep track of my taper in 2019. I realised I’ll be tapering for another 2 years and I have to admit my heart sank just a little bit. 

[elbee]

Good to hear you are working with your Dr. on the D3 and feel comfortable with your approach. Yes, recognizing that healing from this stuff can take a long time was  disheartening for me too. I've found as I've come to accept this though, that I've also experienced a sense of relief from fighting against it less. Buying yourself a cute diary sounds like a kind and gentle way to work with yourself around this acceptance. Well done

[ChessieCat]

Yes, I felt very disappointed and discouraged when I realised how long it was going to take to get off my Pristiq.  And like elbee, found that acceptance helped a lot.  It's going to take as long as it takes and I'd rather get off slowly and not suffer more than necessary than to go too quickly.  It's also good to look at how much you have reduced by.  Like me, you've reduced from 100mg.  Getting down to 12mg is a massive reduction!  I also found that when I accepted that it going to take years to get off that the time between reductions seemed to go much quicker.  In fact a couple of times I've almost missed the reduction date.

 

I've also found it helpful to remind myself that it's my brain that still needs the Pristiq.  And understanding that helps.  Although I have found that when I am feeling bad I flip flop between increasing and cold turkeying, but that seems to be part and parcel of this withdrawal journey.  I've noticed other members making the same comment.  And I think that is where being a member of SA is good, because you can get support to help get through those times of indecision and impatience.

[Andie]

Woke up this morning with no anxiety, so I am going to make myself a cooked breakfast this morning. My appetite is coming back. 

 

Acceptance is by far the most difficult thing about this process. I keep rehashing that I would have done things differently had I had real information about antidepressant use, side effects and the withdrawl process. Things just didn’t feel right in my gut and I didn’t act on it. My doctor at the time just had absolutely no clue, he actually admitted to me on one occasion that he didn’t want to practice medicine anymore..needless to say I found myself another doctor..but the damage was already done. 

 

I keep reminding myself how much better I feel on Lower doses of Pristiq. Less irritability, less foggy, less detached from myself and my surroundings, less agitation, no more blurry vision and no more sweating! The sweating and night sweats were a huge issue for me as not only was it very embarrassing, the sweating was triggering off my ezxema. So no more excema too! 

 

 

 

 

[Andie]

Doctors surgery asked me to pop in as Dr needed to speak to me. Last Ross River Virus result came back negative- so highly unlikely RRV was the cause of my earlier illness. So it’s still a mystery what caused my fever etc. I still feel it was severe seasonal allergies. 

 

Iron results are very low, so GP has organised admission to hospital for an infusion. I am a vegetarian so I am not suprised by this at all. I also need to consider taking B12 supplements, but I won’t try it until I’m sure I’m stable. 

 

Seems my body is in a bit of a mess and maybe this is why I started to feel withdrawal symptoms. I don’t think I’ll ever know for sure. 

 

Trying to practice acceptance and take things one day at a time. It’s hard! 

 

Feeling much better taking divided Doses of Pristiq. 

[elbee]

On 11/26/2018 at 5:25 PM, ChessieCat said:

Like me, you've reduced from 100mg.  Getting down to 12mg is a massive reduction!

This is an important point ChessieCat made. Part of acceptance is learning to look at a FULL, truthful total picture . . . accepting that while you've experience a lot of pain, you've also made INCREDIBLE progress. And self-care is probably what I had most resistance to in this WD process. I can't think of any other way in the larger scope of things that I would have been able to have the patience (other than through the slow taper WD) of learning self-care. This has been one of the most difficult yet important lessons of my life, and you mention time and time again all that you've been doing to be gentle, kind and loving to yourself . . . your practice of self-care. Kudos Andie!  

[Andie]

11 minutes ago, elbee said:

This is an important point ChessieCat made. Part of acceptance is learning to look at a FULL, truthful total picture . . . accepting that while you've experience a lot of pain, you've also made INCREDIBLE progress. And self-care is probably what I had most resistance to in this WD process. I can't think of any other way in the larger scope of things that I would have been able to have the patience (other than through the slow taper WD) of learning self-care. This has been one of the most difficult yet important lessons of my life, and you mention time and time again all that you've been doing to be gentle, kind and loving to yourself . . . your practice of self-care. Kudos Andie!  

Hi Elbee 

 

Like you learning self care has been very difficult and the most importance lesson in my life so far. I struggle with self care vs selfishness. I’m starting to realise if I don’t practice self care I’m not really  helping myself or anyone else. I realise I really have been taking my health for granted being unwell had really turned my world upside down and changed my perception of things. 

 

[Andie]

Had a bad sleep.  Tossed and turned all night and then woke with a bit of anxiety. Feeling tired today. 

 

The sun is up very early now and my bedroom faces the east so I think I’ll have to invest in some block out curtains. 

 

Iron infusion has been arranged for next Wednesday. 

[Andie]

I can feel that I’m ‘waking up’ from from medication induced haze I’ve been in. I liken this to getting new glasses when I thought the old ones were just fine.

 

I was upset today after being contacted out of the blue by a friend who had hurt me very badly. I can really feel that emotional fragility in me. It’s a good feeling and a really scary feeling at the same time. Rather than being anaesthetised, my emotions are quite raw and almost unweildy. They feel thorny. That’s the best way I can describe it. 

 

Spasms are still bothering me, but dealing with them as they come. Once the iron infusion is over and I’m in the clear, I might try using some magnesium cream as my muscles are tight and sore. 

 

Some of the night twitching in my legs could be from the low iron too. 

 

 

 

 

 

[Andie]

On 11/27/2018 at 6:25 AM, ChessieCat said:

Yes, I felt very disappointed and discouraged when I realised how long it was going to take to get off my Pristiq.  And like elbee, found that acceptance helped a lot.  It's going to take as long as it takes and I'd rather get off slowly and not suffer more than necessary than to go too quickly.  It's also good to look at how much you have reduced by.  Like me, you've reduced from 100mg.  Getting down to 12mg is a massive reduction!  I also found that when I accepted that it going to take years to get off that the time between reductions seemed to go much quicker.  In fact a couple of times I've almost missed the reduction date.

 

I've also found it helpful to remind myself that it's my brain that still needs the Pristiq.  And understanding that helps.  Although I have found that when I am feeling bad I flip flop between increasing and cold turkeying, but that seems to be part and parcel of this withdrawal journey.  I've noticed other members making the same comment.  And I think that is where being a member of SA is good, because you can get support to help get through those times of indecision and impatience.

Thanks Chessie 

 

Your support and the support of SA is really invaluable. I’ve come out this period relatively unscathed thanks to what I’ve learned here. It’s now a matter of stabilising and holding there for a while. 

[ChessieCat]

You've been going through a really tough time lately, but you have got through it.  Even though it can be tough at the time, in some ways it can be beneficial because you have learned that you can get through it, and even though we hope that there won't be any times as hard in the future, you can tell yourself that you got through it before so you can do it again.

 

Neuro Emotions

[Andie]

10 hours ago, ChessieCat said:

You've been going through a really tough time lately, but you have got through it.  Even though it can be tough at the time, in some ways it can be beneficial because you have learned that you can get through it, and even though we hope that there won't be any times as hard in the future, you can tell yourself that you got through it before so you can do it again.

 

Neuro Emotions

Totally agree Chessie. I know the signs and triggers to watch for now. 

[Andie]

Update.

 

Appt with Psychiatrist today. He actually admitted that no one understands the extract mechanism of withdrawal and the body is going to try and heal itself. He has seen many cases of prolonged withdrawal with Pristiq, Cymbalta and Effexor in his clinic. 

 

 Spoke with Pharmacist who informed us that it is definitely better to take divided doses of  compunded Pristiq. Pristiq is one of the most difficult medications to get close to the original due to the way the tablets are formulated. Pharmacist says best way to tell what works is to listen to the body and adjust from there. 

 

The plan forward for me is a long hold to stabilise the nervous system and see if the jerking and spasms stop on their own. I am to take a Vitamin E tablet in the form of mixed tocopherols once a day,  stay away from antihistamines and just use nasal sprays.  

 

Once I’m finished my current batch of capsules I will trial the enteric coated ones. 

 

No anxiety this morning. No weird dreams.  Lots of spasms and twitches. 

[ChessieCat]

2 minutes ago, Andie said:

Once I’m finished my current batch of capsules I will trial the enteric coated ones. 

 

If things settle down then I don't think changing to enteric would be a good idea.  If it ain't broke, don't try and fix it.

[Andie]

The dreaded allergies are back again. 

[ChessieCat]

What symptoms are you experiencing when you say allergies?

 

Have you suffered from them before ever taking an antidepressant?

 

Did you suffer from them at higher doses of Pristiq?

[Andie]

9 hours ago, ChessieCat said:

What symptoms are you experiencing when you say allergies?

 

Have you suffered from them before ever taking an antidepressant?

 

Did you suffer from them at higher doses of Pristiq?

Hi Chessie 

 

Its seasonal allergic rhinitis. Hayfever. 

 

Ive always suffered from this,  but the lower the dose of Pristiq the worse the symptoms and the more frequent I have attacks. When these allergies hit, the withdrawl effect from the Pristiq is really intensified. There is a definite connection, but I don’t know what that connection is. Perhaps it’s because Antidepressants are derived from antihistamines and they act on the same receptors. Just my guess. 

[Andie]

Since coming down off Pristiq, I seem to be in a constant allergic state. 

[ChessieCat]

Yes there is a connection between the lower antidepressant dose and allergies because of something to do with histamine.

 

Alto's suggestion:

 

On 3/16/2012 at 10:26 AM, Altostrata said:

 

I have springtime allergies, too.

 

I use Pataday eyedrops for itchy eyes and fluticasone (Flonase) nasal spray.

 

UPDATE: Since 2012, I've changed to ketotifen eye drops and azelastine nasal spray -- they are non-steroidal. Steroidal drops and sprays can advance cataracts or glaucoma.

 

I'd avoid taking an antihistamine if you have withdrawal symptoms. They affect the histamine receptors http://en.wikipedia.org/wiki/Histamine_receptor , which may be involved in withdrawal syndrome.

 

 

And a post which gives more information about why:  allergies-sneezing-stuffed-up-antihistamines-and-what-to-use-for-allergy-relief

 

Edited December 1, 2018 by ChessieCat
updated link

[Andie]

30 minutes ago, ChessieCat said:

Yes there is a connection between the lower antidepressant dose and allergies because of something to do with histamine.

 

Alto's suggestion:

 

 

And a post which gives more information about why:  allergies-sneezing-stuffed-up-antihistamines-and-what-to-use-for-allergy-relief

 

It’s been really bad over here. It gets suddenly hot and dry and it’s intensified when the wind blows from the east. Lots of people seem to be suffering this year. 

 

The couple of times I’ve taken antihistamines I’ve ended up with severe feelings of withdrawl, I’m staying away from them. I’m using beconsase and saline irrigation. 

 

Looking back now...I don’t think I’ve ever been good taking antihistamines with Pristiq. The non sedating ones seem to have an even stronger effect on me. Even before tapering I tried to avoid using them unless really desperate. 

 

 

 

[Altostrata]

Since 2012, I've changed to ketotifen eye drops and azelastine nasal spray -- non-steroidal.

[Andie]

3 hours ago, Altostrata said:

Since 2012, I've changed to ketotifen eye drops and azelastine nasal spray -- non-steroidal.

Thanks Altostrata

 

Those are available here so I will give them a try. 

[Andie]

I woke up feeling really well..however..

 

I’m upset today with anxiety through the roof. 

 

 I’ve had to cancel the iron infusion that was booked for Wednesday as when I went to pick up the vials of iron the Pharmacy refused to give them to me, and rightfully so. My doctor had ordered almost triple the safe dose for use in one sitting. This is the same pharmacy that picked up that I would be better splitting the doses of Pristiq. 

 

Once I get a new script and protocol, I won’t be able to have an infusion until the new year as the clinic is closed over the holiday period. 

 

Between the misdiagnosis of RRV, changing the way I take Pristiq and now this I am feeling utterly fed up and frustrated.  Going back and forth to the Doctor sorting this out has cost me an absolute fortune . 

 

Thank goodness for the Pharmacist.

 

Rant over... I know I’m quick to have anxiety lately and I’m trying to take good care of myself amongst what has been going On.