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Andie: tapering off Pristiq

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Andie

Hi Chessie. 

 

I'm really cross with myself for not reducing to 10.5mg. I had 0.5mg available and I'm usually so careful. It could be that particular dose reduction that has stressed my system as I know that my body struggles with anything over an 11% reduction (I found this out through experimentation- pre SA, new doctors and reading,)

 

Yes this all started after the allergies came on. I was was feeling really well the week before the allergies started. So much so that I was ready to go back to work full time and had an interview lined up. 

 

In terms of stress, I am stressed out the moment over a couple of things. My GP thought it might be an idea to send me to a Clinical Psychologist to help manage anxiety ( the reason for starting Pristiq). She couldn't believe I had been tapering for so long  and said she hadn't heard of this. When I described that I was in physical discomfort she said this was a symptom of depression. Needless to say, I won't be going back.  I am also stressed because I've had to take three weeks off work which I feel guilty about. 

 

Emotionally, I am struggling with the up and down and lack of control. I'm a classical type A personality and I feel like the Pristiq is winning at the moment. 

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ChessieCat

It's important to learn and use non drug coping techniques.

 

I did an online MindSpot CBT course 4 years ago and found it very helpful.  https://mindspot.org.au/   It was free when I did it.  Not sure if it still is.  That, and what I have learned from SA have come in very useful.  EDITED TO ADD:  Australia’s only free therapist-guided digital mental health treatment

 

Non-drug techniques to cope 

 

Claire Weekes was an Australia doctor who suffered from anxiety and learned and taught ways to help.  There are several long YouTube videos, one being an audio book

 

the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system

 

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

Audio:  First Aid for Panic (4 minutes)
 
 
Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

 

Edited by ChessieCat

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ChessieCat

MindSpot - Australia’s only free therapist-guided digital mental health treatment

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Andie

Thanks again Chessie for all your help.  I have signed up to MindSpot 

 

I feel my nervous system has become super sensitised. My current symptoms are

 

morning anxiety, vivid dreams, muscle spasms and muscle twitching. 

 

I am trying to accept the situation and go with the flow, but I’m finding that hard to do. I feel like it’s 2 steps forward 3 steps back. I hate feeling like I have an unhealthy body that I have no control over. It feels like being trapped. 

 

Im going to have to do a long hold and hope that this settles. My doctor wants me to see an immunologist to try and get a better idea of what are my allergy triggers are as  I’ve also developed a lot of food intolerances. 

 

 

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Andie

Hi Chessie

 

My doctor just phoned me with some blood test results. I’ve caught Ross River Virus sometime in the last couple of weeks. So it’s no wonder I’ve been feeling so Unwell and struggling. 

 

Thanka for the links ill I’ll look at those too because I am sure histamine food intolerance Is part of it.

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ChessieCat

Well it's great that you have an answer.  No wonder you've been feeling so crook.  Sorry that you've got it though.  Thanks for letting us know.

 

Please take care of yourself.  And NO TAPERING for the time being.  "Dr" Chessie's orders!  (Everyone please note, I am only joking - I am not a doctor.)

 

If they do want to prescribe something please make sure you check it out, how they work (ie do they affect the brain), drug interactions and also side effects.  

 

I realise it's a virus so antibiotics won't help but it's good to be aware of the following:

 

This is one is big: avoid antibiotics with "flox" in the name.  Cipro is a "flox" antibiotic.  They affect brain chemistry.  All antibiotics affect the gut flora which is disturbed by ADs, and we hope will return to normal after we stop using them. All changes to the gut can affect brain chemistry. However, the "flox" antibiotics are reported on SA to be the most problematic.

 

The fluoroquinolones antibiotics are especially dangerous for someone on benzos.  Fluroquinolones can displace benzodiazepines from benzodiazepine receptors which can send you into acute withdrawal. 

 

This is SA's antibiotic topic:

 

 

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Andie

Hi Chessie

 

Oh goodness. I had no idea about the antibiotics. I will definitely take note of that. You are a font of knowledge and a wonderful support. Thank you so much! 

 

I promise not to taper. 

 

Im really struggling with my mood and I’m now certain that being sick has completley destabilised my nervous system. I realise I become extremely anxious when physically unwell and feel lots of excessive guilt about being sick (a lifelong habit). This is something I need to work on. 

 

Im going to go and listen to Dr Claire Weekes before bed. 

 

Thanks again!! This forum is amazing and I’m so grateful.

 

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ChessieCat
8 hours ago, Andie said:

You are a font of knowledge

 

It might seem that way, but most of it is what I have seen and learned on this site.

 

18 hours ago, Andie said:

I have signed up to MindSpot 

 

It might be a good idea to delay doing this until you are a bit better.  Even though the goal is to help you it may add more stress.

 

8 hours ago, Andie said:

I promise not to taper. 

 

Glad to hear that.  Now is definitely not the time to be reducing.

 

8 hours ago, Andie said:

Im going to go and listen to Dr Claire Weekes before bed. 

 

Good idea.  Acceptance is important.  It is difficult but being able to stay calm and as stress free as possible will help provide a calm environment for you to heal.  It is what it is.  You were going all right until you got sick.  You didn't deliberately get Ross River Fever.  Think of it like having a broken leg.  People wouldn't expect you to go out and mow the lawn with a broken leg.   

 

 

You could try magnesium and see if that helps to reduce the anxiety.  Some members add it to water and sip it throughout the day.  Start with a small amount first to see how you react to it.  Magnesium  

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ChessieCat

Just done a bit of research and found this from https://www.sahealth.sa.gov.au

 

"In most cases, symptoms disappear within 6 weeks, though some people may still have symptoms after a year or two and the symptoms may come and go. About 10% of people have ongoing depression and fatigue."

 

I don't want to be a wet blanket and be negative, but I think it's important to know about this so that you don't automatically attribute issues to AD withdrawal.  It might also help you to take good care of yourself and not try and overdo things.  It can be difficult when you have something which cannot be seen.  Think of it this way, if your partner had it, you would want them to take care of themselves.

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Andie

Hi Chessie 

 

You are correct, now isn’t the right time to starting the Mindspot course. 

 

I was thinking along a similar line to you in that I should be careful about automatically attributing any symptoms I have to the withdrawl. I suddenly ‘crashed’ into depression and anxiety and I couldn’t understand why.

 

I do think my nervous system is sensitised.The whole process of dealing with the effects that Pristiq has had on me has made me quite fragile emotionally. 

 

My regular GP was away for the first couple of weeks I got sick and I went in twice to see one of her colleagues. They couldn’t find what was wrong and once they found out I had anxiety and coming off Pristiq it was suggested that I was 

 experiencing ‘hyperventilation syndrome ‘ and ‘ perhaps not managing without my meds’. It was only until my regular GP returned and saw the state of me (and took my temperature) that any tests were done for an infection source. It’s examples like this that make the process so frustrating and upsetting for me. 

 

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ChessieCat
8 minutes ago, Andie said:

The whole process of dealing with the effects that Pristiq has had on me has made me quite fragile emotionally. 

 

The lower our dose gets the less numbed our emotions are.

 

April 2017 I bought a new car when I was at 25mg Pristiq.  In October/November 2017 I was at 19mg.  I got very excited when I unexpectedly saw some whales when we were checking out a car that my daughter was looking at and the seller's house was on the coast.  I even jumped up and down on the spot which I noticed because I had been having trouble raising my legs high enough to step up the gutter (this has slowly improved).  I realised then that when I got my car it was a dulled excitement.

 

I am dealing with major life issues at the moment and part of me wishes that my emotions weren't as raw as they are.  Being numbed did make it a bit easier to get through difficult things.  However, I also found that being numbed made it harder in some ways.  I have a daughter who is taking Zoloft and I have noticed that she is numbed.  My other daughter has commented on her lack of enthusiasm and I have told her that it is the AD, but she doesn't believe me and thinks that she just doesn't care.

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Andie
12 minutes ago, ChessieCat said:

 

The lower our dose gets the less numbed our emotions are.

 

April 2017 I bought a new car when I was at 25mg Pristiq.  In October/November 2017 I was at 19mg.  I got very excited when I unexpectedly saw some whales when we were checking out a car that my daughter was looking at and the seller's house was on the coast.  I even jumped up and down on the spot which I noticed because I had been having trouble raising my legs high enough to step up the gutter (this has slowly improved).  I realised then that when I got my car it was a dulled excitement.

 

I am dealing with major life issues at the moment and part of me wishes that my emotions weren't as raw as they are.  Being numbed did make it a bit easier to get through difficult things.  However, I also found that being numbed made it harder in some ways.  I have a daughter who is taking Zoloft and I have noticed that she is numbed.  My other daughter has commented on her lack of enthusiasm and I have told her that it is the AD, but she doesn't believe me and thinks that she just doesn't care.

I’m really sorry to hear you are going through your own issues right now. How admirable that you are on here helping me! 

 

  I completely understand what you mean about the numbing. My emotions came roaring back at about 15 mg mark and are becoming stronger.  Its like someone suddenly turned the volume up. I am very shocked at how numbed out I have been. I didn’t think it was even possible.  I was a plank of wood. I would rarely get emotional about things but I would get very irritable and angry. A few people in my life pointed out to me that I didn’t seem ‘right’ and that I had changed.  I thought I was just standing up for myself and had gained more confidence. I didn’t believe them. 

 

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ChessieCat
21 minutes ago, Andie said:

My emotions came roaring back at about 15 mg mark

 

I think I'll put a post in the Pristiq tapering topic about our observations, just so that others are prepared for it.

 

22 minutes ago, Andie said:

I’m really sorry to hear you are going through your own issues right now. How admirable that you are on here helping me! 

 

Thanks Andie.  It's not as selfless as it appears, because it is actually helping me too.  I've posted about my situation on my Intro.  I'm back at work tomorrow and will be having a chat with my boss who is supportive and going to offer suggestions and put me in contact with people who may be able to help me.  It's not WD related but WD and feeling my emotions more fully aren't helping.

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Andie

 

 

Update

I had a panic attacks this morning. The second one I have experienced in my life. The first one I had was a week after starting Pristiq.

 

I am feeling really wiped out. 

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ChessieCat
On 11/6/2018 at 7:50 PM, Andie said:

I’ve caught Ross River Virus sometime in the last couple of weeks.

 

Putting this here both for you and so other members are familiarised with Ross River Virus.  From this site

Signs and symptoms

Many people infected with Ross River virus, particularly children, have no symptoms. The severity of symptoms increases with age.

Symptoms vary from person-to-person and may include:

  • fever
  • chills
  • muscle aches
  • rash
  • fatigue
  • aching tendons
  • swollen lymph nodes.
  • headache, especially behind the eyes
  • joint pain, swelling and stiffness.

The most distinctive and distressing feature of Ross River virus infection is usually joint pain. Any joint in the body may be affected, but the most common sites are the wrists, knees, ankles, fingers, elbows, shoulders and jaw. The pain may be more severe in different joints at different times.

In most cases, symptoms disappear within 6 weeks, though some people may still have symptoms after a year or two and the symptoms may come and go.

 

__________________________________________________________________

 

Even if you aren't experiencing any physical symptoms your body is busy fighting the virus.  At the most it was only 3 weeks ago that you contracted the virus.  Even good stress can increase withdrawal symptoms.

 

These might help:

 

20 hours ago, Leo1983 said:

What your saying to me is you need to learn techniques to manage your life whilst in WITHDRAWAL! And they will also serve you well once you HEAL. 

 

 

On 10/16/2015 at 5:01 AM, brassmonkey said:

Acknowledge, Accept, Float.  A concept stolen from Claire Weekes.  It is a process for handling situations that you have no control over.  Acknowledging the situation/symptom, getting to know it on a personal level.  Accepting that the situation/symptom is there, its real and there is nothing you can do about it. Letting the Situation/symptom Float off as you get on with your life as best as you can.  It's sort of like dealing with an unwanted house guest.  At first you get to know them and make them comfortable.  Then you realize they are not making any effort to leave and there is nothing you can do, but ignore them as best as you can until they go away.

 

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Andie

Thanks Chessie. 

 

My system is clearly under some strain and I am definitely struggling with the joint pain. My parents are are with me today so that is a big help.  

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ChessieCat

As I said before, at least you know what is causing it.

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ChessieCat

How are you doing Andie?

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Andie

Hi Chessie 

 

Thanks for checking up on me. I’ve had a very trying week. I’ve increased my dosage to 11mg and I’m feeling a lot better. 

 

Ive been suspicious that I’ve had withdrawal symptoms and I think being acutely unwell has masked most of it. It was just really and timing.

 

 I had been having vivid dreams and waking up with panic  and just emotionally spiralling from there throughout the day with intense anxiety. 

 

Since increasing the dosage This has has stopped and I am emotionally feeling well, but I’m still experiencing jerking movements and muscle spasms. At what point do I consider another increase in dosage? I have lots of 0.5mg capsules. 

 

Im feeling much much better but this has by far been the biggest setback/hurdle while coming off Pristiq. 

 

Im prepared for a long hold and just had a new lot of compounded capsules made up. 

 

I had had a long chat with my Compounding Pharmacist this morning and he told me that they add Methocell to the ground up Pristiq powder to make it slow release again. Methocell works by releasing the medication over over 8-10 hours. I haven’t had any issues with any of my compounded medications but I just wonder if this affects the levels of Pristiq in our body if we only take the medication once a day. Do you have any experience with this? 

 

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Andie

Chessie, 

I’m so grateful if you gave me the information about generic Desvenlafaxine and That I stayed with the original brand. 

 

Im also happy with deciding to stay with Pristiq and not switch to Effexor like my doctor suggested. I said no to the offer of Lorazepam and shredded the script! 

 

Thank goodness for this site- I have no clue where I would be right now without it. 

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Andie
56 minutes ago, Andie said:

 

Thanks for checking up on me. I’ve had a very trying week. I’ve increased my dosage to 11mg and I’m feeling a lot better. 

 

Ive been suspicious that I’ve had withdrawal symptoms and I think being acutely unwell has masked most of it. It was just really and timing.

 

Sorry. I meant to say it was bad timing with becoming unwell and not knowing which condition was causing which symptom. I don’t know what the connection is being acutely unwell with a virus has with developing withdrawl symptoms. I assume it’s just the additional stress on the body? 

 

But I know now that I need to be really careful when I feel something coming on. 

 

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ChessieCat
9 hours ago, Andie said:

I’m still experiencing jerking movements and muscle spasms.

 

When did these first appear?  When do they happen?  Is it all the time or just sometimes?

 

9 hours ago, Andie said:

At what point do I consider another increase in dosage?

 

The idea of updosing/reinstatement isn't to get rid of withdrawal symptoms completely.  It's to bring them to a bearable/tolerable level that you can live with.  It's good that you are feeling some improvement, but you still need to consider that you are still recovering from the virus.  I think it would be better if you tried not to increase your dose any higher.  Just hold on the 11mg and keep daily notes.

 

On 10/31/2018 at 5:10 PM, ChessieCat said:

Once i got to a dose less than 10mg (can't remember what dose exactly) I started taking my dose morning and night, taking the larger amount in the am and the smaller dose, eg 1.5mg, 1mg or 0.5mg in the pm before bed.

 

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Andie
4 hours ago, ChessieCat said:

When did these first appear?  When do they happen?  Is it all the time or just sometimes?

 

I have always had some very mild and very occasional jerkiness with Pristiq. It became intolerable about mid October when i was at my sickest and it has stayed that way. It happens all the time but with varying intensity. 

4 hours ago, ChessieCat said:

The idea of updosing/reinstatement isn't to get rid of withdrawal symptoms completely.  It's to bring them to a bearable/tolerable level that you can live with.  It's good that you are feeling some improvement, but you still need to consider that you are still recovering from the virus.  I think it would be better if you tried not to increase your dose any higher.  Just hold on the 11mg and keep daily notes

 

I am loathe to increase the dosage but the jerking and spasms are really intolerable and stopping me from going out and doing things and waking me up at night. I’m curious about increasing the dosage as I had such a huge improvement increasing to 11mg. Is there any risk of harm by updosing again if I need to? 

 

When I do start taking a split dose I’ll have to take my larger dose at night. My body has never liked me taking Pristiq in the morning for some reason. 

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ChessieCat

It's only been 4 days since you increased.  It takes about 4 days to get to full level in the blood and a bit longer to register in the brain.  You might not need to increase.  I'd be giving it a full 2 weeks before thinking about increasing.

 

Just relax and be as patient as possible.  Keep daily notes.  You might see on paper improvements that you don't notice.

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Andie
3 hours ago, ChessieCat said:

It's only been 4 days since you increased.  It takes about 4 days to get to full level in the blood and a bit longer to register in the brain.  You might not need to increase.  I'd be giving it a full 2 weeks before thinking about increasing.

 

Just relax and be as patient as possible.  Keep daily notes.  You might see on paper improvements that you don't notice.

I will hold Chessie. I think my fear is that if I miss the opportunity to updose that I will be stuck with these symptoms permanently. 

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Andie

Just keeping a record here for myself to look back on. My notebooks seem to disappear to the place my socks and pens do. 

 

It it has been hot and dry these last few days. Suffering from allergies again. Lots of people suffering from allergies right now including my two dogs! Using nasal spray instead of antihistamine tablets. 

 

Holding at 11mg

 

 Still experiencing lots of spasms and twitches all over my body. having vivid dreaming just before waking . No zapping, depersonalisation or brain fog. Feeling a bit sweaty, anxious and fatigued. 

 

Im reminding myself that even though I’m struggling I’m much better than I was a week ago. 

 

 

 

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ChessieCat
On 11/18/2018 at 3:40 PM, Andie said:

I think my fear is that if I miss the opportunity to updose that I will be stuck with these symptoms permanently. 

 

Many members have the opposite issue where they panic and end up taking too much drug.  It's better to do it gradually if needed.

 

1 hour ago, Andie said:

I’m much better than I was a week ago. 

 

That's good.

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Andie

Just realised I made a mistake in one or my original posts. The book where I read anout the 10% method was ‘ Your Drug May be Your Problem’ by Dr Peter Breggin. 

 

 

 

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ChessieCat

I've added a correction for you.

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Andie

The third test for Ross River Virus has returned a negative result. First it was confirmed and now it’s no longer  confirmed. They tell me this means I probably never had it in the first place.

 

I’m beyond frustrated right now. 

 

 

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ChessieCat

How frustrating.  I've only glanced over these.  I googled:  positive and negative results for ross river fever

 

https://ww2.health.wa.gov.au/~/media/Files/Corporate/Reports and publications/PDF/RRVdiseasemanagementguideforGPs2010.pdf

 

http://www.health.gov.au/internet/main/publishing.nsf/content/cda-cdi3802c.htm

 

 

This is another google search term that automatically appeared but I didn't look further:  rrv igg positive rrv igm negative

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Andie
6 hours ago, ChessieCat said:

 

How frustrating.  I've only glanced over these.  I googled:  positive and negative results for ross river fever

 

Thanks again for searching for these resources. I really appreciate it. 

 

My Psychiatrist has spoken to my Compounding Pharmacist and between them they have decided to increase my dosage to 12mg but divided into 4 separate doses of 3mg over 24 Hours. The Pharmacy can only gurantee an extended release of between 6-8 hours. My doctor thinks I am an ultra rapid metaboliser and at at a ‘low dose’ this is been intensified. 

 

Failing this, my doctor would like to try switching me over to Prozac. 

 

I am very nervous.. 

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ChessieCat

Splitting the dose sounds very logical.  Seems like you have a very reasonable psychiatrist.  You might want to get a pill keeper so you don't miss/double dose.  Another member suggested that to another member recently after they messed up their dosing.  It would be a good idea to set an alarm too.

 

If it was me, I'd be reluctant to change to Prozac.  Prozac is an SSRI and Pristiq is an SNRI so you would most likely get withdrawal issues from stopping the Pristiq.  The psychiatrist may be thinking of changing to Prozac because of it having a long half life.

 

I think splitting the dose is a much better option which hopefully will work.  You will need to give it several months.  Keep daily notes on paper.

 

And you don't know if you have had RRV.  Is it possible to get tested again?  Is it possible that another test would come up positive?  Are there any other tests available that would be better?  Just brainstorming for you here.

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Andie
8 hours ago, ChessieCat said:

Splitting the dose sounds very logical.  Seems like you have a very reasonable psychiatrist.  You might want to get a pill keeper so you don't miss/double dose.  Another member suggested that to another member recently after they messed up their dosing.  It would be a good idea to set an alarm too.

Hi Chessie 

 

Thank goodness I have a good Psychiatrist and a good GP. It took me a long time to find them, believe me. I have my super duper pill container ready and I will definitely set an alarm on my phone.

8 hours ago, ChessieCat said:

 

If it was me, I'd be reluctant to change to Prozac.  Prozac is an SSRI and Pristiq is an SNRI so you would most likely get withdrawal issues from stopping the Pristiq.  The psychiatrist may be thinking of changing to Prozac because of it having a long half life.

 

I want to avoid switching to Prozac at all costs. I raised the issue of changing to an SSRI from an SNRI and I was told that there shouldn’t be an issue as Pristiq is only an SNRI at high doses. I don’t know whether this is true or what is considered a ‘high dose’ of Pristiq. I still don’t want to change to Prozac.

 

My doctor is thinking about the long half life. Before using the compounding method my doctor tried switching me from 

50mg Pristiq to 75mg Effexor with a view to using ProZac as a bridge but I couldn’t stand the Effexor and crashes into withdrawal after one dose. I don’t believe 50mg = 75mg Effexor. With the symptoms I had , 75mg was too low a dose and not equivalent to 50mg. My body could tell. 

 

8 hours ago, ChessieCat said:

 

I think splitting the dose is a much better option which hopefully will work.  You will need to give it several months.  Keep daily notes on paper.

 

And you don't know if you have had RRV.  Is it possible to get tested again?  Is it possible that another test would come up positive?  Are there any other tests available that would be better?  Just brainstorming for you here.

I agree. Splitting the dose sounds like a much better option. 

 

I appreciate your brain storming Chessie. My GP says it’s highly unlikely I have it, but I asked to be tested again. My GP does think there was some infectious cause for my being so unwell but they don’t know what it is/was.  I just know I got a fever on the 1st of October but thought I had hayfever and took some antihistamines.

 

Then I was bed bound for two weeks. One week later I started to get these ‘withdrawal’ symptoms. It could have been coincidence or bad timing or the illness putting strain on my body .I’m at a loss to work out what has happened.. but this is the worst I have felt in a long time. I had a very similar episode in November 2015 but  I wasn’t tapering at that time. 

 

I am feeling better than I was, so that is encouraging. I’m reminding myself to be grateful for the support I have. 

 

I spent the day watching movies with my two dogs so that took the edge off and distracted me from the weird sensations in my body. 

 

Edited by ChessieCat
removed some info about work place at request of member

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Andie

Yesterday I tried taking my capsules over 3 doses. 4mg each time. 

 

I’m feeling pretty unwell this morning so I think am going I have to slowly spread the 12mg across to the other two dose times.

 

I am still thinking about the Prozac bridge but won’t even attempt this until I’m stable again. 

 

 

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