Andie: tapering off Pristiq

[Andie]

1 hour ago, FindRest said:

Do you limit yourself to 1 “chip” a day or take a chip as needed? 

I've been allowing myself no more than 2mg a day. 1mg in the am and then pm. It seems to keep the worst of it at bay. 

 

I have had a radical uptick of anxiety since Wednesday and still trying to find a balance. 

[Andie]

Update.

 

Feeling fragile but im keeping my head above water. Struggling with feelings of loss of control. 

 

Sleep has on the whole improved so much. I'm also able to do light exercise in the evening. Ive noticed a relationship between disrupted sleep and morning anxiety. The more disruption, the more dreaming and anxiety. If I happen to wake between 4.30 and 5.30 it's Better to start my day than try and get more sleep. Thinking back this isn't new- I had this prior to withdrawal but was definitley caused by Pristiq. 

 

Increasing anxiety since Wednesday morning which coincides with when I took my last 'official' dose of Pristiq.  

 

On a side note- I can't stand the taste of the Prozac. 

 

 

[Andie]

Definite link between fractured sleep and dreaming. More disturbances results in rebounding dreams. 

 

I can usually take 0.25mg Melatonin but cannot tolerate at the moment. Sleep becomes extremely fragmented. 

 

Still having Paraesthesia in arms and legs. Improving and  not getting any worse. 

 

Prozac dose needs to come down for sure. Dr advises to come down to 5mg immediately as I’ve only been on 10mg for 2 weeks and should have some buffer from long half life. 

 

On on the whole I am better. less anxiety, less spasms, even mood,  better sleep but system is in upheaval and 10mg was a massive overshoot. Cannot tolerate the liquid Prozac I am using as the tiny amount of alcohol in it is making me flushed and sweaty. Again- another sign of my system in flux. 

 

Doctor originally wanted to use 20mg but I talked him into letting me use 2.5 and titrating up.

 

I suspect I was not getting the correct dosage using the compounded formulation. I think I was getting much less than what was on the label as well as dose dumping. I couldn’t understand how I got withdrawal syndrome on my slow taper. 

 

Trying to focus on the positives. 

 

 

 

[Andie]

Another thing to note is that I feel like getting changed and puttng on some makeup instead of staying in my pyjamas all day. 

 

Going to take my dog for a short walk. 

[FindRest]

I love your attitude!  Sorry you are having symptoms, but so thankful you’ve been having some positives as well. 

 

I can relate to: “it's Better to start my day than try and get more sleep”. Waking up with anxiety isn’t any fun, nor the ruminating thoughts that run around our heads if we just lay there. Hope the decrease in Prozac helps this. 
 

Thanks for keeping us up to date. Hugs. 

[Andie]

Thank you! I think I just have to accept that there is some major healing to be done. 
 

I hate the morning anxiety- I think it’s the worst part of it. 
 

Have you swapped out the Pristiq for Effexor yet? 

[FindRest]

Yes, I started today! About to post a quick update. Been a pretty good day!

[Andie]

Love this. Saving link here to show my family. They are big Amanpour fans.

 

https://edition.cnn.com/videos/tv/2018/05/17/amanpour-allen-frances-antidepressants-interview.cnn

[Andie]

I haven't decreased the dose of Prozac yet as I want to make only one change at a time. I am going to stop taking the rescue doses of Pristiq as I seem to be having rebound symptoms after 12 hours. It's also further evidence that the delivery of the compounded Pristiq is causing chaos in my body. My body doesn't like Pristiq in general but it HATES the compounded one even more. 

 

Tinnitus, anxiety and tingling in arms and legs. It  seems to be worse on rebound than the actual WD of Pristiq on the whole. 

 

Ond steady dose of the Prozac is what I'm aiming for. 

 

 

[Andie]

Hi @Altostrata

 

I feel really guilty bringing your attention to my thread as I know the site is really busy at the moment. 

 

I would really appreciate any advice you can give, or if there is something I am missing that you can point out. 

 

I have had a mostly successful bridge to Prozac and I am feeling  better than I have for quite a while. My nervous system has experienced a shock and I am experiencing symptoms (anxiety, teariness, paraesthesia and nighmares) in a definite windows and waves pattern. It is uncomfortable but manageable at this point. 

 

I tried switching using low dose Effexor but I developed tachycardia and postural hypotension. Switching to Prozac came as a last resort as my GP and original Psychiatrist were nervous about introducing Prozac, and referred me on for a second opinion. The second Psychiatrist wanted me off the compounded Pristiq immediately due to its unpredictability, and introduced low dose Prozac over 4 weeks increasing weekly from 2.5-10mg with a test drop of Pristiq after a week at each dose. I failed at 2.5, 5 and 7.5mg- I had immediate nausea and vomiting. Doctor and I both think I was holding on at the higher doses as I was just massively oversaturated.

 

I think I overshot at 10mg but it was not far off (  8-9.5 mg would have been spot on) and I can reduce this dosage. I was taking low doses of Pristiq to smooth things over but I have noticed rebounding symptoms such as anxiety, tinnitus and paraesthesia 12 hours after. The feeling of  rebounding is worse than that of the complete withdrawal,  so I am abandoning the Pristiq all together as to not ping pong my brain any further. 

 

My sleeping pattern off the Pristiq has changed dramatically and I now realise I was experiencing dose dumping on the Pristiq. 

 

The last 15 months have been an absolute mess, but I am hoping that once I can finally find some stability, my nervous system will repair itself. 

 

Thank you for everything you do Alto. 

[Altostrata]

It looks like added the Prozac a month ago and you took your last Pristiq only 4 days ago?

 

It can take longer than a month for your nervous system to settle down after a big change like that.

 

Why do you think 10mg Prozac is too much?

[Andie]

3 hours ago, Altostrata said:

 

It looks like added the Prozac a month ago and you took your last Pristiq only 4 days ago?

 

Hi Alto

Correct, almost 5 weeks on Prozac, 6 days without 'scheduled Pristiq' and 2 days with absolutely no Pristiq

 

3 hours ago, Altostrata said:

Why do you think 10mg Prozac is too much?

4 days after commencing the 10mg Prozac  I started to feel  profoundly fatigued, out of my body, dizzy and couldn't stand bright lights. I felt completely zombiefied.  Interestingly, my sleep returned to normal. I must admit that since I stopped using the small transition doses of Pristiq, being on 10mg doesn't feel too bad. 

 

Compared to Pristiq, I can really feel that Prozac takes a long time to ramp up. 

 

[Andie]

1 hour ago, Andie said:

Hi Alto

Correct, almost 5 weeks on Prozac, 6 days without 'scheduled Pristiq' and 2 days with absolutely no Pristiq

 

4 days after commencing the 10mg Prozac  I started to feel  profoundly fatigued, out of my body, dizzy and couldn't stand bright lights. I felt completely zombiefied.  Interestingly, my sleep returned to normal. I must admit that since I stopped using the small transition doses of Pristiq, being on 10mg doesn't feel too bad. 

 

Compared to Pristiq, I can really feel that Prozac takes a long time to ramp up. 

 

 

Forgot to mention the fatigue etc lifted once the Pristiq was dropped. So perhaps the combination of the two was the cause. 

 

The plan was to reduce Pristiq in 4 steps over two weeks while at 10mg of Prozac, but the relief was so great after dropping Pristiq that was able to complete it in a week. 

[Andie]

Sleep is improving in leaps and bounds. It’s quite unbelievable.

 

There is no doubt in my mind now that the compounded Pristiq messed me up big time. In fact, I don’t actually know how many mg my body was actually absorbing. I don’t even know if Pristiq can withstand the acidity of the stomach. There is good reason why most Pharmacies will not attempt to compound Pristiq. 

 

Current symptoms are: 

• muscle spasms and pain in legs
• Twitching 
• some anxiety 
• vivid dreaming 
• tinnitus 

I don’t feel too bad on 10mg, but I definitely feel ‘medicated’ and I am constantly yawning, which is new. 

[FindRest]

I’m so glad your sleep is improving!!  
 

Thank goodness you’re not taking the compounded Pristiq any longer.  I think you’ve made a wise decision. Did you have any of those same symptoms while you were on the Pristiq tablets (uncut)? I had a ton of muscle and joint pain while taking it, along with tinnitus. 

 

26 minutes ago, Andie said:

I definitely feel ‘medicated’

I think this is important to pay attention to. 
 

Hope tomorrow brings you even more noticeable improvements!

[Andie]

2 minutes ago, FindRest said:

I’m so glad your sleep is improving!!  
 

Thank goodness you’re not taking the compounded Pristiq any longer.  I think you’ve made a wise decision. Did you have any of those same symptoms while you were on the Pristiq tablets (uncut)? I had a ton of muscle and joint pain while taking it, along with tinnitus. 

 

I think this is important to pay attention to. 
 

Hope tomorrow brings you even more noticeable improvements!

I definitely had some of those symptoms but not to the same extent.  Back when I was on the 50mg, the main concerns were high blood pressure, tachycardia, sweating, muscle pain and this feeling of being disconnected. I also had profound fatigue and felt I was just dragging myself everywhere. 

 

I am keeping an eye on that medicated feeling. The yawning is something new.  I have a hunch that maybe a 1 or 2 mg or somewhere in between reduction will be perfect.  but at the same time I don’t want to make too many changes. I am watching and waiting. It’s like my CNS is making rapid changes and everything is trying to click back together. 

 

 

[Andie]

I’ve worked out what I feel like- a human Rubik’s  Cube.

[Andie]

I'm going to take the plunge and come down to 9.5 mg Prozac at my next dose. 

 

Over the the course of today I felt increasingly  agitated, and irritated but flatlined at the same time.  I wanted to pace around And I didn't feel settled in myself.  I've felt this before, when I was at 50mg Pristiq. It's a very distinct feeling of one foot on accelator and one on break. It's the only way I can describe 'feeling medicated'. 

 

I feel pretty confident a dose reduction is needed...and it's easy to do with my liquid. 

[Giulietta]

On 4/12/2017 at 5:24 AM, Andie said:

I resigned from my position in 2016 and have been tapering since November 2016. So far so good, but it has been a long, emotional and isolating process. I still have some struggle every time I reduce my dosage, and it would be great to have the support of others who understand what I am going through. 

 

Hello Andie

 

This is not much fun - but you are getting there. It is so frustrating and tiring. When things aren't looking up I remind myself that I will get there and this is temporary (just how temporary I wonder some days).

 

I did a medically advised CT in 2018 - I was on 20 mg - whic wasn't doing anything - but it was. Panic and agoraphobia, etc. ensued. I reinstated the 20 mg and tried what I thought was compounding in Dec 2018. More hell but I was told to expect physical symptoms and other emotional ones. Given what I experienced about this drug I was determined to s tay with it. I didn't transition to prozac b/c I had anxiety about what that would do.

 

Since the CT (or almostI) I have experienced an astounding array of symptoms - and I don't kmow if physical are worse than emotional. I suppose it depends on the day. Even though I am at a 'low' dose - I have  (unwittingly) done a lot of damage and have been told by SA staff tht I am in prolonged WD. While this is my 'path' in life - you seem to be on the up and up! So keep following mods advice.

 

I  haven't worked since before this fun began and I would like to. Are you working now?

 

 

 

 

 

[Andie]

2 minutes ago, Guilietta said:

 

Hello Andie

 

This is not much fun - but you are getting there. It is so frustrating and tiring. When things aren't looking up I remind myself that I will get there and this is temporary (just how temporary I wonder some days).

 

I did a medically advised CT in 2018 - I was on 20 mg - whic wasn't doing anything - but it was. Panic and agoraphobia, etc. ensued. I reinstated the 20 mg and tried what I thought was compounding in Dec 2018. More hell but I was told to expect physical symptoms and other emotional ones. Given what I experienced about this drug I was determined to s tay with it. I didn't transition to prozac b/c I had anxiety about what that would do.

 

Since the CT (or almostI) I have experienced an astounding array of symptoms - and I don't kmow if physical are worse than emotional. I suppose it depends on the day. Even though I am at a 'low' dose - I have  (unwittingly) done a lot of damage and have been told by SA staff tht I am in prolonged WD. While this is my 'path' in life - you seem to be on the up and up! So keep following mods advice.

 

I  haven't worked since before this fun began and I would like to. Are you working now?

 

 

 

 

 

 

I stepped down from a senior role and started working part time. My whole life revolved around work before I got sick and it's been a real wake up call. There has been a real vacuum in my life since then.   I would love to be back full time but I don't think it's possible until I'm stabilised on the Prozac. 

 

I think I've been lucky in many ways as I tapered slowly and stopped tapering when things got really bad. I only had one drug to deal with as well. 

 

Its ts so hard because all we can do is take it one day at a time. 

 

 

[Giulietta]

Likewise. I had a midi-level role and between that and being hurriedly moved off lexapro - I experienced 'unmasking' the famous expression.

 

I started to look for work again in Sept but have had several relapses - a string of them. I hope you enjoy your PT work and hope you stabilize soon.

3 minutes ago, Andie said:

I only had one drug to deal with as well. 

 

I have been 'tapering' duloxetine only - but neurologist said that lamotrigie was toxic so I am coming down that and am not happy about that and may most a question about it.

 

Yes, one day at a time.

 

I find my appetite goes up and down from day to day....

[Andie]

10 hours ago, Guilietta said:

I find my appetite goes up and down from day to day....

 

Me too. The more agitated I feel, the less I want to eat. 

[Andie]

Woke up in the middle of the night with sweating and I’m an absolute sweaty mess again this morning. Terrible tinnitus that sounds like a constant high pitched whine in my head. I’m feeling irritable and have a headache. 

 

Still think this is more a side effect of the Prozac rather than the withdrawal. 

 

Sleep is still really good, so I hope this remains after dropping the Prozac a bit. Going to 9.5 at next dose. 

 

[gardenlady]

Andie, Congrats on successfully bridging to Prozac from Pristiq!  I've followed your progress as I am considering bridging to a low dose of Prozac from Cymbalta.  However, unlike you, I would have to do it without the help of a doctor as there is none in my area knowledgable about tapering or who even recognizes that AD withdrawal is a real phenomenon.  I think I can get some liquid Prozac from my internist, but he is clueless about tapering....he thinks I should just stop the drug now as in his opinion I'm on such a low dose.  I'm decreasing Cymbalta one bead at a time but have had to slow down greatly due to harsh withdrawals such that it might take me another 2 years to finish.  As the akathisia is so bad, I simply can't tolerate it as I've had it (akathisia) for 3 years already.   I'm currently at 27 beads/5.2 mg.

 

How did you start your Prozac...at what dose and then at what speed did you increase it and then hold before making your first Pristiq cut?  I'm terrified that when I try to cut Cymbalta even after being on the Prozac that I'll have unbearable symptoms.  I live alone and so have no one to talk me through bad times.  I'm trying to figure out how many beads of Cymbalta to cut after I've worked up to the optimum Prozac dose.  

 

Thanks in advance for any details you can offer as to how you did this.  I'm so glad that you are off of the offending Pristiq and will soon be on the road to recovery. 

 

  

[Andie]

Hi GL

 

Thanks! It’s such a relief to be done with the Pristiq after 10 long years. It’s now a matter of stabilising and getting the Prozac dosage in a more comfortable place. 

 

My Doctors are wonderful people and very well intentioned, but I had to be very clear with them that I was not going to bomb my brain with high doses of Prozac and I was going to do it my way or no way. My Psychatrist told me my 6 kilo Poodle would be able to tolerate higher doses than what I was planning on taking. The only real instruction he gave me was not to stay at any particular dose of Prozac for more than four weeks and to drop the Pristiq quickly if I could manage it. The idea was to sneak the Pristiq away while Prozac was lifting me up and holding me steady. 

 

Part of this involved a lot of guess work as I was taking compounded Pristiq where I didn’t really know how much was being absorbed. Because of this I started titrations low at 2.5mg. I could have started much lower at 0.5. 

 

Week One- 12 Pristiq and 2.5mg Prozac. Didn’t feel much at all. Test Dropped 4 mg Pristiq after 7 days  and was sick. 

 

Week Two-  12 Pristiq and 5mg Prozac. Withdrawal symptoms started to disappear  and I could feel Prozac kicking in. Test drop 4mg after 7 days and failed. 

 

Week 3-  12mg Pristiq and 7.5 Prozac- Withdrawal symptoms gone and I can feel the Prozac in my system now. Feeling really good excercising again. Failed test drop. 

 

Week 4- 12 Pristiq And 10 Prozac- After 4 days felt very fatigued and over medicated. I could feel that now was a good time to drop Pristiq. Dropped 6mg successfully  and had immediate relief from fatigue. Dropped the rest over the next few days, with relief each time. 

 

If if I could change anything, in hindsight I would have held longer than a week at each increase in Prozac as it definitely takes a while to build in the body.  I might not have had to take 10mg to switch.  I am glad I ramped up the Prozac first as I got a chance to feel how Prozac ‘feels’ in my body. Doing it this way made it easier to work out what effects were from Prozac, Pristiq or a a combo of the two. 

 

Right At this moment I can’t feel any symptoms of withdrawal only side effects of Prozac. 

 

I think you could test the waters by dropping small amounts like I did.  I was actually extremely surprised I was able to drop everything in a week. 

 

It took me a year to decide to switch. I was terrified as I had been hospitalised for a month with Akathisia when I started up Pristiq. To my shock, the switch itself was no where near as bad as I though it would be.  I think ramping up and getting Prozac on board before dropping was absolutely key in my situation but may not be for others as the two drugs have major interactions. 

 

SNRI withdrawal has been hands down the most horrific thing I’ve been through. I’m sorry you have to deal with it on your own, that is an extremely tough spot to be in.

 

If it’s any minor consolation at all, You can always message me And I’m sure the mods will be there to support and guide  you during the process. 

 

For or me it’s been absolutely worth it. I’ve still got a way to go stabilising and putting myself back together again, but at least I know have some hope for a full recovery where there wasn’t one before. 

 

 

[Giulietta]

5 hours ago, Andie said:

SNRI withdrawal has been hands down the most horrific thing I’ve been through. I’m sorry you have to deal with it on your own, that is an extremely tough spot to be in.

 

I don't know if it is the 1st or 2nd - after coping with an epilepsy diagnosis and treatment and stabilization.

 

@gardenlady you are also welcome to PM me.

 

I believe I have seen others (mods) suggesting moving at a slower rate to cross-taper.

 

7 hours ago, gardenlady said:

I'm terrified that when I try to cut Cymbalta even after being on the Prozac that I'll have unbearable symptoms.  I live alone and so have no one to talk me through bad times.  I'm trying to figure out how many beads of Cymbalta to cut after I've worked up to the optimum Prozac dose.  

 

We all react differently. My symptoms on cymbalta (and I have been with others who think I am dramatizing things) have been horrific and I questioned transitioning to prozac  but was afraid to. I thought I would have worse symptoms.  I just wanted off this garbage and perhaps I made a mistake about not cross-tapering. Where you are at a known dosage of cymbalta you are in a better position than I was/am.

 

I didn ot raise this to the MD.

 

At 1 bead (.2 mg) of cymbalta I continue to have a host of some incapaciting and some pain in the neck symptoms - every day. Prozac may be a good choice for you. I was a veritable cold turkey.

 

Hugs,

G.

 

 

[Andie]

17 minutes ago, Guilietta said:

I believe I have seen others (mods) suggesting moving at a slower rate to cross-taper.

 

Yes I have seen a few different versions of cross tapering out there. 

[gardenlady]

Andie, Thanks a million for your helpful post with all the bridge details!  I may PM you so as to not hijack your thread.  

[Andie]

Update. Day 2 on 9.5mg. 

 

I still have tinnitus,  sore muscles and sweating. 

 

Spasming and twitching has reduced as well as agitation and irritability. 

 

Slept right through the night with a very contained anxiety rush on waking. I know I was dreaming but I can't remember the content. 

 

Intrestingly, I've been having some GI upset and reflux. 

 

This Is a one step forward, two steps back process. 

 

 

 

[Andie]

3 hours ago, gardenlady said:

Andie, Thanks a million for your helpful post with all the bridge details!  I may PM you so as to not hijack your thread.  

Sure, no problem. 

[Andie]

2 hours ago, FindRest said:

You can also try “brown noise” and “pink noise” with Alexa. There are also several different apps, and YouTube, that have a variety of continuous play sounds for tinnitus. 

 

Whoa! 

 

I download a tinnitus app to my phone and tried the combination of brown and pink noise- amazing, tinnitus totally disappeared while I playing it. 

 

Thanks so much! 

 

Oddly enough I did feel relaxed by the sound of my robot vacuum, which has a similar sound ! 

[FindRest]

Which app did you get? I couldn’t decide. 
 

Haha about the robot vac, I’ll have to try mine out!! Just think, we could turn our Roombas on when we go to bed!

[Andie]

Hi @Altostrata

 

I'm feeling better on a reduced dose of Prozac, I think it needs to come down a bit more but,  I'll hold on at 9.5 for a few more days. I know Prozac half life means I have to wait a bit longer. 

 

I think the dose is too high because I am feeling like I am back up at 50mg Pristiq with sweating and muscle aches. I've got really bad tinnitus but @FindRest has given me a fantastic suggestion to use white noice . I have tried it and and it's totally cancelling out the tinnitus while I have it playing. 

 

PTL my sleep is improving! I can sleep right through the night now with just a very contained anxiety/ cortisol spike when I wake in the morning. 

[Andie]

13 minutes ago, FindRest said:

Which app did you get? I couldn’t decide. 
 

Haha about the robot vac, I’ll have to try mine out!! Just think, we could turn our Roombas on when we go to bed!

It’s called Resound Tinnitus Reflief. I got mine on iTunes. 

[Andie]

Had a long chat with my local Pharmacist (Compounding Also, but can’t do complicated concoctions as they are limited by their machinery)  about making my own fluoxetine solution. They say it’s definitely worth trying because the savings will be huge. $3 vs $55 per month.  
 

I have come away with a box of 20mg dispersable fluoxetine tablets, an amber bottle with bung, 10mL syringe and 1mL syringe. 

 

If it gets too tricky, they can make me a 10mg in 1ml suspension that will last for 6 months. They can also add a dye to make it easy to measure. 
 

and the best thing is they warned me to go slow because the withdrawal can be brutal! 
 

 

 

 

 

[Andie]

Just over a week has passed since dropping Pristiq.

 

Bothered by tinnitus and muscle pain. A bit sweaty. Had a few waves of dizziness this morning. 

 

Continuing to sleep very well. 

 

Still early days yet, but taking all into consideration I’m doing quite well. 

 

Since adding And switching to Prozac I’ve been able to excercise every day.