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Invisibleunless: have you done a web search, e.g. google "prozac switch" "research OR study"?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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Good question.   I have read that with most ADs, you should wait a minimum of 3 weeks before making the next cut. With Prozac, you might want to wait a minimum of 4 weeks.   Personally, I exp

InvisibleUnless

nope.  frankly, i would not be asking here unless i was too sick to be trying to track down things on my own.  relying on journal databases is less useful than the experience of users here in terms of finding pertinent articles, as well, because most do not take into account withdrawal syndrome in the first place.  of course, even those potentially inappropriate articles are good to know of at least as part of a rebuttal.

 

i have pretty limited cognitive and energy resources so i try to be tactical about asking for help.  it is fine if this request is not fielded over here, but i figured to make the attempt.  i have pre-identified articles to parse numbering into the hundreds at present, on the general topic of psychotropic side effects, and reading even one a day is usually not feasible most of the time.  reading through search results, even just titles, is overtaxing a lot of the time and i try to spend my limited resources or more urgent issues like acute instances being presented to me rather than clashing with psychiatrists in public forums.  convergences of those concerns are where i occasionally ask for assistance.

 

i do appreciate your suggestion, though.  many other individuals here are not well enough to be running the literature, either, and people that are are likely to have their hands full with other issues.  this was just asking if someone has something handy.

from 2005-2012, i spent 7 years taking 17 different psychotropic medications covering several classes.  i would be taking 3-7 medications at a time, and 6 out of the 17 medications listed below were maxed or overmaxed in clinical dosage before i moved on to trying the next unhelpful cocktail.
 
antidepressants (SSRIs, SNRIs, NDRIs, tetracyclics): zoloft, wellbutrin, effexor, lexapro, prozac, cymbalta, remeron
antipsychotics (atypical): abilify, zyprexa, risperdal, geodon
sleep aids (benzos, off-label antidepressants & antipsychotics, hypnotics): seroquel, temazepam, trazodone, ambien
anxiolytics: buspar
anticonvulsants: topamax
 
i tapered off all psychotropics from late 2011 through early 2013, one by one.  since quitting, ive been cycling through severe, disabling withdrawal symptoms spanning the gamut of the serious, less serious, and rather worrisome side effects of these assorted medications.  previous cross-tapering and medication or dosage changes had also caused undiagnosed withdrawal symptoms.
 
brainpan addlepation

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  • Moderator Emeritus

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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There are no studies supporting a cold swap. Psychiatrists who believe this is a good idea are not listening to their patients.

 

There are studies recommending cross-tapering.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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InvisibleUnless

thanks for combining the two sources.  i am too sick to rigorously parse the google search, but it has nice booleans.  i peeked at the study but will have to do so again when i am more able.

 

There are no studies supporting a cold swap. Psychiatrists who believe this is a good idea are not listening to their patients.

 

There are studies recommending cross-tapering.

i suspected as much, but did not want to jump to any conclusions.  thanks for jumping in.

 

then again, when has "do you have any research to support that?" ever flown with the average psychiatrist.

from 2005-2012, i spent 7 years taking 17 different psychotropic medications covering several classes.  i would be taking 3-7 medications at a time, and 6 out of the 17 medications listed below were maxed or overmaxed in clinical dosage before i moved on to trying the next unhelpful cocktail.
 
antidepressants (SSRIs, SNRIs, NDRIs, tetracyclics): zoloft, wellbutrin, effexor, lexapro, prozac, cymbalta, remeron
antipsychotics (atypical): abilify, zyprexa, risperdal, geodon
sleep aids (benzos, off-label antidepressants & antipsychotics, hypnotics): seroquel, temazepam, trazodone, ambien
anxiolytics: buspar
anticonvulsants: topamax
 
i tapered off all psychotropics from late 2011 through early 2013, one by one.  since quitting, ive been cycling through severe, disabling withdrawal symptoms spanning the gamut of the serious, less serious, and rather worrisome side effects of these assorted medications.  previous cross-tapering and medication or dosage changes had also caused undiagnosed withdrawal symptoms.
 
brainpan addlepation

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"then again, when has "do you have any research to support that?" ever flown with the average psychiatrist."
:lol:


Or the other way around, when a patient says, "I've looked at the research, and I think this is the best way to handle X"...
and the doctor generally doesn't take it very well.
I actually have a copy of some fairly snarky notes from my GP when I explained why I am no longer on buproprion. [Patient says she "did some research" and decided to stop taking it.]  :angry:  <_<  *
In this practice, all notes, labs, etc. are available online, so she had to know that I'd be able to see it. Her notes were really poorly written too.

I had my last shrink pretty well trained. When I'd tell him, "this is my plan, and I've done my research", he'd generally accept it, sometimes ask a few questions, usually check back in the following weeks to see how I was doing. He also knew my educational background, and that I don't mess around with poor-quality evidence.  :D 
Of course, when I decided to stop buproprion, and taper off slowly, I came up with probably 20 recent relevant journal citations, and would have had no problem handing him the list if he'd questioned my decision.

* In most cases, me doing research for something involving my health starts with PubMed, which should be at or near the top of the list of where that doctor should head when she needs to look up recent, relevant, peer-reviewed, published journal articles. But she didn't bother to ask anything about my "research" (as she put it), just assumed I'm an uneducated idiot. :angry:

Free from Wellbutrin / buproprion.
Now working on sleeping well / enough. Hopefully I can eventually get off the sleep meds too.

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  • 10 months later...

I'm wondering if there are people who used Prozac as a "stepping stone" from another SSRI near the end of the taper. I'm on ~1.8mg of Paxil after a long taper, and I'm considering a switch to Prozac to make the final stretch easier. I understand the risks involved, but I seem to find a lot of people who have succeeded with a cross taper. 

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

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Henosis  there may well be people who have succeeded with a cross taper but it depends on how you define success. I guess if one was successful they wouldn't be here right. However this site is voluminous  in bridge switch attempts that  have been problematic.

I wouldn't call being on  paxil one day and then on (many) multiples of that dosage in Prozac the next and then still stuck there many months later a 'success' while pushing the drug free ETA out by many years in the process.

Reading through your drug sig I get the feeling that you shoudnt go there. Just look what happened  with the prior cross taper attempt with nortrip. Not to mention the many failed past drug switch attempts sending you into a complete mess only to end up back on paxil again. Qu. Will things will be any different this time? Answer : What do you think? 

 

I think you should be congratulated on getting down to 3.5mg and being free of other drugs.  

By the way if you tapered from 3.5 to 1.8 in the last 3 months then that is faster than the 10% rate rec here. You are tapering too fast. Personally I wouldn't be in any hurry at this stage. If it was me I would be conservative by dropping the taper rate so I make even smaller cuts with longer holds following in the Brassmonkey footsteps. To go from 1.8 mg to 0.5 mg with cuts every 4 weeks (at 5% of previous dose) will take another 2 years but is that such a big deal if you have a life and can function. You may hardly notice it. Whats another two or three years in light of the 14 years prior drug use.

In my opinion especially for you anyway it would be a high risk move.

Heres the thing say you manage to pull off a 1mg to 1mg switch to Prozac  are you thinking that you can then speed up the taper? If so that would be a big mistake.

What if things turn bad then what ? I am in no doubt about what the doctor will then do ....it will be an escalation of dosage and  an introduction of other drugs to quell wdl symptoms and on top of that your intelligence will be insulted by the doctor  establishing for all of time that you have now had a relapse, while talk of  withdrawal symptoms will be non existant.

 

nz11

Thought for the day: Lets stand up, and let’s speak out , together. G Olsen

We have until the 14th. Feb 2018. 

URGENT REQUEST Please consider submitting  for the petition on Prescribed Drug Dependence and Withdrawal currently awaiting its third consideration at the Scottish Parliament. You don't even have to be from Scotland. By clicking on the link below you can read some of the previous submissions but be warned many of them are quite harrowing.

http://www.parliament.scot/GettingInvolved/Petitions/PE01651   

Please tell them about your problems taking and withdrawing from antidepressants and/or benzos.

Send by email to petitions@parliament.scot and quote PE01651 in the subject heading. Keep to a maximum of 3 sides of A4 and you can't name for legal reasons any doctor you have consulted. Tell them if you wish to remain anonymous. We need the numbers to help convince the committee members we are not isolated cases. You have until mid February. Thank you

Recovering paxil addict

None of the published articles shed light on what ssri's ... actually do or what their hazards might be. Healy 2013. 

This is so true, with anything you get on these drugs, dependance, tapering, withdrawal symptoms, side effects, just silent. And if there is something mentioned then their is a serious disconnect between what is said and reality! 

  "Every time I read of a multi-person shooting, I always presume that person had just started a SSRI or had just stopped."  Dr Mosher. Me too! 

Over two decades later, the number of antidepressant prescriptions a year is slightly more than the number of people in the Western world. Most (nine out of 10) prescriptions are for patients who faced difficulties on stopping, equating to about a tenth of the population. These patients are often advised to continue treatment because their difficulties indicate they need ongoing treatment, just as a person with diabetes needs insulin. Healy 2015

I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015

Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017

 

 

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Henosis, I agree with NZ.  In general it is better to taper off the drug you are currently taking rather than risk trying to change to a different drug.  Changing over can be difficult because you can experience WD from the first drug and start up/side effects/bad reaction to the new drug and you will not know what is causing what.  Slow and steady wins this "race", but it's not a hurrying race, it's slow and steady reaches the goal of getting off.

NEW!!!              INTERVIEW with Altostrata, SA's founder               NEW!!! 

 

ADs:  25 years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering Oct 2015  Current from 14 Nov 2020:  Pristiq 0.50 mg

My tapering program                                      My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

REMINDER TO SELF:  I don't need the drug now, but my still brain does.

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  • 2 weeks later...

At this point I am wondering if I will ever improve.   Doctor wanted me to switch to Prozac several years ago, but I was too scared and I thought "surely this will be all over this year," which is what I said every year, but now I don't have that hope any more after 6+years. 

 

I have read the thread on SA about bridging and switching about 4 times but never felt confident about doing it.  The one thing that put me off was the fact it said that switching does not cover any w/d symptoms you have and I guess that would be the one thing I would be hoping for - some letting up with all the w/d symptoms.  I also noticed Prozac was stimulating so that put me off.  I thought about Endep which was calming in the past, but also made me like a zombie but it didn’t have much of a half life.

 

Then when things went downhill badly about a year ago, and got worse and worse, I was ready to switch to Prozac a few months ago, but that is when Doc wrote the script for Cymbalta saying it was better, etc. along with a script for taking Serapax every day.  I was furious and tore the scripts up.

 

Now it has come to my attention that the tablet I am taking is not made my GSK but by an Australian company called Aspen!  I have posted that on SA and been told by a Mod that it is a generic brand, so I now wonder if that has been the cause of all my distress???

 

I am now feeling so hopeless and so mad that all this suffering was a result of being put on this drug for pain and never told it was addictive and now been switched without knowing it to a generic form.  Even the active ingredients listed on the front of the packet have an extra ingredient to the GSK one!  Does anyone know anything about this?  Does this mean I have basically switched to a different a/d???

 

After seeing Songbird’s update I am now seriously considering a switch to Citapolam.  She has been on the drug a long time like myself, tried a long slow taper and is about my age and seems to have successfully switched over.  I like the fact it is calming and has a longer half life than most and while not as long as Prozac, is longer than Paxil, so it has some things in its favour.

 

I still have concerns about this, of course, but I think this info will do for today.  I would appreciate any input in the meantime.

Edited by grandmaD
to put in paragraphs

1995-2007      20mg Aropax/Paxil for pain.  Years of up and down doses

2008                Endep, Lexapro and then Esipram (hell!) CT (oh dear!)

2009                20mg Aropax.  Tried skipping doses for a year (more hell!)

                        2010                10mg.  10% taper.  Lasted 4 months. Crashed again

2011                5% taper. 9mg-7mg (hell got even worse!)

2012                2.5% taper.  6.6mg – 5.6mg (worser still & unbearable)

2013                5% taper.  Big mistake.  5.5mg – 4.6mg  (even worserer)

2014                2.5% taper.  4.9mg – 4.5mg;    2015 2.5% taper 4.4 - 4.0mg

2016                2.5% taper.  3.9mg  Feb 3.8   Mar 3.7  May 3.6   Jul 3.5

2017                2.5% taper.  Jan 3.4;   Mar 3.35;  Apr 3.3; Oct 3; Dec 2.9;

2018                2.5% taper. Jan 2.8; Mar 2.7; Mar: 2.75; Jun 2.7; Aug 2.6; Oct 2.5; Nov 2.4; Dec 2.3

2019                Jan 2.2; Feb 2.1;

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  • 4 months later...
  • Moderator Emeritus

I found a meta-study (study of many studies) that evaluated equivalent doses to 40 mg fluoxetine (prozac) which may be useful in identifying an end cross-over/bridge dose to discuss with the person who prescribes your medication(s).

source: https://www.ncbi.nlm.nih.gov/pubmed/25911132

 

From the abstract at that link:

We included 83 studies (14 131 participants). In the primary analysis, fluoxetine 40mg/day was equivalent to

 paroxetine dosage of 34.0mg/day
 agomelatine 53.2mg/day
 amitriptyline  122.3mg/day
 bupropion (wellbutrin) 348.5mg/day
 clomipramine 116.1mg/day
 desipramine 196.3mg/day
 dothiepin 154.8mg/day
 doxepin 140.1mg/day
 escitalopram 18.0mg/day
 fluvoxamine 143.3mg/day
 imipramine 137.2mg/day
 lofepramine 250.2mg/day
 maprotiline 118.0mg/day
 mianserin  101.1mg/day
 mirtazapine 50.9mg/day
 moclobemide 575.2mg/day
 nefazodone 535.2mg/day
 nortriptyline 100.9mg/day
 reboxetine 11.5mg/day
 sertraline 98.5mg/day
 trazodone 401.4mg/day
 venlafaxine 149.4mg/day.

 

Sensitivity analyses corroborated the results except for doxepin.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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  • 3 months later...

Thought I’d add my experience here.

 

after a horrific withdrawal, I reinstated Paxil and tapered down to about 2mg before really running into wall. I slowly added Prozac, of which I’m now on 10mg (approx 4 months).

 

it doesn’t especially help cognitive or physical issues related to withdrawal, but I have noticed less intrusive thoughts and haven’t had a panic attack since starting.

 

Overall, I’d rate it as mildly helpful. I’m still just as sensitive to Paxil reductions, and there is no way I’d be able to do a quick cross taper. I’m essentially just using it as a buffer until I’m off of Paxil completely at which time I’ll start to taper it as well.

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

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  • 3 months later...
Itzakadoozee

I want to switch from escatalopram to prozac to continue my taper. Tapering escatalopram produces extreme withdrawal at low doses. Very scared to try though.

 

2005-2015 sertaline, 2015 to November 2018 escatalopram. Used liquid titration to drop doses. By 0.5mg at first then drops as small as 0.01mg at end of taper. Jumped of at 0.02mg

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  • 2 weeks later...
Iatrogenesis
On 1/7/2018 at 3:07 PM, scallywag said:

I found a meta-study (study of many studies) that evaluated equivalent doses to 40 mg fluoxetine (prozac) which may be useful in identifying an end cross-over/bridge dose to discuss with the person who prescribes your medication(s).

source: https://www.ncbi.nlm.nih.gov/pubmed/25911132

 

From the abstract at that link:

We included 83 studies (14 131 participants). In the primary analysis, fluoxetine 40mg/day was equivalent to

 paroxetine dosage of 34.0mg/day
 agomelatine 53.2mg/day
 amitriptyline  122.3mg/day
 bupropion (wellbutrin) 348.5mg/day
 clomipramine 116.1mg/day
 desipramine 196.3mg/day
 dothiepin 154.8mg/day
 doxepin 140.1mg/day
 escitalopram 18.0mg/day
 fluvoxamine 143.3mg/day
 imipramine 137.2mg/day
 lofepramine 250.2mg/day
 maprotiline 118.0mg/day
 mianserin  101.1mg/day
 mirtazapine 50.9mg/day
 moclobemide 575.2mg/day
 nefazodone 535.2mg/day
 nortriptyline 100.9mg/day
 reboxetine 11.5mg/day
 sertraline 98.5mg/day
 trazodone 401.4mg/day
 venlafaxine 149.4mg/day.

 

Sensitivity analyses corroborated the results except for doxepin.

 

Great info! Funny thing, when I was planning to switch over to Prozac from Zoloft, I looked for info online on dose equivalence and there was a website, sadly I can't find it now, where certified doctors post answers to questions and there were 3 (I think) different answers on what dose of Prozac is equivalent to 50mg Zoloft and none was correct. Hahaha! Another proof it's better to do your research than trust a doctor who can't even be bothered to look that info up online.

 

(I think it was HealthTap and they've deleted the question and answers by now)

 

But I have a question. I was wondering, and I'm simply trying to understand better, not criticising anything, why is your policy to discourage bridging? I understand you want to recommend people the least dangerous approach, but don't a lot of people try different drugs over time and have no problem switching between them? Doesn't it mean in that case switching to Prozac would carry no risk for them and even if they couldn't tolerate it, they could safely go back on their original drug and that would be a waste of maybe a few months time? Isn't it still worth it to potentially waste some time if it could mean not only a safer process, but potentially a (much) shorter one (if one wanted to try a shorter taper)? For example, I was able to quit Olanzapine and I'm having no problems quitting Prozac, but was unable to quit Zoloft over about the same amount of time. So isn't it worth it to try switching to another drug, doesn't even have to be Prozac but something with a longer half-life (Olanzapine has around 30, Zoloft around 20 I believe) if it could potentially mean less time spent quitting the drug, so being free sooner? Personally, I really wouldn't want to spend 3 or more years tapering off Zoloft when I can spend a year tapering off Prozac. I despise these drugs and that difference is a lot of time, and that's very important to me.

1 year risperidone, 1 year olanzapine (10 mg). attempted first withdrawal cold turkey, failed. 2 more years olanzapine, switched to abilify which was very disruptive so attempted quitting cold turkey, failed. then 4 years amisulpride at 150 mg and about 3 zoloft at 150 mg. attempted withdrawal from both in 3 weeks, failed. reinstated zoloft and bridged to olanzapine (10 mg), successfully withdrew it over 10 months. tried withdrawing zoloft over 12 months, failed. bridged to prozac, at 40 mg,  now at 12 mg.

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  • 3 months later...

Hi Everyone 

 

please feel free to move this post if it needs to be in my introduction topic. 

 

My Doctor is asking me to consider making a switch to Prozac as I am struggling on low doses of Pristiq. I am currently on 12mg. I have had my Pristiq compounded and the pharmacy can only guarantee a sustained release of 6-8 hours( I’m hitting the wall every morning) My doctor has instructed me to divide the doses up during the day.  I am going to see if dividing the dose helps. 

 

I have an appointment with my doctor next week and I would like to be prepared if the topic of switching to Prozac is brought up. 

 

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 Effexor in together before dropping the Pristiq. 

 

Swapping over is really my final option, but I’d like to be prepared for my appointment next week. I believe I can have the Prozac compounded into a liquid. 

 

Thankyou in advance and apologies if I have put this in the wrong place. 

 

Edited by ChessieCat
correction as per following post

Current Dose

0.5mcg Clonidine and 1.25 Diazepam PRN for treatment of iatrogenic hypertension. 

2010 .Prescribed Pristiq 100 mg in July by GP

2010 .Reduced to 50mg by splitting and weighing. Held at 50mg

2014. Reduced from 50-35 .Held at 35mg. 

2017. Taper from 35mg commenced using compounded Desvenlafaxine

2018. 23/06 13.5mg. 21/07  12.5mg. 25/08 11.5mg. 09/2018 10mg. 14/11 11mg (updose) 21/11 -12mg (updose)

2019. Still holding at 12mg and stuck. 

2020. January 2019 Prozac Bridge-- Prozac 2.5 to 10mg and

Pristiq 23rd Jan 6mg/ 27th Jan 5mg/ 28th Jan 3mg/ 30 Jan 0

Prozac 6th Feb 9.5mg. Vitamin D3 5000iu with K2

Magnesium Glycinate with Glycine and Passionflower  600mg 

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1 hour ago, Andie said:

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

12 mg Pristiq sorry. 

Current Dose

0.5mcg Clonidine and 1.25 Diazepam PRN for treatment of iatrogenic hypertension. 

2010 .Prescribed Pristiq 100 mg in July by GP

2010 .Reduced to 50mg by splitting and weighing. Held at 50mg

2014. Reduced from 50-35 .Held at 35mg. 

2017. Taper from 35mg commenced using compounded Desvenlafaxine

2018. 23/06 13.5mg. 21/07  12.5mg. 25/08 11.5mg. 09/2018 10mg. 14/11 11mg (updose) 21/11 -12mg (updose)

2019. Still holding at 12mg and stuck. 

2020. January 2019 Prozac Bridge-- Prozac 2.5 to 10mg and

Pristiq 23rd Jan 6mg/ 27th Jan 5mg/ 28th Jan 3mg/ 30 Jan 0

Prozac 6th Feb 9.5mg. Vitamin D3 5000iu with K2

Magnesium Glycinate with Glycine and Passionflower  600mg 

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On 1/7/2018 at 8:07 AM, scallywag said:

I found a meta-study (study of many studies) that evaluated equivalent doses to 40 mg fluoxetine (prozac) which may be useful in identifying an end cross-over/bridge dose to discuss with the person who prescribes your medication(s).

source: https://www.ncbi.nlm.nih.gov/pubmed/25911132

 

From the abstract at that link:

We included 83 studies (14 131 participants). In the primary analysis, fluoxetine 40mg/day was equivalent to

 paroxetine dosage of 34.0mg/day
 agomelatine 53.2mg/day
 amitriptyline  122.3mg/day
 bupropion (wellbutrin) 348.5mg/day
 clomipramine 116.1mg/day
 desipramine 196.3mg/day
 dothiepin 154.8mg/day
 doxepin 140.1mg/day
 escitalopram 18.0mg/day
 fluvoxamine 143.3mg/day
 imipramine 137.2mg/day
 lofepramine 250.2mg/day
 maprotiline 118.0mg/day
 mianserin  101.1mg/day
 mirtazapine 50.9mg/day
 moclobemide 575.2mg/day
 nefazodone 535.2mg/day
 nortriptyline 100.9mg/day
 reboxetine 11.5mg/day
 sertraline 98.5mg/day
 trazodone 401.4mg/day
 venlafaxine 149.4mg/day.

 

Sensitivity analyses corroborated the results except for doxepin.

What about duloxetine (Cymbalta)?  

 

2016-Aug-Prescribed 2 mg Ativan & 10 mg Ambien; Oct-c/o from 20 mg Lexapro to 60 mg Cymbalta; Nov-Dec-Tapered off 10 mg Ambien    

2017-Jan-Feb c/o from 1.75 mg Ativan to 13 mg Valium & begin daily liquid micro taper; May-taper Cymbalta 60 mg to 48 mg with severe withdrawals.  Begin 11 month Cymbalta hold.

2018-Jan 11 completed Valium taper; Apr-Resume Cymbalta taper.  Interval dose progress: Apr 43 mg; May 40 mg; Jul 35 mg; Sep 29 mg; Dec 21 mg; 

2019- Apr 14 mg; Jun 11 mg; Aug 9 mg; Oct 7 mg; Nov 6 mg

2020-Jan 5.2 mg; Feb 4.8 mg; Mar 4.3 mg; Apr 3.9 mg; May 3.5 mg; Jun 3.3 mg; Jul 2.9 mg; Aug 2.7 mg; 28 Sep 2.4 mg/12 beads; 25 Oct 2.2 mg/11 beads; 22 Nov 2.0 mg/10 beads

 

 

 

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On 11/22/2018 at 8:06 AM, gardenlady said:

What about duloxetine (Cymbalta)?  

 

PLEASE SEE:  this post   (about the information which was provided below)

 

This is a flyer I found, but I'm not sure of its provenance: https://www.healthalliance.org/media/Generics_antidepressants_comparison_chart.pdf

 

 

Edited by ChessieCat
link not recommended Alto/CC added link to info post

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/14/

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg / July 2014 dropped from 100mg to 75mg, held for six months

2015 tapered to 50mg over several months, held for several months, some more drops

2016 Feb 35mg, 6 Mar 33mg, more drops (note big drop (calc error) & up to 25mg), more drops (about 2mg at a time)

2017 - more small drops, more long holds

2018 March at 11mg;  April 20 9mg; June 11 8.1mg; (July 10 7.7mg / July 18 7.3mg); ( Sept 2 7.2mg, Sept 5 7.1mg, Sept 9 7mg); 30 Sept 6.5mg, ? 6mg, 23 Nov 5.5mg) 19 Dec 5mg

2019 (micro drops over two weeks 24 Mar 4.9mg, 28 Mar 4.8mg, 31 Mar 4.7mg, 4 Apr 4.6mg, 7 Apr 4.5mg / 22 April 4.4mg, 26 April 4.3mg, 2 May 4.2mg, 5 May 4.1mg, 9 May 4mg), 3 Oct 3.9mg, (20 Oct 3.8mg, 27 Oct 3.7mg, 3 Nov 3.6mg), 24 Nov 3.5mg, 8 Dec 3.4mg, 15 Dec 3.3mg, 22 Dec 3.2mg

2020 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg

Current Sertraline: July 24: 2 mg / Armour Thyroid / endless allergy meds, erg

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On 11/22/2018 at 12:42 PM, bubbles said:

 

This is a flyer I found, but I'm not sure of its provenance: https://www.healthalliance.org/media/Generics_antidepressants_comparison_chart.pdf

 

PLEASE SEE:  this post   (about the information in the quote above and what is being discussed below)

 

Thankyou for this. I can see Pristiq in there too. 

 

Edited by ChessieCat
link not recommended Alto/CC added link to info post

Current Dose

0.5mcg Clonidine and 1.25 Diazepam PRN for treatment of iatrogenic hypertension. 

2010 .Prescribed Pristiq 100 mg in July by GP

2010 .Reduced to 50mg by splitting and weighing. Held at 50mg

2014. Reduced from 50-35 .Held at 35mg. 

2017. Taper from 35mg commenced using compounded Desvenlafaxine

2018. 23/06 13.5mg. 21/07  12.5mg. 25/08 11.5mg. 09/2018 10mg. 14/11 11mg (updose) 21/11 -12mg (updose)

2019. Still holding at 12mg and stuck. 

2020. January 2019 Prozac Bridge-- Prozac 2.5 to 10mg and

Pristiq 23rd Jan 6mg/ 27th Jan 5mg/ 28th Jan 3mg/ 30 Jan 0

Prozac 6th Feb 9.5mg. Vitamin D3 5000iu with K2

Magnesium Glycinate with Glycine and Passionflower  600mg 

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PLEASE SEE:  this post   (about the information which is being discussed below)

 

From this chart, 20 mg of Prozac equals 30 mg of Cymbalta.  So, if I'm on 25 mg of Cymbalta and want to bridge to Prozac, is 10 mg of Prozac too little?  My doctor gave me 10 mg Prozac capsules and told me to take it for a week and then cut the Cymbalta.  I'm scared since even 2.5% cuts of Cymbalta are brutal.  I'm afraid I'll get psychotic & suicidal when eliminating the Cymbalta with only 10 mg of Prozac to fight off the withdrawals.  I live alone and have absolutely no one whom I can call or who can help me.  How can I attempt this bridge in this situation? 

 

Edited by ChessieCat
added link to info post

 

2016-Aug-Prescribed 2 mg Ativan & 10 mg Ambien; Oct-c/o from 20 mg Lexapro to 60 mg Cymbalta; Nov-Dec-Tapered off 10 mg Ambien    

2017-Jan-Feb c/o from 1.75 mg Ativan to 13 mg Valium & begin daily liquid micro taper; May-taper Cymbalta 60 mg to 48 mg with severe withdrawals.  Begin 11 month Cymbalta hold.

2018-Jan 11 completed Valium taper; Apr-Resume Cymbalta taper.  Interval dose progress: Apr 43 mg; May 40 mg; Jul 35 mg; Sep 29 mg; Dec 21 mg; 

2019- Apr 14 mg; Jun 11 mg; Aug 9 mg; Oct 7 mg; Nov 6 mg

2020-Jan 5.2 mg; Feb 4.8 mg; Mar 4.3 mg; Apr 3.9 mg; May 3.5 mg; Jun 3.3 mg; Jul 2.9 mg; Aug 2.7 mg; 28 Sep 2.4 mg/12 beads; 25 Oct 2.2 mg/11 beads; 22 Nov 2.0 mg/10 beads

 

 

 

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On 11/23/2018 at 8:20 AM, gardenlady said:

From this chart, 20 mg of Prozac equals 30 mg of Cymbalta.  So, if I'm on 25 mg of Cymbalta and want to bridge to Prozac, is 10 mg of Prozac too little?  My doctor gave me 10 mg Prozac capsules and told me to take it for a week and then cut the Cymbalta.  I'm scared since even 2.5% cuts of Cymbalta are brutal.  I'm afraid I'll get psychotic & suicidal when eliminating the Cymbalta with only 10 mg of Prozac to fight off the withdrawals.  I live alone and have absolutely no one whom I can call or who can help me.  How can I attempt this bridge in this situation? 

 

PLEASE SEE:  this post   (about the information in quote above and which is being discussed below)

 

Hi Gardenlady 

 

I am in the exact same situation as you are re Prozac. If I do switch, I won’t be doing it for a while. I live alone too so I like to be fully prepared. 

 

Edited by ChessieCat
added link to info post

Current Dose

0.5mcg Clonidine and 1.25 Diazepam PRN for treatment of iatrogenic hypertension. 

2010 .Prescribed Pristiq 100 mg in July by GP

2010 .Reduced to 50mg by splitting and weighing. Held at 50mg

2014. Reduced from 50-35 .Held at 35mg. 

2017. Taper from 35mg commenced using compounded Desvenlafaxine

2018. 23/06 13.5mg. 21/07  12.5mg. 25/08 11.5mg. 09/2018 10mg. 14/11 11mg (updose) 21/11 -12mg (updose)

2019. Still holding at 12mg and stuck. 

2020. January 2019 Prozac Bridge-- Prozac 2.5 to 10mg and

Pristiq 23rd Jan 6mg/ 27th Jan 5mg/ 28th Jan 3mg/ 30 Jan 0

Prozac 6th Feb 9.5mg. Vitamin D3 5000iu with K2

Magnesium Glycinate with Glycine and Passionflower  600mg 

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@gardenlady and @Andie

 

It sounds like these are good questions to ask in your personal threads so that a moderator can see them and help you make a decision.

All the best.

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/14/

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg / July 2014 dropped from 100mg to 75mg, held for six months

2015 tapered to 50mg over several months, held for several months, some more drops

2016 Feb 35mg, 6 Mar 33mg, more drops (note big drop (calc error) & up to 25mg), more drops (about 2mg at a time)

2017 - more small drops, more long holds

2018 March at 11mg;  April 20 9mg; June 11 8.1mg; (July 10 7.7mg / July 18 7.3mg); ( Sept 2 7.2mg, Sept 5 7.1mg, Sept 9 7mg); 30 Sept 6.5mg, ? 6mg, 23 Nov 5.5mg) 19 Dec 5mg

2019 (micro drops over two weeks 24 Mar 4.9mg, 28 Mar 4.8mg, 31 Mar 4.7mg, 4 Apr 4.6mg, 7 Apr 4.5mg / 22 April 4.4mg, 26 April 4.3mg, 2 May 4.2mg, 5 May 4.1mg, 9 May 4mg), 3 Oct 3.9mg, (20 Oct 3.8mg, 27 Oct 3.7mg, 3 Nov 3.6mg), 24 Nov 3.5mg, 8 Dec 3.4mg, 15 Dec 3.3mg, 22 Dec 3.2mg

2020 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg

Current Sertraline: July 24: 2 mg / Armour Thyroid / endless allergy meds, erg

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On 11/21/2018 at 11:13 AM, Andie said:

Hi Everyone 

 

please feel free to move this post if it needs to be in my introduction topic. 

 

My Doctor is asking me to consider making a switch to Prozac as I am struggling on low doses of Pristiq. I am currently on 12mg. I have had my Pristiq compounded and the pharmacy can only guarantee a sustained release of 6-8 hours( I’m hitting the wall every morning) My doctor has instructed me to divide the doses up during the day.  I am going to see if dividing the dose helps. 

 

I have an appointment with my doctor next week and I would like to be prepared if the topic of switching to Prozac is brought up. 

 

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 Effexor in together before dropping the Pristiq. 

 

Swapping over is really my final option, but I’d like to be prepared for my appointment next week. I believe I can have the Prozac compounded into a liquid. 

 

Thankyou in advance and apologies if I have put this in the wrong place. 

 

Moved to personal thread. 

Current Dose

0.5mcg Clonidine and 1.25 Diazepam PRN for treatment of iatrogenic hypertension. 

2010 .Prescribed Pristiq 100 mg in July by GP

2010 .Reduced to 50mg by splitting and weighing. Held at 50mg

2014. Reduced from 50-35 .Held at 35mg. 

2017. Taper from 35mg commenced using compounded Desvenlafaxine

2018. 23/06 13.5mg. 21/07  12.5mg. 25/08 11.5mg. 09/2018 10mg. 14/11 11mg (updose) 21/11 -12mg (updose)

2019. Still holding at 12mg and stuck. 

2020. January 2019 Prozac Bridge-- Prozac 2.5 to 10mg and

Pristiq 23rd Jan 6mg/ 27th Jan 5mg/ 28th Jan 3mg/ 30 Jan 0

Prozac 6th Feb 9.5mg. Vitamin D3 5000iu with K2

Magnesium Glycinate with Glycine and Passionflower  600mg 

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1 hour ago, bubbles said:

@gardenlady and @Andie

 

It sounds like these are good questions to ask in your personal threads so that a moderator can see them and help you make a decision.

All the best.

Thanks bubbles. Will do. I wasn’t sure where to put this and now I know. 

Current Dose

0.5mcg Clonidine and 1.25 Diazepam PRN for treatment of iatrogenic hypertension. 

2010 .Prescribed Pristiq 100 mg in July by GP

2010 .Reduced to 50mg by splitting and weighing. Held at 50mg

2014. Reduced from 50-35 .Held at 35mg. 

2017. Taper from 35mg commenced using compounded Desvenlafaxine

2018. 23/06 13.5mg. 21/07  12.5mg. 25/08 11.5mg. 09/2018 10mg. 14/11 11mg (updose) 21/11 -12mg (updose)

2019. Still holding at 12mg and stuck. 

2020. January 2019 Prozac Bridge-- Prozac 2.5 to 10mg and

Pristiq 23rd Jan 6mg/ 27th Jan 5mg/ 28th Jan 3mg/ 30 Jan 0

Prozac 6th Feb 9.5mg. Vitamin D3 5000iu with K2

Magnesium Glycinate with Glycine and Passionflower  600mg 

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9 hours ago, Andie said:

Hi Gardenlady 

 

I am in the exact same situation as you are re Prozac. If I do switch, I won’t be doing it for a while. I live alone too so I like to be fully prepared. 

Hi gardenlady and andie ,im in the same boat for a switch and waying it up as best I can .take care to you both.

Alcohol free since February 2015 

1MG diazepam

4.5MG PROZAC.

 

 

 

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Just now, powerback said:

Hi gardenlady and andie ,im in the same boat for a switch and waying it up as best I can .take care to you both.

Hi Powerback 

 

I was actually just looking at your thread this morning. You and I seem to in a similar quandry. Effexor and Pristiq are very similar. 

 

My doctor actually wanted me to switch to Effexor and taper off from there using the bead method. I didn’t want the fuss of counting beads so I stayed with Pristiq. 

 

I just wanted to let you know a childhood friend of mine came off Effexor and has been problem free now for 5 years.  Another friend of mine just came off Pristiq and is also doing well. 

Current Dose

0.5mcg Clonidine and 1.25 Diazepam PRN for treatment of iatrogenic hypertension. 

2010 .Prescribed Pristiq 100 mg in July by GP

2010 .Reduced to 50mg by splitting and weighing. Held at 50mg

2014. Reduced from 50-35 .Held at 35mg. 

2017. Taper from 35mg commenced using compounded Desvenlafaxine

2018. 23/06 13.5mg. 21/07  12.5mg. 25/08 11.5mg. 09/2018 10mg. 14/11 11mg (updose) 21/11 -12mg (updose)

2019. Still holding at 12mg and stuck. 

2020. January 2019 Prozac Bridge-- Prozac 2.5 to 10mg and

Pristiq 23rd Jan 6mg/ 27th Jan 5mg/ 28th Jan 3mg/ 30 Jan 0

Prozac 6th Feb 9.5mg. Vitamin D3 5000iu with K2

Magnesium Glycinate with Glycine and Passionflower  600mg 

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  • 2 weeks later...
  • Administrator
On 11/22/2018 at 12:42 PM, bubbles said:

 

This is a flyer I found, but I'm not sure of its provenance: https://www.healthalliance.org/media/Generics_antidepressants_comparison_chart.pdf

 

On 11/22/2018 at 1:00 PM, Andie said:

Thankyou for this. I can see Pristiq in there too. 

 

On 11/23/2018 at 8:20 AM, gardenlady said:

From this chart, 20 mg of Prozac equals 30 mg of Cymbalta.  So, if I'm on 25 mg of Cymbalta and want to bridge to Prozac, is 10 mg of Prozac too little?  My doctor gave me 10 mg Prozac capsules and told me to take it for a week and then cut the Cymbalta.  I'm scared since even 2.5% cuts of Cymbalta are brutal.  I'm afraid I'll get psychotic & suicidal when eliminating the Cymbalta with only 10 mg of Prozac to fight off the withdrawals.  I live alone and have absolutely no one whom I can call or who can help me.  How can I attempt this bridge in this situation? 

 

On 11/23/2018 at 10:48 AM, Andie said:

Hi Gardenlady 

 

I am in the exact same situation as you are re Prozac. If I do switch, I won’t be doing it for a while. I live alone too so I like to be fully prepared. 

 

@bubbles

    

@Andie

 

@gardenlady

 

I can't see any basis for the equivalencies in that chart, as I explained here

 

 Please review the information here

 

Switching to Prozac is enough of a shock to your system, there's no reason to pound on it with a high dose of Prozac.

Most methods do not recommend more than 10mg Prozac to bridge from any antidepressant.

 

 

 

Edited by ChessieCat
link not recommended Alto/CC link updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 6 months later...

I’m not sure, but I think my last two posts were deleted? Can someone please explain why, or is it some kind of computer glitch?

Past four years: Fluoxetine, 10mg; currently tapered down to 2.8mg. 

Diazepam, 5mg, once daily (goes up to 8mg sometimes during taper). 

1999-2016: Mainly sertraline but also Venlafaxine  and Paroxetine. 

31 Oct: discontinued Fluoxetine.

1 Nov 2019: started Sertraline, 12.5mg, once every two days. 

13 Nov 2019: Reinstated Fluoxetine due to adverse effects from Sertraline. Plan to start Citalopram once stabilised on Fluoxetine 

 

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  • Administrator

@Greenriver look at your Introductions topic.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 months later...

Hi all, 

 

Has anyone switched from amitriptyline (or any tricyclic) to Prozac? 

 

I'm struggling to reduce by less than 10% monthly and wondering if this would be an option for me. 

Amitriptyline, 50 mg, on 12 mg as of Feb 2020. 

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  • Altostrata changed the title to The Prozac switch or "bridging" with fluoxetine
  • 2 months later...
Biloelagirl89
On 7/11/2012 at 5:02 PM, dalsaan said:

Has anyone switched from Mirtazapine (remeron) to Prozac? Or from an AD that was in a different class to Prozac. Am thinking about this but am nervous

that I will still have withdrawal effects due to the different mechanisms of action between Mirtazapine and Prozac.

 

dalsaan

I am also curious about this and wanting to know, as I am withdrawaling from mirtazapine. Please let me know how you went ?

 

-17th August started abilify 10mg 2020 to 24th of August 2020.

-Stopped abilify 10mg 7 days after taking it, as I developed induced akathisia on day 4.

-21st of August 2020 started self medicating 30mg morning and night mirtazapine to help subside the akathisa. 

- 28th of August 2020 stopped mirtazapine 30 mg morning and night cold Turkey.

-28th of August took       -Clonidine 50 mc morning and night.

-Reinstated Mirtazapine 4th of October 15mg.

-

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  • Moderator
ChessieCat

@Biloelagirl89

 

You can see member's drug history in their drug signature.  You can also find their Introduction topic by hovering over their avatar, clicking on find content and then clicking on Topics.

 

From dalsaan's drug signature it looks like she did not change to Prozac.

 

From her Intro topic:

  

On 6/8/2017 at 10:31 AM, dalsaan said:

I finally jumped off my microdose of mirtazapine two weeks ago.

 

 

NEW!!!              INTERVIEW with Altostrata, SA's founder               NEW!!! 

 

ADs:  25 years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering Oct 2015  Current from 14 Nov 2020:  Pristiq 0.50 mg

My tapering program                                      My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

REMINDER TO SELF:  I don't need the drug now, but my still brain does.

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