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chell: Pristiq tapering

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My dr gave me a rx for 25mg to help me ween off of pristiq. I currently take 50 mg. I’m not well after one day. There’s nothing lower than 25mg and you can’t cut the tablets because there is a time release coating. Help!

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Hi chell,


Welcome to SA.  I'm really pleased that you have found SA so early in your drug reduction journey.  You've come to the right place.  And you've got me as your welcomer! 😊  I found SA two weeks after reducing my 100mg Pristiq to 50mg and experiencing extreme cog fog, where even walking took my full concentration.  It got the stage that I was unable to type.  Being a typist for 40+ years I knew something was wrong.  SA had suggested updosing when I had joined a few days before this happened so I did that and about 4 hours later I was able to type again.  I'm now down to 4.75mg.  The link to my topic is in my signature.


So, back to you.  From what you have written it looks like you have been taking 50mg and your last dose was 25mg.  If that is correct, next time you are due for your dose go back to taking 50mg.


Because you have only just reduced your dose by half, it shouldn't take long for things to settle down again.


SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?


If we take the drug away too quickly we can experience withdrawal symptoms.  Dr Joseph Glenmullen's Withdrawal Symptoms


This topic explains how to get the doses you need:  Tips for tapering off Pristiq (desvenlafaxine)


I get my Pristiq tablets compounded with a slow release formula and have been taking it this way successfully for the last 3 y 2 m.  I have made posts in that topic explaining how I am tapering Pristiq, including what doses I get made up and my tapering schedule  Once I got under 10mg I started taking my dose twice a day.  We are unable to get 25mg Pristiq in Australia so you won't need to get the 30mg and 40mg capsules like I did.


Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

  • details for last 2 years - dates, ALL drugs, doses
  • summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature



I will give you some more information in the following posts.


This is your own introductions topic where your can ask questions about your own situation and journal your progress.

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Here's some additional information which might help you to understand what is happening:


Recovery isn't linear it happens in a Windows and Waves Pattern


Withdrawal Normal Description


When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect. 


The same thing happens when we take the drug away.   That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.  These explain it really well:


Video:  Healing From Antidepressants - Patterns of Recovery




On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.




On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  


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During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.


Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.


This document has a diagram of the body explaining what happens in the body when we become anxious:





Audio FEMALE VOICE:  First Aid for Panic (4 minutes)


Audio MALE VOICE:  First Aid for Panic (4 minutes)


Non-drug techniques to cope




Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.


Claire Weekes' Method of Recovering from a Sensitized Nervous System


Audio:  How to Recover from Anxiety - Dr Claire Weekes


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)
On 4/28/2017 at 4:03 AM, brassmonkey said:


AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.


I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.


It can take some practice, but AAF really does work.  I hope you give it a try.



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Hi chell, 


Just wanted to welcome you to SA as well. Please put in your drug signature. Just press on the link ChessieCat gave you It helps us to see your history at a glance instead of having to go through the whole thread every time. Thank you.


Wishing you all the best in your recovery 💚

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I only have 50 mg and 25 mg available to me. I am not sure how I can reduce by 10% since you can't cut these pills. I am on day 6 of 25 mg and I am not feeling well. Yesterday was overall pretty good but now I have a headache, nausea and just feel foggy. The Dr. suggested using Prozac or switching to Effexor. I am scared because I withdrew from Effexor years ago and it was awful! I have heard of compound pharmacies but don't know how to go about this. I hate to give up and do the 50 again after I have suffered for 6 days now.

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4 hours ago, chell said:

I am not sure how I can reduce by 10% since you can't cut these pills.


The tablets can be cut.  The major issue is that it is difficult to cut them precisely.  I cut mine before I started getting them compounded.  Fresh cut hers and then she started weighing them and then she started getting them compounded.  Many members here use the Gemini 20 scale.  See:  using-a-digital-scale-to-measure-doses


4 hours ago, chell said:

I am on day 6 of 25 mg and I am not feeling well.


I suggest that you cut a 25mg tablet in half as accurately as you can and take 37.5mg.  The sooner you updose the better.  You can then organise to get a scale to weigh them or get them compounded.


4 hours ago, chell said:

The Dr. suggested using Prozac or switching to Effexor.


Switching to Effexor would probably be a better option than changing to Prozac.  Especially since you were taking it before.  Pristiq was created when the patent was for Effexor was coming to an end $$$.  They are "sister" drugs.  baroquep changed to Effexor. 


Pristiq is an SNRI whereas Prozac is an SSRI, so you might still experience withdrawal symptoms.

4 hours ago, chell said:

I am scared because I withdrew from Effexor years ago and it was awful!


This is probably because you reduced the drug too quickly.


4 hours ago, chell said:

I have heard of compound pharmacies but don't know how to go about this.


In Australia we can take our tablets in to the compounding pharmacist and tell them what we want without anything from the doctor.


I think it is different in the US where you have to get the doctor to write the prescription for the compounder.  This topic has some information:  getting-custom-dosages-at-compounding-pharmacies-us-uk-and-elsewhere

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