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liz419: Pristiq taper


liz419

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Hi everyone! I wanted to share my Pristiq story with you all. I hope it can be helpful! I was prescribed Pristiq 100 mg when I was 13. After being on it for 6 years, I finally asked my doctor last summer if I could get off it. He was able to drop my dosage down to 50 mg and then 25 mg with minimal side effects. Once I got down to 25 mg, he told me to take one tablet every other day. However, I got awful brain zaps, chills, and tiredness and so he just told me to just stay on it. I was really disheartened but just decided to listen to him, as I thought 25 mg was at least better than being stuck on 100 mg. However, a few weeks ago, I found this site and was really intrigued by the idea of going to a compound pharmacy to help me taper off. Me and my mom called several, all of which told us it is impossible to do because Pristiq is extended release. However, we finally found one pharmacy that told us they could do it. We did more research into the pharmacist there, and apparently he is well-known for his research on compounding drugs. We gave him my tablets and he was able to make them into a liquid solution. He is starting me on 20 mg and every month I will go down 5 more mg until I am completely tapered off! I took my first dose yesterday and I had absolutely no side effects! I'm attaching a picture of the bottle here for you all to see.

meds.jpg

2012: Started Pristiq 100 mg

2018: Tapered down to 50 mg (June) and down to 25 mg (July)

2019: Tapered down to 20 mg (May 8) thanks to compounding pharmacy

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  • ChessieCat changed the title to liz419: Pristiq Taper
  • Moderator Emeritus

Hi, Liz.

 

Welcome to Surviving Antidepressants.

 

On 5/9/2019 at 10:59 PM, liz419 said:

He is starting me on 20 mg and every month I will go down 5 more mg until I am completely tapered off!

 

I'm glad you found a compounding pharmacist to help you off these drugs.

 

Are you planning on removing 5 mg each month? Please note that this is too rapid a taper. Going from 20 mg to 15 mg is a 25% reduction. We recommend no more than a 10% dosage reduction every 4 weeks, with the 10% calculated on the last dosage. The amount of decrease is proportionate to the last dosage (not the original prescription) and keeps getting smaller. For more, please see:

 

Why taper by 10% of my dosage?

 

So your first reduction from 20 mg would be 18 mg, which is a 10% reduction. 

 

You can always go slower, of course. And you may want to if you develop withdrawal symptoms at the 10% rate. 

 

Some more information:

 

Tips for tapering off Pristiq (desvenlafaxine)

 

How psychiatric drugs remodel your brain

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide Method of Micro-tapering

 

A section that we highly recommend to members is the non-drug coping section. You'll find a lot of information on non-drug ways of making your journey off these drugs easier and will prepare you for your drug-free life ahead. 

 

Non-drug techniques to cope with emotional symptoms

 

We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

 

King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

  • Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs
  • This is a direct link to your signature:  Account Settings – Create or Edit a signature.

 

Please use this thread to document your taper and to ask questions. 

Edited by Shep
fixed typo

 

 

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  • Moderator Emeritus

Hi Liz and welcome to SA from me too,

 

Because you have changed from the extended release form of Pristiq and are now taking the drug in an immediate release form, my suggestion is that you keep daily notes of your symptoms to see if there is any pattern occurring that might indicate interdose withdrawal.

 

In Australia Pristiq is only available in 50mg and 100mg tablets.  My compounded capsules have slow release formula added and I seemed to be okay taking my capsule/s once a day after I got below 50mg.  But once I got to 10mg I decided to split my dose and take it twice daily.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  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 from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hi @liz419 & Welcome to the group! This is a great place for support & information. Stay strong & Hang in there, it does get better!

2 years Drug History Prior to Tapering:

Between 2011 & 2018 I had approximately 58 dose changes between the 4 main medications I took as well as 14 new medications add & taken away.

Prozac (Fluoxetine):(Aug 2016-Dec 2016: 60MG),(June 2017-Nov 2017: 60MG),(Dec 2017: 80MG),(June 2017-Sept 2 2018: 60MG),(Sept 3 2018-Sept 5 2018: 40MG),(Sept 6 2018-Sept 8 2018: 20MG),(Sept 9 2018: 0MG).

Cymbalta:(Jan 2017-May 2017: 60MG).

Cyclobenzaprine: (Aug 2016: 30MG,(Feb 2017: 30MG).

Diazepam (Valium):(Aug 2016-Sept 15 2016: 30MG),(Sept 16 2016-Oct 2017: 15MG),(Nov 2017-Aug 19 2018: 6MG),(Aug 20 2018: 0MG).

Gabapentin:(Aug 2016-Aug 3 2018: 2400MG),(Aug 4 2018-March 26 2019: 2000MG),(March 27 2019-March 30 2019: 1600MG),(May 1 2019: 2000MG)

Hydrocodone:(Aug 2016-Oct 2016: 10-325/4daily),(Nov 2016-Feb 2017: 10-325/3daily),(March 2017-April 2017: 5-325/4daily),(May 2017-April 2018: 10-325/3daily),(June 2018-Aug 25 2018: 10-325/5daily),(Aug 26 2018-Sept 2 2018: 4.5daily),(Sept 3 2018-Sept 10 2018: 10-325/4daily),(Sept 11 2018-Sept 18 2018: 10-325/3daily),(Sept 19 2018-May 1 2019: 10-325/3.5 daily).

Oxycodone: May 2018: 10-325MG/4daily). 

Please see my Intro for full drug history.

         **Forgive Yourself For Not Knowing What You Didn't Know Before You Knew It!  -Maya Angelou/

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Hi Liz 

 

Welcome. Go slow and go gentle. I found it relatively easy coming down from 100-15mg. Once I got to 15, I had to really slow down my taper. 

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 months later...
  • Moderator Emeritus

Hi Liz,

 

Just wondering how you are going with the Pristiq liquid.

 

Are you still using it?

 

Are you still only taking it once a day?

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  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 from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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1 minute ago, ChessieCat said:

Hi Liz,

 

Just wondering how you are going with the Pristiq liquid.

 

Are you still using it?

 

Are you still only taking it once a day?

Thank you all so much for your support! Hi yes, I am still taking it once a day and I am down to 5 mg! I was really worried about the side effects of going all the way down to single digits but they are still minimal thankfully.

2012: Started Pristiq 100 mg

2018: Tapered down to 50 mg (June) and down to 25 mg (July)

2019: Tapered down to 20 mg (May 8) thanks to compounding pharmacy

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  • Moderator Emeritus
4 hours ago, liz419 said:

I was really worried about the side effects

 

Side effects are caused by taking the drug.  Withdrawal symptoms are what we experience when we remove the drug too quickly.

 

I think you mean withdrawal symptoms.

 

Quote

2019: Tapered down to 20 mg (May 8) thanks to compounding pharmacy

 

And you are now down to 5mg?  You've made a 50% 75% reduction in 3 months.

 

That is W A A A Y too big a reduction in such a short period of time.

 

Shep already advised you of this:

 

On 5/13/2019 at 9:51 PM, Shep said:

Are you planning on removing 5 mg each month? Please note that this is too rapid a taper. Going from 20 mg to 15 mg is a

25% reduction. We recommend no more than a 10% dosage reduction every 4 weeks, with the 10% calculated on the last dosage. The amount of decrease is proportionate to the last dosage (not the original prescription) and keeps getting smaller. For more, please see:

 

Why taper by 10% of my dosage?

 

Q:  Is there any reason that you are trying to get off so quickly?

 

My suggestion would be to hold on 5mg for at least 3 months to ensure that you don't get delayed withdrawal.

 

do-withdrawal-symptoms-always-show-up-right-away-delayed-onset

 

Edited by ChessieCat
corrected %

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  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 from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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2 hours ago, ChessieCat said:

And you are now down to 5mg?  You've made a 50% reduction in 3 months.

 

That is W A A A Y too big a reduction in such a short period of time.

 

 

I think it's an 80 percent reduction. Did you start at 25mg Liz?

 

I'm really pleased you are doing so well, but like Chessie said, I think it would be really wise to consider slowing down your taper.

 

Withdrawal hit me really suddenly after having a really easy taper. 

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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  • Moderator Emeritus
24 minutes ago, Andie said:

 

I think it's an 80 percent reduction. Did you start at 25mg Liz?

 

Good catch.  Thanks Andie. 👍  I've corrected my post.  Liz started at 20mg so it's 75%.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  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 from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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It reads like Liz's first reduction was from a 25mg tablet to 20mg in liquid form. 

 

Sorry Liz- just looking out for you! 

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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  • ChessieCat changed the title to liz419: Pristiq taper
  • Moderator Emeritus

We're working from different figures.  I'm working from her drug signature which makes no mention of being on 25mg.  And I did mention 3 months in my post.

 

But you are correct that Liz was on 25mg before she started on 20mg liquid.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  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 from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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