Yogendra: 24 years on meds - now on Pristiq / desvenflaxine

[Yogendra]

13 hours ago, delsol said:

I just want to respond to say good luck, and amidst the sea of many posts on here, the fact that yours says "24 years" is what made me click. It's been 27 years for me. I think those of us who have been on these drugs for over 20 years are probably more common than we realize. I sometimes feel shame and then remember that if it was easy to kick these drugs, I would have been able to do it 20 years ago! Wishing you peace and an occasional moment of wellness during this challenging time.

Thanks Delsol,

 

Yes perhaps you are true the ppl like us are more in numbers than we think of. Yes I know reducing the doses and switching over the meds and that too without guidance of any doctor may sometimes be very troubling. But I am left with no other option.

 

I clearly remember the day I visited doctor for few anxiety issues and I was since then put on various meds. And then it continued. I wish I had tried some other options. Meds only hushes the nature's voice and the problem more often than not remains  as it is and event gets aggravated sometimes. Eventually we have to face it and emerge stronger. That is the only way out.

 

Let's see where this journey takes us. One thing is sure that I just can't live like this on meds and with these side effects. I want to be free of all this mess and have burning desire to live healthily at least upto 150 years.

[Yogendra]

For the last 5~6 days I have been feeling low, sometimes anxious, sometimes depressed, crying spells. May be due to the dose adjustments or the life events. 

 

Not changing dose (12.5mg ER desvenlaflaxine and 75mg ER Venlaflaxine) for the time being. Will wait for stabilization.

 

 

[ChessieCat]

is this accurate? 

17.07.2019 --> Switched from Desvenlaflaxine 50 ER to Venlaflaxine 75 ER (night) and Desvenlaflaxine 25 ER (morning).

11.08.2019 --> Desvenlaflaxine ER 12.5 mg (morning) and Venlaflaxine ER 75 mg (night)

 

Des 25 + 75 Ven

Des 12.5 + 75 Ven

 

When doing a cross over it is recommended not to make a reduction at the same time.  When you reduced the desvenlafaxine from 25mg to 12.5mg you should have increased the venlafaxine.

 

If you are finding that the withdrawal symptoms are unbearable you could do a small increase in the venlafaxine.

[Yogendra]

3 minutes ago, ChessieCat said:

is this accurate? 

17.07.2019 --> Switched from Desvenlaflaxine 50 ER to Venlaflaxine 75 ER (night) and Desvenlaflaxine 25 ER (morning).

11.08.2019 --> Desvenlaflaxine ER 12.5 mg (morning) and Venlaflaxine ER 75 mg (night)

 

Des 25 + 75 Ven

Des 12.5 + 75 Ven

 

When doing a cross over it is recommended not to make a reduction at the same time.  When you reduced the desvenlafaxine from 25mg to 12.5mg you should have increased the venlafaxine.

 

If you are finding that the withdrawal symptoms are unbearable you could do a small increase in the venlafaxine.

Yes dear CC, I did sudden switch over and then reduction too. Dates are correct.

 

Symptoms are disturbing though not unbearable. Will increase venlaflacine from 75mg to 75+37.5=112.5mg if symptoms become more difficult to handle.

 

Currently it's mood swings, low more often, heart pounding, anxious and crying spells. Will increase dose if it starts affecting my professional life.

 

Thanks ChessieCat !!

[ChessieCat]

6 minutes ago, Yogendra said:

Will increase venlaflacine from 75mg to 75+37.5=112.5mg if symptoms become more difficult to handle.

 

I don't think you would have to increase that much.  You might find that increasing to a total of 80mg or 85mg might be enough.  I definitely would not go up to a total of 112.5mg.  You've already been on the 12.5mg + 75mg for 2 weeks so your brain will have already made some adaptations to the lower dose.  It is better to increase by a small amount.

[Yogendra]

6 minutes ago, ChessieCat said:

 

I don't think you would have to increase that much.  You might find that increasing to a total of 80mg or 85mg might be enough.  I definitely would not go up to a total of 112.5mg.  You've already been on the 12.5mg + 75mg for 2 weeks so your brain will have already made some adaptations to the lower dose.  It is better to increase by a small amount.

Oh yes. Sure will do this way.

[Yogendra]

9 hours ago, ChessieCat said:

 

I don't think you would have to increase that much.  You might find that increasing to a total of 80mg or 85mg might be enough.  I definitely would not go up to a total of 112.5mg.  You've already been on the 12.5mg + 75mg for 2 weeks so your brain will have already made some adaptations to the lower dose.  It is better to increase by a small amount.

Hello CC,

 

I have increased my dosage of Venlaflaxine ER night from 75 mg to around 80 mg by counting bead method. In morning I shall keep 12.5 mg Desvenlaflaxine ER as it is. 

 

Will see how I respond to this. Will Hold on like this for few weeks.

[ChessieCat]

Keep notes of your symptoms on paper, especially what improves.  This can help you see what effect the updose is having on your symptoms.  And might help you to see if the dose is enough or you need a tiny bit more.

 

It takes about 4 days for a dose to get to full strength in the blood and a bit longer for it to register in the brain.  Please note that the idea of updosing isn't to get rid of symptoms completely but to bring them to a bearable level.

 

My suggestion would be to stay on the new dose and the same combination for at least 4 weeks, because you have made a reduction and an updose.

 

Remember the aim is to keep withdrawal symptoms to a minimum.  There is also no rush to do the cross over from desvenlafaxine (Pristiq) to venlafaxine (Effexor).

 

Slow and steady.

[Yogendra]

On 8/26/2019 at 2:56 AM, ChessieCat said:

Keep notes of your symptoms on paper, especially what improves.  This can help you see what effect the updose is having on your symptoms.  And might help you to see if the dose is enough or you need a tiny bit more.

 

It takes about 4 days for a dose to get to full strength in the blood and a bit longer for it to register in the brain.  Please note that the idea of updosing isn't to get rid of symptoms completely but to bring them to a bearable level.

 

My suggestion would be to stay on the new dose and the same combination for at least 4 weeks, because you have made a reduction and an updose.

 

Remember the aim is to keep withdrawal symptoms to a minimum.  There is also no rush to do the cross over from desvenlafaxine (Pristiq) to venlafaxine (Effexor).

 

Slow and steady.

Hello CC,

 

Sure and thank you very much for your valuable advice. Shall follow the same. Will do it on slow and steady pace. 

 

I have one question that currently I am on 12.5 mg dose of desvenlaflaxine. This I am achieving by cutting 25 mg tablet into half by tablet cutter. And if I want to further reduce the dose of desvenla., I have no other option than to reduce it to zero and increase venla. to adequate amount in order to compensate. Is there any other way? Note that there are no compounding pharmacies here. 

[ChessieCat]

You could try crushing the tablet up between two spoons and then dividing the powder up.

 

3 reasonably sized square pieces of medium weight paper

fold them all in half

to make them lay flatter, fold in half, then fold in half backwards and then both ways again

put two pieces of paper together with fold the same way

place the papers opened flat on a flat surface

crush tablet between 2 spoons over the papers

carefully slide out the bottom piece of paper so that they overlap

fold papers so that the powder is in the groove of the top layer

carefully place the papers opened out on a flat surface

use a thin, flat/straight edge like a know or razor blade to move half of the powder to the bottom sheet

to halve the remaining powder put the 3rd piece of paper underneath and repeat the process

 

[Yogendra]

After few days of ups and downs I guess I have now stabilised on this dose.

 

I don't know what happened to me the day before yesterday when I felt very good and happy about nothing. Whole day I was at peace and calm as if nothing has happened to me , sleep was also ok. But since yesterday I am again back to the same feeling a bit low and anxious. Let's see what is there for me in times to come.

 

 

[Yogendra]

On 8/27/2019 at 9:05 AM, ChessieCat said:

You could try crushing the tablet up between two spoons and then dividing the powder up.

 

3 reasonably sized square pieces of medium weight paper

fold them all in half

to make them lay flatter, fold in half, then fold in half backwards and then both ways again

put two pieces of paper together with fold the same way

place the papers opened flat on a flat surface

crush tablet between 2 spoons over the papers

carefully slide out the bottom piece of paper so that they overlap

fold papers so that the powder is in the groove of the top layer

carefully place the papers opened out on a flat surface

use a thin, flat/straight edge like a know or razor blade to move half of the powder to the bottom sheet

to halve the remaining powder put the 3rd piece of paper underneath and repeat the process

 

Will do this way when I reduce desvenlaflaxine further down from 12.5 mg.

 

I am thinking of buying a weighing balance too which can measure in mgs.

[ChessieCat]

Gemini 20 - that's what BrassMonkey used for his taper and other members are finding it okay too.

[Yogendra]

Fingers crossed ... Still mantaining the same doses. Condition -- stable with bit of anxiety 

[Yogendra]

Heard that Venlaflaxine ER is better taken during daytime instead of night. Hence making such changes. Today I just changed the timings of taking the medicines. 

 

Now I am doing as below --

 

Venlaflaxine ER 80 mg in noon

Dysvenlaflaxine ER 12.5 mg in night

[Rhiannon]

On 9/5/2019 at 5:49 PM, Yogendra said:

After few days of ups and downs I guess I have now stabilised on this dose.

 

I don't know what happened to me the day before yesterday when I felt very good and happy about nothing. Whole day I was at peace and calm as if nothing has happened to me , sleep was also ok. But since yesterday I am again back to the same feeling a bit low and anxious. Let's see what is there for me in times to come.

 

 

This is very normal. The fact that you sometimes feel good, is a good sign. But the times when you are feeling bad, healing is in progress as well. It's just an up and down journey. It sounds to me like you are stabilizing well. Things may be a bit bumpy since you changed your times of taking doses but that should settle down quickly.

[Yogendra]

On 11/9/2019 at 12:59 AM, Rhiannon said:

This is very normal. The fact that you sometimes feel good, is a good sign. But the times when you are feeling bad, healing is in progress as well. It's just an up and down journey. It sounds to me like you are stabilizing well. Things may be a bit bumpy since you changed your times of taking doses but that should settle down quickly.

Yes U were right after few hours of changing the timings I started feeling anxious and depressed until yesterday. Today got relived somewhat from such feelings. Lets see what happens tomorrow onwards. Planning to go to office tomorrow. Yestersay I took leave and today was holiday here.

 

 

[Altostrata]

How is your switch to venlafaxine going, Yogendra?

[Yogendra]

6 hours ago, Altostrata said:

How is your switch to venlafaxine going, Yogendra?

Hi Alto,

 

It's been 4 months since I initiated switch over. It is going ok ok and manageable. Sometimes symptoms reoccur just to subside next day. Thanks for all the help and courage you guys are giving me to taper and switch over and eventually to become AD free. I wish I could find this site in 1996 or so. It's been around 25 years now I have been ON and OFF ADs. During these years I Cold Turkied many times only to feel devastated and depressed and then everytime I was put on ADs again. This cycle repeated many times during these 25 years. Once I tried to come off but that was too haste and stopped the medicines after tapering for just 2~3 months which I now realise was too fast.

 

Now as I have become part of the SA family I feel quite OK and especially when I know there are many brothers and sisters of mine suffering and trying to come off ADs. I feel soothed. I feel relaxed though briefly. It gives me strength to fight. 

 

 

Yesterday I felt good and used the opportunity and met one of our SA family members ---- PassionLifeTime. We sat , talked and shared each other experiences. Went his home and met his Father and Mother and other family members too. It's good that we came in touch with each other through this site. Thanks !!

 

Now I shall reduce Pristque by 10% . I have brought the miligram accuracy digital scale from Amazon which may reach here within next week. So after that I will attempt to taper Pristique by 10% and if possible by 20%.

 

Smart Weigh Gem20 High Precision Digital Milligram Scale 20 X 0.001G Ideal For Weighing Gems Jewelry And Other Precious Objects (Silver)

Will keep you updated for sure.

 

[Yogendra]

Date -- 15.11.2019

 

Desvenla ER (Pristiq) reduced from 12.5 mg to 11.355 mg. Around 9.16 % reduction.

 

Venla ER (Effexor) same as earlier i.e. 80 mg.

 

 

[Yogendra]

Not tapering further for a while. Yesterday and day before were not good days. Felt low and like crying too. Today is OK OK. Evening was better.

 

I am cutting and weighing Pristiq with the help of miligram scale. I don't whether I am getting the required equal doses of it daily.

 

Don't know where the salt desvenlaflaxine is proportionately distributed all over the tablet or not. Require some expert comments on it.

 

Till then I have no other option than to cut and weigh using this kilogram scale.

 

Will taper once I am well stabilized on the current dose. 

[Yogendra]

No reduction in the doses yet. Will wait more. May be post1~2 weeks I would do.

[Andie]

Just keep in mind that the controlled release is compromised when you cut Pristiq. I didn’t have a problem with this until I got down to about 20mg. 

 

This is my experience only, but I wish I had of gone straight over to Effexor without trying to do a long cross taper with the crushed Pristiq. I think it made things more complicated as I was still experiencing inter dose withdrawal from the compounded Pristiq plus start up side effects from Effexor. The small dose of Effexor was not covering the Withdrawal of the Pristiq. I hope this makes sense. 
 

I have had more luck with Prozac because of the long half life. 
 

This of course Is just my experience but I thought I would let you know. 

[Yogendra]

12 minutes ago, Andie said:

Just keep in mind that the controlled release is compromised when you cut Pristiq. I didn’t have a problem with this until I got down to about 20mg. 

Yes I understand Andie but I don't have any other option. There are no compounding pharmacies here. I am cutting and weighing using miligram weigh. And side by side I am taking venlaflaxine to compensate.

 

Andie how did you reduce desvenla- before 20 mg and after that. Did you do it through compounding ?

[Andie]

I am thinking out loud but I wonder if you could jump straight over to an equivalent dosage of Effexor and forget about using the Pristiq all together. I’m not a Mod or a Doctor, but Just speaking from experience in trying to do the same as you have. 
 

I used compounded Pristiq to get to 12 mg and then got withdrawal syndrome. I tried splitting the dose but couldn’t stabilise at all. I probably should have stopped at 20mg but didn’t realise the insomnia I was beginning to experience was being caused by the Pristiq. The slow release added to the crushed powder couldn’t replicate the drug delivery of the original tablet. 
 

The problem is That everyone responds differently to taking a broken Pristiq tablet and is dependant on how sensitive your body own body is to these medications. 

[Andie]

On 12/16/2018 at 4:49 PM, Andie said:

 

University of British Columbia

Pharmaceutical Sciences Student Journal, Volume 3, Issue 1, March 21 2016, pages 31-33. 

 

Preparation of Lower Dosages of SNRI Antidepressants to Ameliorate Discontinuation Symptoms: Two Case Studies.

Benton Attfield, B.Sc. (Biology), B.Sc. (Pharm) Lori Bonertz, B.Sc. (Pharm)
Cory Hermans, B.Sc. (Pharm)
Valerie Kantz, Senior Pharmacy Technician.

 

Full text pssj-v03-i01_attfield.pdf

 

Abstract

There is a large body of evidence showing that adverse effects experienced with antidepressant treatment ameliorate over time and that disease-state symptoms improve for many patients.

However, there is a paucity of information relating to how to stop these medications when a patient’s depression has remitted. Presented here are two cases that demonstrate the role pharmacists play in helping patients discontinue SNRI medications through the preparation of lower strength dosage forms.

 

From the paper:
 

 

 

Have you read this article? My Pharmacist found it when trying to help me find an equivalent dosage. 
 

[Yogendra]

19 minutes ago, Andie said:

Have you read this article? My Pharmacist found it when trying to help me find an equivalent dosage. 
 

Thanks Andie, will open and read it now.

[Yogendra]

26 minutes ago, Andie said:

Have you read this article? My Pharmacist found it when trying to help me find an equivalent dosage. 
 

Read your article,

 

I guess I may like to stop desvenlaflaxine and upside venlaflaxine.

 

I will try to find out the possibility of stopping desvenla. 

 

Thanks for the article. I may consider 2 times the venlafla for each dose of 1 unit of desvenla. 

[Andie]

Yes it might be worth discussing this with your Dr and you have the article to show them. 
 

If you do decide to swap over the only advice I can really give you is to hold for a while without making any reductions. Let your body adapt to the removal of Pristiq and find your baseline from there. I am doing the same with my Prozac dose and I am finding I only have very minor symptoms of withdrawal..for now. 

[Yogendra]

31 minutes ago, Andie said:

Yes it might be worth discussing this with your Dr and you have the article to show them. 
 

If you do decide to swap over the only advice I can really give you is to hold for a while without making any reductions. Let your body adapt to the removal of Pristiq and find your baseline from there. I am doing the same with my Prozac dose and I am finding I only have very minor symptoms of withdrawal for now. 

Thanks Andie for your kind support.

 

I don't generally consult doctors as I am done with them. I haven't found any good doctor yet. Will see though.

[Andie]

3 minutes ago, Yogendra said:

Thanks Andie for your kind support.

 

I don't generally consult doctors as I am done with them. I haven't found any good doctor yet. Will see though.

Get in touch any time. 
 

I understand about Drs, it took me a very long time to find a good one. 

[Yogendra]

1 minute ago, Andie said:

Get in touch any time. 
 

I understand about Drs, it took me a very long time to find a good one. 

I find this site more useful than any doctor around Delhi here. 

 

It's the ppl like you and others who give their advice basis their own experience which really helps one taking decisions.

 

Fingers crossed for the journey ahead. I am happy that such website exists.

[Yogendra]

Yesterday reduced 10% on desvenlaflaxine (night).

 

[Altostrata]

How are you doing, Yogendra?

[Yogendra]

8 hours ago, Altostrata said:

How are you doing, Yogendra?

Hi Alt,

Thanks , I am doing good. But cautious while reducing the doses as the body shows discomfort signs even if I reduce by 10%. It may be due to the dose reduction or may be due to the daily life stress. I dont know and neither would want to. Going slow. 

 

Rest is fine. During the withdrawal sometime I feel absolutely fine! But that state does not remain longer. 

 

After sticking around with ADs for decades I knew it may be difficult for me to withdraw but it seems neither impossible too. I hope I can do it.

 

This website has helped me a lot.

[Yogendra]

Venla -- 75mg + 11 beads @ 28.06.2020

 

Dysvenla -- same (weigh = 60)

 

Not fine .. sleep disturbed .. last two days

 

Anxiety increased, panic sort of - may be situational, irritation , become angry easily +- short temper.