Hope2020: Pristiq to Prozac

[Hope2020]

I am currently trying to get off Pristiq. After a year on 75 mg I wasn’t feeling better so my dr is trying to switch me to Prozac using a cross tapering method.  I’m not trying to get completely off antidepressants since I haven’t been able to keep my Anxiety under control. I’m just trying to switch to something that will hopefully work.
 A month ago my dr dropped me to 50mg of pristiq and added 10 of Prozac. 2 weeks later I had so much anxiety that she increased to 20 mg of Prozac.  I still had unbearable anxiety. So this week she had me drop to 25mg of pristiq and increased Prozac to 40 mg. It’s now been 4 days and I still feel anxious and depressed.  Do I have to allow more time? I have now been on Prozac for a month (10 to 40 mg) I can’t imagine how I will feel when I drop those last 25mg of pristiq. Should I wait to hopefully feel better on the Prozac before I do that? Is it that maybe Prozac is not working for me? Or did I come off pristiq too quick?  Please help. 

Edited April 13, 2020 by Shep
added username to title

[Shep]

10 hours ago, Hope2020 said:

I’m not trying to get completely off antidepressants since I haven’t been able to keep my Anxiety under control. I’m just trying to switch to something that will hopefully work.

 

Hi, Hope.

 

I'm not sure we're the right web forum for you. Surviving Antidepressants is a site for tapering off psychiatric drugs, not switching to other drugs. Although some people do switch to Prozac in order to taper (known as the Prozac Bridge), what you're aiming to do is simply change drugs. This is called medication management. We aren't doctors here, so we aren't able to help you with this. 

 

Also, I don't know what you mean by finding a drug that "will hopefully work." We don't know of a magic pill that makes anxiety or depression go away. The so-called "chemical imbalance theory" of depression has been debunked (and it never was proven). The same is true of the so-called "anxiety disorders." Some people are numbed down by these drugs, so that can help you feel less psychic pain, but it also makes you feel less joy. And in the long run, these drugs chronify the feelings of detachment, hopelessness, anxiety, and fatigue because they perturb neurotransmitter pathways in the brain. Please see:

 

Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria

 

Learning new skills such as mindfulness, getting plenty of exercise, avoiding toxic relationships, having meaningful work, eating a healthy diet, volunteering and giving back, etc. all go a long way to helping you feel your best. We have a list of non-drug coping skills you may find helpful here: 

 

Non-drug techniques to cope with emotional symptoms

 

More on what we know about antidepressants:

 

History We Can’t Overlook Anymore: Details Before the Anti-Depressant Era

 

Again, chemical imbalance is a myth. Stop the lies, please.

 

Irving Kirsch: The Placebo Effect and What It Tells Us About Antidepressant Efficacy

 

You may want to read Robert Whitaker's book Anatomy of an Epidemic. Here is the book trailer video: 

 

Robert Whitaker, author Anatomy of an Epidemic video (11.5 minutes)

 

Many (if not most) of us here were told a story by a doctor about having faulty brain chemistry, which led us onto these drugs. But the science on these drugs tells a completely different story. You may want to check out some of the journal articles gathered here:

 

From journals and scientific sources

 

After your review of these links, please let us know if you'd like to learn more about tapering off antidepressants.

 

If you decide you wish to keeping taking these drugs, you may want to join a forum such as patientslikeme.com or depressionforums.org. Or you can contact your local NAMI chapter, as that group advocates the use of psychiatric drugs. 

 

 

[Hope2020]

Thank you so much for responding. My ultimate goal is to get completely off all these horrible meds.  But my dr said I first have to have my anxiety and depression under control before I can consider that option. I think if I can successfully switch to Prozac and get pristiq completely out of my system I will be on my way.  I don’t think pristiq did much on the time I was on it.  And I didn’t want the dr to just keep upping the dosage since I read how hard it is to get off it.  I’m starting to wonder if I just damaged my brain and am scared I will never be the same.  My withdrawal symptoms are more anxiety than ever and insomnia lately.  I definitely want off of all antidepressants. 

[Altostrata]

Welcome, Hope.

 

18 hours ago, Hope2020 said:

I am currently trying to get off Pristiq. After a year on 75 mg I wasn’t feeling better so my dr is trying to switch me to Prozac using a cross tapering method.  I’m not trying to get completely off antidepressants since I haven’t been able to keep my Anxiety under control. I’m just trying to switch to something that will hopefully work.
 A month ago my dr dropped me to 50mg of pristiq and added 10 of Prozac. 2 weeks later I had so much anxiety that she increased to 20 mg of Prozac.  I still had unbearable anxiety. So this week she had me drop to 25mg of pristiq and increased Prozac to 40 mg. It’s now been 4 days and I still feel anxious and depressed.  Do I have to allow more time? I have now been on Prozac for a month (10 to 40 mg) I can’t imagine how I will feel when I drop those last 25mg of pristiq. Should I wait to hopefully feel better on the Prozac before I do that? Is it that maybe Prozac is not working for me? Or did I come off pristiq too quick?  Please help. 

 

1) Pristiq can cause anxiety. Did your anxiety increase while you were taking Pristiq?

 

2) Pristiq combined with Prozac can cause even more activation. This is a drug combination that is not recommended for this very reason.

 

3) Increasing Prozac to 40mg with 25mg Pristiq can cause even more activation. This is a drug combination that is not recommended for this very reason.

 

It appears to me that you are having an adverse reaction to the Pristiq and Prozac combination (which would have been avoided by a knowledgeable clinician) and possibly to Pristiq when you were taking it alone.

 

Your "anxiety" is an adverse effect of the drugs, which your doctor has misdiagnosed. If I were you, I would not take advice about psychiatric drugs from this doctor any more. She doesn't know what she's doing.

 

If I were you, I would immediately reduce the Prozac back to 20mg. This probably won't eliminate all the drug-induced activation, but hopefully will reduce it. Please let us know how you're doing.

 

As Shep said, this is a site for going off drugs. We don't treat anxiety or psychiatric disorders here, but we see adverse reactions to drugs all the time. Please let us know if you would like advice tapering off the drugs.

 

 

[Hope2020]

Thanks for your response.  to answer you question, Pristiq didnt really cause more anxiety,  it just never really helped.   And the reason she put me on Prozac was to make the tapering off pristiq easier ( which it has not been). Today she said to go back on the prisitq - which im hesitant too since i am already 5 days into this hell hole, OR she said i can just start taking Klonopin to help with the withdrawal.    I chose the latter and am thinking of just taking Klonopin to get me through this next week and hopefully the symptoms will subside within the next week or so.  I'm so confused.     I feel that none of these psychiatrist really know what they are doing.   This is just from cutting down to 25mg from 50.  I cant imagine what its going to be like when i have to drop the other 25.  I think im going to cut it like some people have suggested.  Definitely wont be stopping it cold turkey.  Have you heard of anyone feeling better withing 10 days or so of withdrawing from Pristiq ? Just trying to see if there is light at the end of this tunnel. 

[Altostrata]

I would have suggested reduction of Prozac -- it's clearly too high a dose -- and then dropping the Pristiq so you can accomplish your crossover to Prozac.

 

If you would like to continue working with this doctor, please do so. If you have any adverse effects from her drug recommendations, please work them out with her. It's her job to do this, we shouldn't have to fix her errors.

[Shep]

12 hours ago, Hope2020 said:

Today she said to go back on the prisitq - which im hesitant too since i am already 5 days into this hell hole, OR she said i can just start taking Klonopin to help with the withdrawal.    I chose the latter and am thinking of just taking Klonopin to get me through this next week and hopefully the symptoms will subside within the next week or so.

 

Please note that you can become dependent on Klonopin in 2 - 4 weeks. We don't recommend adding in a benzodiazpine to help with withdrawal. It's best to do a slow taper. 

 

I'm going to leave you some links to read over that explain how to properly taper, as well as links to tapering off both Pristiq and Prozac and information on the Prozac Bridge. 

 

Why taper by 10% of my dosage?

 

Tips for tapering off Prozac (fluoxetine)

 

Tips for tapering off Pristiq (desvenlafaxine)

 

The Prozac switch or "bridging" with Prozac

 

After you read through these links (or at least the first post in each), please let us know your thoughts. 

 

On 4/12/2020 at 9:23 PM, Hope2020 said:

So this week she had me drop to 25mg of pristiq and increased Prozac to 40 mg. It’s now been 4 days and I still feel anxious and depressed.

 

7 hours ago, Altostrata said:

I would have suggested reduction of Prozac -- it's clearly too high a dose -- and then dropping the Pristiq so you can accomplish your crossover to Prozac.

 

In light of how recent your changes were, what Alto is suggesting sounds very reasonable. 

[Hope2020]

I taking your advice and dropping the Prozac to 20.  I also went back to  50 mg of Pristiq this morning.  I think 50% drop was just too much.  Now what? How long do I stay on this before starting to try to taper again?  I took melatonin and l theanine last night to try to get some sleep.  Sleep a little better. Not great but better. I’ve never had a sleep problem. It’s always been my saving grace.  But this last week I can’t sleep. It’s awful.  I don’t know if that comes from Pristiq withdrawals or the 40mg of Prozac.   I don’t feel well.  I wake up with anxiety that starts at my feet and comes shooting up to my head.  It consumes my entire body. I need to get off of all this.  I can’t remember feeling this bad ever.  

[Altostrata]

I would definitely NOT increase Pristiq! You're perpetuating the adverse drug-drug interaction. Please stop experimenting with your drugs.

 

If I were you, I would drop to 20mg Prozac and stay with 25mg Pristiq. This may be bumpy, but you should feel better in a few days. Then I would drop the Pristiq.

 

We are not after clobbering your "psychiatric" symptoms, we're trying to reduce the adverse effect of 2 drugs being prescribed together by a doctor who doesn't know what she's doing. More antidepressant is not better!

 

The sleeplesssness is because you have been taking too much of everything.

 

Did you ever take Effexor? This is important: Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Hope2020]

Thank you!! But now Im  really freaking out because i took the 50 this morning. did i just screw everything up ? Im desperate at this point.  Im currently looking for a new psychiatrist.  Please advise what i should do tomorrow.  Please help.  I need advice before i can see the new doctor 

[Altostrata]

17 minutes ago, Altostrata said:

If I were you, I would drop to 20mg Prozac and stay with 25mg Pristiq. This may be bumpy, but you should feel better in a few days.

 

Since you increased the Pristiq today, you're likely to feel a surge in symptoms. When you take less tomorrow, it will all average out over a week or so.

 

Very few doctors of any type, including psychiatrists, know anything about tapering drugs. Your current psychiatrist is only especially bad, because she doesn't know anything about mixing drugs, either.

[Hope2020]

Thank you!!   will do.  

[Hope2020]

how long does it generally take to regenerate our neurotransmitters?  or are they permanently damaged ?  Im just beyond scared .

[Hope2020]

@Altostrata @Shep I went on Pristiq because of anxiety. I have no stress, no work issues, great family life etc. basically no reason for this anxiety. I go to therapy once a week, I meditate, try to exercise and eat well, and still unbearable anxiety (especially in the mornings). I understand that Prozac was a terrible idea but how do I get rid of this anxiety?  The doctor wanted to keep raising the dosage on the pristiq which is why I said I rather switch to something that would hopefully take care of my anxiety and would be easy to withdraw from. This is how the Prozac came to be.  Since neither the pristiq or Prozac worked have ever worked, in fact I think I’ve gotten worse, how do I treat this anxiety?  I have been told the ONLY way to do that is to get on meds and then when my anxiety is gone start weaning off. The only thing that helps me is .25 Xanax I take maybe once a week. 

[Altostrata]

Please don't worry about regenerating neurotransmitters.

 

Did you ever take Effexor? Is it possible you take Xanax a little more often?

 

You can't address your pre-existing anxiety now, you're in the middle of a drug reaction. We can talk about your earlier symptom pattern once you get your dosage settled.

 

We don't treat anxiety here, we help people minimize drugs. You may need to change some lifestyle habits or learn calming techniques to cope with anxiety.

 

This is important: Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

 

 

[Hope2020]

I’ve never taken Effexor.  And prior to this week I had only taken Xanax. Once a week at most. This week I have taken it the last 3 days because the pristiq withdrawals or the 40mg of Prozac were mote than I could handle which is why my dr wanted me to take klonopin instead.  
I will add my signature tomorrow from my computer. 

[Shep]

6 hours ago, Hope2020 said:

Once a week at most. This week I have taken it the last 3 days because the pristiq withdrawals or the 40mg of Prozac were mote than I could handle which is why my dr wanted me to take klonopin instead.  

 

Please let us know your history of psych drugs. More and more drugs are popping up.

 

This will help us give you advice on setting up a game plan for stabilizing and then tapering off. 

[Hope2020]

 

I added my signature.. hope you can shed some light on this horrible process 

[Altostrata]

Hi, Hope. Your signature didn't take. Instructions: Please put your drug and withdrawal history in your signature

 

What drugs did you take today, at what times of day, and what dosages? How do you feel?

[Hope2020]

.25 Klonopin that has me very sleepy

25 Pristiq

20 Prozac

 

Couldn't sleep last night so i took 10mg Melatonin and  400 Ltheanine ..  still couldn't sleep so i took a big swig of liquid Benadryl and slept until like 6 am I woke up again with horrible anxiety and cried.   Took the Klonopin at 7.45 am and am although groggy still feeling ok.   I keep praying tomorrow is the day i wake up feeling better.

 

 

 

 

[Altostrata]

What times of day do you take these drugs? How often do you take Klonopin?

 

Please put your drug and withdrawal history in your signature

[Hope2020]

with breakfast. (between 7-8 am)   Today was the first time i ever took Klonopin. 

 

I will put my withdrawal symptoms from my computer tomorrow. 

[Hope2020]

@Altostrata i dont think i can do it much longer. Its been like 6 days and im coming out of my skin. The only withdrawal symptoms i have are extreme anxiety and all 

i want to so is cry.  How much longer do you think?  Thats just from

dropping 25mg.   Im really losing my s**^. 

[Altostrata]

What you're feeling might not be withdrawal, it's because you're taking Pristiq and Prozac together.

 

If you drop Pristiq, you might feel better. But you'll have to carefully take notes, because you might get withdrawal from that. So it's important for you to track symptoms so we can tell if you get withdrawal from dropping Pristiq.

 

Good chance you'll feel better, though, because you're taking too much serotonergic.

[Hope2020]

The Prozac was given to help get me off pristiq. I’ve read a ton of posts where this is very common. you really don’t think it’s because I cut my pristiq dosage in half after taking it for a year? 

[Altostrata]

On 4/12/2020 at 6:23 PM, Hope2020 said:

A month ago my dr dropped me to 50mg of pristiq and added 10 of Prozac. 2 weeks later I had so much anxiety that she increased to 20 mg of Prozac.  I still had unbearable anxiety. So this week she had me drop to 25mg of pristiq and increased Prozac to 40 mg. It’s now been 4 days and I still feel anxious and depressed.

 

On 4/14/2020 at 1:03 PM, Altostrata said:

Since you increased the Pristiq today, you're likely to feel a surge in symptoms. When you take less tomorrow, it will all average out over a week or so.

 

 

Your doctor should not have mixed those high dosages of Pristiq and Prozac. See https://www.drugs.com/drug-interactions/pristiq-with-prozac-2796-12488-1115-648.html

 

You are probably feeling the effects of the increase in Pristiq you made 2 days ago. Anxiety is a common adverse effect of too much Pristiq.

 

Pristiq and Prozac are not calming drugs.

 

If I were you, I'd drop the Pristiq. Those 2 drugs should never be mixed. Besides, you intended to cross over to Prozac anyway.

[Hope2020]

The Prozac was given to help get me off pristiq. I’ve read a ton of posts where this is very common. you really don’t think it’s because I cut my pristiq dosage in half after taking it for a year?  I’m terrified.  Are there any good AD detox centers ?  Waiting a week or 2 to speak with my psychiatrist is not enough.  I’m terrified.  I can’t sleep. I’m in constant pain.  I’m running out of gas and trying to hold off for my family.  I will find out about Lamictal and see if that could help if I drop these 2 meds.  I just need to stabilize. 

[Altostrata]

15 hours ago, Altostrata said:

Your doctor should not have mixed those high dosages of Pristiq and Prozac. See https://www.drugs.com/drug-interactions/pristiq-with-prozac-2796-12488-1115-648.html

 

You are probably feeling the effects of the increase in Pristiq you made 2 days ago. Anxiety is a common adverse effect of too much Pristiq.

 

Pristiq and Prozac are not calming drugs.

 

If I were you, I'd drop the Pristiq. Those 2 drugs should never be mixed. Besides, you intended to cross over to Prozac anyway.

 

The concept of crossing over from an antidepressant such as Pristiq to Prozac REQUIRES THAT YOU DROP THE PRISTIQ.

 

The addition of Prozac to Pristiq is not supposed to make you feel great, it's to effect the crossover so you're not cold-turkeying Pristiq.

 

You have been on the Pristiq and Prozac combination TOO LONG. It is a dangerous combination. If I were you, I would drop the Pristiq.

 

DROPPING THE PRISTIQ IS THE POINT OF ADDING THE PROZAC.

 

Adding lamotrigine is not going to make the combination of Pristiq and Prozac comfortable for you. If you persist in taking Pristiq and Prozac together, we cannot continue to counsel you regarding the adverse effects. You are making your own problems.

[Hope2020]

I dropped the pristiq this morning.   I keep thinking it is  Pristiq withdrawal im having.    And i dont persist on taking both these drugs...  THis is all new to me and im scared to do something that will make me feel worst than i already do.   

[Altostrata]

Please let us know how you're doing. Since you made a big change, you may feel some bumps. But you were having such a bad time on the drug combination, you might feel better soon.

[Hope2020]

thanks.  I received the magnesium. 100 mg.  How much of that should I take.  It says to take 2 tablets twice a day. Is that good? 

[Altostrata]

It's better to take small amounts of magnesium more frequently. You may wish to cut tablets in half and take 6 times a day.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Shep]

On 4/15/2020 at 4:31 PM, Hope2020 said:

Couldn't sleep last night so i took 10mg Melatonin and  400 Ltheanine ..  still couldn't sleep so i took a big swig of liquid Benadryl and slept until like 6 am I woke up again with horrible anxiety and cried. 

 

Please don't do this again. It sounds like you had a paradoxical reaction which created the horrible anxiety. The more you dampen down the nervous system with sedating drugs and supplements, the more it fights to stay awake. This is the paradoxical reaction.

 

Also, 10 mg Melatonin is way too high a dose. 

 

Melatonin for sleep

 

Information on l-theanine is here:

 

L-Theanine for anxiety, insomnia

 

Benedadryl is very problematic during withdrawal. For more, please see:

 

Antihistamines for withdrawal insomnia (diphenhydramine, doxylamine, hydroxyzine)

 

When adding in a supplement, please do so one at a time and at a very low dose. For more:

 

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

 

Also, I received your PM and have added the information you provided for your signature (and color-coded it for an easier read). 

[Hope2020]

I managed to get off Pristiq.  It was a horrible month or so to say the least.   The psychiatrist put me on 50mg of Seroquel so i was able to get some sleep while i was on the tail end of my Pristiq withdrawal.  It has now been a couple of months since ive been completely off Pristiq and Prozac but am still on the Seroquel.   The psychiatrist has wanted to up the dosage every time I go see her.  She says that i need to be on the therapeutic dose since i still wake up with some anxiety.    I have insisted on not raising it since i feel i am doing pretty good on just the 50.   It is instant realease so i take it about 20 minutes before bed time and i get great sleep.   I never had sleeping issues prior to the Pristiq.    What is your recommendation for getting off the seroquel ?  i am assuming the same 10% taper but since I have read that it is more like a high dose of Benadryl i thought i would ask .  I have 2 concerns  for coming off   1.  I am afraid that my anxiety/depression will come back with a vengeance   2. that i may have sleep issues forever.      Any suggestions, advice would be greatly appreciated. 

[Altostrata]

Did you simply quit Pristiq? What happened to the Prozac and Klonopin?

 

About morning anxiety:

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

More about how light stimulation affects our body clocks

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

What is the sleep cycle?

 

5 hours ago, Hope2020 said:

I have 2 concerns  for coming off   1.  I am afraid that my anxiety/depression will come back with a vengeance   2. that i may have sleep issues forever.      Any suggestions, advice would be greatly appreciated. 

 

Wherever you go, there you are. If you go off psychiatric drugs, you may have to learn to manage whatever motivated you to go on them in the first place. But since you've been taking them since 2009, I would not expect "relapse", you have an entirely different nervous system now.

 

What you want to avoid are withdrawal symptoms, some of which can feel like psychiatric symptoms, and withdrawal insomnia. Slow tapering can help you do this, see Tips for tapering off Seroquel (quetiapine) Please let us know how you're doing.

[Hope2020]

I dropped the Prozac when you told me to..  Then i started taking the 25mg of prisitq one day yes, one day no for about a week and then dropped it all together.  I felt awful, but then i was put on the seroquel and that made things better.  I took the Klonopin as needed throughout the Pristiq withdrawl and the first week of seroquel.   I haven't taken a xanax or Klonopin in over a month now.    I will start trying to taper off the seroquel next month.  I have too much going on trying to get my head above water now with since i was out of work with the Covid and now am back on and very busy.  I cant risk feeling bad with the withdrawls right now.  But i will surely let you know how it goes.   Im so glad this forum exists and so grateful for all the people writing their experiences.  Stay safe and thank you very much for all your advice.