Gaia: too fast taper off of Pristiq and Trileptal and Risperdal

[Gaia]

In July I was admitted to the hospital and taken off almost all of my meds (Pristiq and Trileptal and Risperdal) and put on Latuda. I immediately lost my appetite and had hot and cold flashes and sweating. After a week or two I started having diarrhea, nausea, and vomiting. My psych said it was withdrawal from the Pristiq and that it would last up to 6 weeks. After 6 weeks I stopped taking the Latuda after a short taper, just in case that was the cause. Nothing changed. After 8 weeks I saw a gastroenterologist who agreed that it was withdrawal. Now, 3 months into it I’m wondering if I should go back on the Pristiq (if Pristiq is in fact the culprit), just to get relief from these horrible symptoms. My sickness follows a pattern and is always in the morning, waking me up at around 6 am and then continuing for 4-6 hours of pain and trips to the bathroom. Later in the day I am relatively okay. Sometimes I have lingering nausea or fatigue. My mood is okay. I don’t seem to have a lot of depression and anxiety but my mood is negative while I’m experiencing bouts of vomiting, etc. I’m finding it impossible to hold a regular job. This is truly disabling. I’m miserable every day and it’s really starting to affect my overall well-being. I have been eating mostly Ensure meal replacement shakes for the past three months because I have no appetite. I have lost over 30 pounds.

Should I try reinstatement? Of the Pristiq? The Risperdal? Should I just tough it out? 
Any advice on dealing with these symptoms would be greatly appreciated. Doc has prescribed Zofran and Phenergan for nausea, neither of which seem to work. 

[ChessieCat]

Hi Gaia and welcome to SA,

 

Thank you for creating a drug signature.

 

Are you currently taking any other drug/supplements?  If yes, please add those to the drug signature.

 

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This is your own Introduction topic which is the best place to ask questions about your own situation and journal your progress.  This way your history is in one place and you will not need to repeat yourself.  Also, the mods regularly check for new posts in the Introduction forum.  Because of how busy SA is and the large number of members if you post elsewhere the mods might not see the post.

[ChessieCat]

2 hours ago, Gaia said:

and put on Latuda

 

Please add this to the drug signature.  Thank you.

[Gaia]

After another miserable morning of vomiting, nausea, and abdominal pain. I am strongly starting to consider reinstating but instead of Pristiq going back on the Effexor and then doing the bead removal method.  If I knew that toughing it out meant it was over in a few weeks, I’d just stick to it. But there seems to be no end in sight. Mostly I’m worried that I am seriously damaging my body and that my withdrawal is needlessly extended and painful. It’s hard to keep up hope when faced with this experience every single morning. My worries for reinstatement are that it won’t work and it just makes everything worse.

[Altostrata]

Welcome, Gaia.

 

Yes, Effexor is a reasonable substitute for Pristiq, they are closely related drugs. You may need only perhaps 6 beads from a 37.5mg capsule to reduce the withdrawal symptoms. Trying just a little bit to start will limit an adverse effect if Effexor is not the answer. You'd stay on this for some months to let your system settle down, then taper off bead by bead.

 

Why were you switched to Pristiq from Effexor before? Why did your doctor have you suddenly go off Pristiq, Trileptal, and Risperdal at the same time? Is this the same doctor who prescribed Cymbalta, Trileptal, and Saphris together?

 

What is the trazodone supposed to be doing for you? Were you taking trazodone with the other 3 drugs? What effects do you feel from it? When did you start it? Was it before or after you started having nausea? Please read up on trazodone adverse effects on drugs.com

 

 

[Gaia]

9 minutes ago, Altostrata said:

Why were you switched to Pristiq from Effexor before? Why did your doctor have you suddenly go off Pristiq, Trileptal, and Risperdal at the same time? Is this the same doctor who prescribed Cymbalta, Trileptal, and Saphris together?

 

What is the trazodone supposed to be doing for you? Were you taking trazodone with the other 3 drugs? When did you start it?

 

 

I was switched from Effexor to Pristiq because I had the Genesight genetic testing done and it indicated that Pristiq would be a better medication for me. I was taken off most of my meds and started on Latuda at the psych hospital so it was not my regular psych doctor. I guess they assume if you are at the hospital your current cocktail must not be working. And it wasn’t. I was very sedated but still suicidally depressed despite all the meds. The doc at the hospital said that I was way overmedicated and on an extremely high dose of Trileptal (900 mg 2x/day.) The abrupt withdrawal from Saphris in 2019 was also instigated by a hospital doctor that decided to take me off all of my meds to start a new one.
 

I’ve been taking the Trazodone for quite some time now, yes along with the 3 other drugs. Probably since August 2019? Was on 200mg, down to 100mg now. I take it for sleep, but now that I’m off every other med my psych thinks that the Trazodone is also therapeutic for my depression. She wanted me to go back to 200mg but I don’t feel like I need to. Mentally I feel really stable and steady; the only thing that bums me out are these horrible GI symptoms every day.

[Gaia]

3 hours ago, Altostrata said:What effects do you feel from it? When did you start it? Was it before or after you started having nausea? Please read up on trazodone adverse effects on drugs.com

 

 

I started the Trazodone well before (a year before) the nausea started. I don’t notice many effects from the Trazodone other than mild sleepiness and improved sleep (staying asleep all night.) I can’t tell what it does or doesn’t do for my mood as I don’t really have a good drug-free baseline to compare to. It might make me a little tired during the day, but still much improved from cocktail I was on before which made me very sedated.

[Gaia]

Wow! Wow wow wow. I never would’ve believed it if I hadn’t tried it myself. I took 6 beads of Effexor last night as recommended and woke up this morning with NO VOMITING. I had diarrhea and slight nausea still but the abdominal pain was completely gone and the best part is I didn’t puke like I have every morning for the past 3 months. This is some kind of miracle. This website is a lifesaver. I’ve been struggling and suffering for so long and I’m so glad I got the advice I did. Thank you! Thank you so much!

I will stay on this dose for awhile and then taper off completely. I was worried that the Effexor wouldn’t work because perhaps the withdrawal symptoms were from the Risperdal instead. Or that I had waited too long to reinstate. But I am just so happy this morning to wake up feeling okay and not miserable. I might actually be able to hold down a day job!

[ChessieCat]

That is great news and I can fully understand how amazed you are.  I had a similar thing happen.

 

It is such a relief, isn't it.  Please keep in contact and let us know how you are doing.  And we can also help with deciding on whether you are ready to taper.  It's better to hold for longer than to reduce too soon so please be patient.

 

This is what happened to me:

 

I reduced my Pristiq from 100mg to 50mg and for 2 weeks I experienced severe cog fog, and even walking took my whole concentration.  I joined SA but didn't updose as suggested because I was trying, through the brain fog, to learn about what was happening.  A couple of days after joining I got to the stage that I was unable to type.  Having been a typist for 40+ years I knew that something was really wrong.  I was very thankful for SA's suggestion.  I went and took extra Pristiq.  Astoundingly after only about 4 hours (not days) I was able to type again and the brain fog was lifting.  Because I had a benchmark I knew that it was because of the drug.

[ChessieCat]

Please also be aware that you might still have some ups and downs, windows and waves.

 

Windows and Waves Pattern of Stabilization

[Altostrata]

Good to hear a little Effexor helped. It isn't a miracle, we do this all the time!

[Gaia]

Woke up to the usual vomiting, intense nausea, and abdominal pain. Very disappointing after being so excited to not get sick yesterday. Do I updose by a number of beads a day until my symptoms go completely away?

[ChessieCat]

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.

 

You need to give it some more time.

 

Please continue to let us know how you are each day so that we can assess whether the reinstatement dose is helping or if it might need to be changed.

 

Also, please note that the idea of reinstatement isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

Edited November 4, 2020 by ChessieCat

[Gaia]

After trying the Effexor for a bit and not noticing any change in symptoms I discontinued it out of fear I would just be getting reattached to a drug that wasn’t doing anything to help. Quitting it I had no change in symptoms. 
But then a week or so later I was blessed with 3 days in a row of no vomiting. Then my vomiting and nausea was way worse for a few days. Then a return to baseline daily vomiting. The past two days I’ve had no vomiting although my nausea was much worse yesterday. There’s no rhyme or reason and no pattern to when I’ll feel better or worse. I have been trying to change my diet to be easier on my guts but I’ve been haphazard enough about it that the results are inconclusive. I reintroduced Latuda this week because my depression and anxiety especially was really ramping up. I think I’m malnourished because of the chronic vomiting and diarrhea. If anyone has any tips on getting enough calories when you have no appetite that would be awesome. I’ve lost 40 pounds so far from this. Luckily I’m fat so I still have room to lose but this can’t go on forever or I’ll be in serious trouble. Is there anything that can be done to speed along the CNS repair and recovery process?

[Altostrata]

6 hours ago, Gaia said:

I reintroduced Latuda this week because my depression and anxiety especially was really ramping up.

 

How are you feeling since you reinstated Latuda?

[Gaia]

11 minutes ago, Altostrata said:

 

How are you feeling since you reinstated Latuda?

I haven’t noticed a huge effect on my moods, just slightly less depressed and anxious. It doesn’t seem to be affecting the nausea/vomiting/diarrhea one way or the other. I expect that the mood effects will increase as I’m on it longer. I’ve only taken it for less than a week.