FinleyDog: hesitantly switching from Prozac to Pristiq

[FinleyDog]

HI, thanks for adding me. 

I have been on SSRI's for the last 20 years. I've tried several different ones and after going through a paxil withdrawal from hell I swore I'd never take anything but prozac ever again. 
Now here I am 5 years on Prozac (blah, drowsy all the time, unmotivated and unempathetic) so,  I made the decision to try switching drugs again because I cannot tolerate my anxiety symptoms and rumination when I am free of them ( though I often wonder if they would eventually balance out I have too many other health issues to deal with one more thing). 

I've been tapering off generic prozac for the last few months from 20mg to 7.5mg, I had stopped altogether about 6 weeks ago and had too many withdrawal symptoms so went back up to 7.5 and then worked my way down to 5mg then last week stopped the 5mg and switched to Pristiq. My eyesight has been blurred, stomach nauseas and upset as well as a constant headache and often feeling drugged, though on some mental level feel much closer to my real self. I realized today after 2 days of bad fatigue that I am going through prozac withdrawal symptoms again,  so I took 5mg of prozac and felt slightly better within the hour or so. But I am not sure how to proceed, as I don't believe I can take both. At least my dr said not to for more than a few days. 

Should I stop the pristiq since I'm only a week in, or slowly continue to taper with my prozac liquid? 🤔

Very Confused. 

 

I so wish I found this forum months ago. I would have done things very different. 

[hayduke]

Hi FinleyDog, welcome to SA.

 

Please create a signature with dates, dosages and changes of all drugs and supplements you've been taking.  This is to give us a clearer picture of your situation.

 

It sounds like your initial taper was going reasonably well although probably faster than we would generally advise.

 

Why taper by 10% of my dosage?

 

Why did you switch to Pristiq?  Your body now has a lot more sudden new jazz to contend with, while your nervous system already will be trying to adapt to your lower dosages of Prozac.  You really want to minimise the number of variables in play to give yourself as much stability as you can.

 

How psychiatric drugs remodel your brain

 

Since it's only been a week, I would be looking at promptly cross tapering back to your previous steady dose of Prozac, at around the same speed as your first cross taper.  At least that way you'd be headed back towards more what your body's been used to instead of setting it a whole bunch of new challenges.  Either way you're probably in for some discomfort until your physiology catches up. 

 

Non-drug techniques to cope with emotional symptoms

 

I would then do a long or long-ish hold at that dose of Prozac until I was feeling settled and stable again.  Then consider a straight taper off from there at around 10% as in the link above. 

 

Preparing to taper

 

Tips for tapering off fluoxetine (Prozac)

 

Cheers

[FinleyDog]

Heyduke 

Thanks so much for the reply ice been anxiously checking this site for advice.

 

I didn't find this site early enough in my journey and just did what the Dr had suggested. So here I am late to the knowledge and suffering.

 

Can you just clarify if you meant to stop the pristiq while going back on my previous dose of prozac or did you mean to take both while my body adjusts? 

 

Thanks and I'll go back and update my meds on the bottom. 

[hayduke]

Thanks for checking.

 

Yes, I mean if I were you, I would want to do a quick cross taper off the Pristiq and back onto the Prozac, then stabilise.

 

Can you please list the exact dosages of Prozac and Pristiq you've taken each day for the last fortnight?

 

[FinleyDog]

I can't figure out how to leave a signature. I'm working on it.

 

I was previously taking 5mg liquid prozac. Stopped that and 1 night later started 50mg the lowest dose of pristiq 9 days ago. 

 

2 nights ago I took 5mg of prozac at bed and continued the pristiq in the am. 

Same with last night. 

My pain and numbness subsided but my heaviness and fatigue is really bad.

 

I was trying to get off the prozac due to the tiredness and apathy it caused by my anxiety was so bad coming off it that I assumed I must need it. I also have addisons disease ( I make no cortisol or other hormones) so my Dr thought the pristiq might help with energy. Which it did for the first few days before the prozac withdrawals kicked in again.

 

 

 

[hayduke]

Thanks for that.  I would maintain the 5mg Prozac you're well used to now.

 

Since you've only taken Pristiq for such a short time I would try half doses (25mg) for two or three days and see how I felt.  You'll have to listen to your body.  It's probably going to be a gritty week or two, but you could also try a smoother ramp of 3/4, 1/2, 1/4 doses over the next few days if that's easy for you.  I think I would want to be off Pristiq within 3-5 days at this stage, maybe 7 if you feel you need to.

 

Once you're more stable again you can look at other approaches to managing fatigue, a lot of people here will have things to say about their experiences with that.

If you look in the top right and click on your screen name and choose Account Settings, you will see you can edit your signature in there.

Edited August 30, 2021 by hayduke

[FinleyDog]

pristiq is not meant to be cut. So I'll have to just stop it. 

 

I have a syringe and I know the 5mg mark is 12 lines ( the pharmacist showed me) but can I just decrease each week by 1 line or 2 and not know the actual dose amount as long as I stick to the lines on the syringe and decrease that way? I am so thankful for this site. I only wish I had found it sooner, I would have not started the pristiq at all after seeing how difficult it is to get off. 😪

[hayduke]

I think you're likely to have been quick enough to put the Pristiq back on the shelf without requiring a longer taper.  Although your nervous system's already mid-flight with your prozac taper.

 

Some people seem to do ok with breaking up the tablets.  It is difficult to find definitive information on this, but it appears that doing so will disable the extended-release properties.  That would mean that if you're weighing out the powder from these crushed tablets, you would want to divide your daily dosage into halves taken 12 hrs apart.

 

@FinleyDog I've made an edit to suggest this might work better than a liquid in this case.  Though if you did, the same thing applies.

 

I would try something like a 3/4 dose next.  When that feels ok, you can keep stepping down.  Let us know how you're getting on, and if you need to go slower.

 

A knowledgeable compounding pharmacy might also be a good option if you can get to one next day or so.  Perhaps one of the other mods can advise on that.

 

I would be aiming to get clear of the Pristiq in short order then stabilising as the first thing.  Worry about the Prozac taper later.

 

Fish oil (omega 3, also found in hemp protein powder) and magnesium supplements may help you stay more at ease during this.  I'm very partial to getting my magnesium from epsom salt baths or foot baths.

Edited August 30, 2021 by hayduke

[FinleyDog]

I took an Epson salt bath last night and or helped so I took one this am again.

Thanks 

[Altostrata]

Hello, @FinleyDog You've been taking Pristiq only for a week? You can simply stop it.

 

Please add the dosages and dates you started your drugs, including Pristiq, in your signature.

 

Have you communicated your difficulties to your doctor? It's your doctor's responsibility to switch you from one antidepressant to another, it's what he or she gets paid for. Since you are inclined to stay on an antidepressant, if I were you, I'd go back to 7.5mg Prozac, see how you feel, and ask your doctor about what drug to switch to from there. 

 

We don't help with drug switches for therapeutic purposes, only drug bridging to enable tapering. (Pristiq does not enable tapering under any circumstances.)

 

 

[FinleyDog]

yes, my doctor was the one switching me to pristiq, and yes she knows of the difficulty. She said I can take both while I wean If I'd like to continue with the switch. But as I am certain you are aware, doctors do not understand that these withdrawals are longer lasting than they suspect. My Doctor originally told me that I could just stop the 10mg cold turkey, since it was the lowest dose, so it just goes to show you that they are clueless. I had been on Prozac for about 5 years, that was clearly too abrupt for me. 

Anyway, I've decided to stop the switch to pristiq, after seeing this site and stay on the prozac until I can safely and slowly wean off of it. I'm hoping that If i do it slowly enough that I won't experience the depression and anxiety that in the past I took as a relapse. But if for some reason I go on something again I will do pristiq next time, because it was giving me energy. 

[Rosetta]

Hi.  I do not believe Pristiq was giving you energy.  I would say you were feeling the effect of reducing the Prozac too much at once and the effect of a new drug, Pristiq, on your destabilized nervous system.  I’ve been there.  Many people feel better, more alive, and have more energy a few days after quitting an antidepressant.  
 

For people who are going to experience WD, things tends to go downhill, very far downhill, from there.  They mistake feeling better as evidence that quitting too quickly “worked.”  

 

When the nervous system has experienced the shock of abrupt cessation of an AD, it is very fragile for months or longer.  Using small doses of OTC pain drugs, supplements, etc. is a good idea.  Sometimes, trying a new drug or having alcohol or a new supplement is the straw the breaks the camel’s back.  It’s a good idea to avoid alcohol for at least a few months, take 1/2 doses of Tylenol or any other drugs, avoid surgeries, and ask for non-adrenaline (no epinephrine) numbing agents at the dentist’s office.  When one does try alcohol again, using a very small amount of something weak is best for several months, too.

 

Good luck, Rosetta

[FinleyDog]

Thanks for tips. Funny thing I've been having issues tolerating any supplements or medicine for the last several years. And I've been wondering if my body hated the prozac the entire time. It made me tired all day long even though I took it at bed and I (without knowing better) for the last year was taking prozac only a few days a week because my energy was so much better on the days I didn't take it. So perhaps you are correct and it was just the stopping of the prozac that gave me energy. 

My Dr had suggested the pristiq for a few reasons but the 1st being that the noradrenaline part may be better for my energy and that is why I assumed It was that. One thing is for certain and that was I was mkt drowsy all day. Now I look forward to getting off prozac again so that my days aren't filled with wanting to nap. Lol 

I will take things carefully but of course.whem it rains it pours and I have lots of tests coming up for my stomach issues so Its gonna be a uphill battle if there are antibiotics involved.

 

Thanks again! 

[FinleyDog]

I'm feeling super irritated and just need reassurance that this is from Withdrawal and not relapsing into depression...I really hope this isn't my true self. 

 

[getofflex]

Previous post moved to your intro topic to keep your history all in one place.  Please post questions and discussion about your situation in this one thread, to avoid confusion and duplication of efforts.  Thank you.  

 

Your drug signature says you were on Pristiq from 8/23/21 to 8/30/21.  Did you just stop taking it, or are you still taking it now?  What are the dates of your prozac tapers?  I just see the dose reductions, but no dates.  I can better answer your question if I know more about your drug history.  Thank you.  

[hayduke]

7 hours ago, FinleyDog said:

I'm feeling super irritated and just need reassurance that this is from Withdrawal and not relapsing into depression...I really hope this isn't my true self. 

 

 

I'd expect to feel on the tender side for a little while after an excursion onto Pristiq like that.  Especially against the backdrop of your Prozac taper.  This is a good point to just hold at the same Prozac dose for a while until your body can catch up with the changes it's having to process.

There's a lot more info about what's actually happening there, and some ways to help get comfortable with it, in the links in my first reply above.

 

Cheers

 

[FinleyDog]

Confused as to what to do

 

Hi.

Had been on 10mg Prozac for 6 years, then pristiq for 1 year , then trintellix for 9 weeks. I stopped taking trintellix 10mg cold turkey because my dr said I had only been on it 9 weeks and that it had a long half life. I felt great for 10 days and then started with horrible withdrawal symptoms. I tried to take 5mg trintellix again and felt awful ( but awful the way trintellix always made me feel). After 2 days of it I took 20mg Prozac last night and feel better today. But I do not know where to go from here. It was a stupid move to take so much Prozac but felt better within hours. I don’t want to have to taper off the 20mg if I don’t have to. Can I take a lesser dose of Prozac now and start a slow taper? 
 

my dr and the psychiatrist aren’t very helpful and both say that I should be able to stop after 2 weeks. 

 

Edited August 24, 2022 by ChessieCat
added topic title before merging with intro topic

[FinleyDog]

Vortioxetine Equivalent

 

Hi 

does anyone know the Vortioxetine dose equivalent in fluoxetine? Vortioxetine Made me feel horrible every day so I’m tapering with liquid fluoxetine instead. 
thanks 

 

Edited August 24, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

It's been 1 year since your were last here.

 

Please update your drug signature showing all drugs changes and include the date and the dose you took.  And if you stopped a drug include the date and the last dose you took.

 

Account Settings – Create or Edit a signature

 

Q:  What are your current symptoms?

 

Q:  How is your sleep?

 

I've ask the other staff for their assistance.  However at this time the site is very busy with a large number of new members joining so I don't know how long it will be before someone will respond.

 

32 minutes ago, FinleyDog said:

Vortioxetine Equivalent

 

Hi 

does anyone know the Vortioxetine dose equivalent in fluoxetine? Vortioxetine Made me feel horrible every day so I’m tapering with liquid fluoxetine instead. 
thanks 

 

 

https://www.nps.org.au/assets/Products/Guidelines-switching-antidepressants_A3.pdf

[ChessieCat]

On 8/31/2021 at 6:49 AM, Altostrata said:

We don't help with drug switches for therapeutic purposes, only drug bridging to enable tapering.

 

Please note the above.

[FinleyDog]

I am not switching for therapeutic doses. I’m trying to be completely off antidepressants. I bridged from trintellix to Prozac (generic) because I can’t handle trintellix. I now need to wean off the Prozac. 

[Altostrata]

Almost a year ago:

On 8/30/2021 at 1:49 PM, Altostrata said:

if I were you, I'd go back to 7.5mg Prozac, see how you feel

 

You've been bouncing around on antidepressants since we last saw you, in a way that does not suggest you were "bridging" to go off, but trying out new drugs for "therapeutic" purposes.

 

It will take a few weeks for 20mg Prozac to ramp up to full effect. If it seems too much, you may wish to reduce it to 10mg or 7.5mg. Then, you might want to stay there for some months to let your nervous system settle down from all the drug changes and adverse reactions. If you want to go off, see Tips for tapering off fluoxetine (Prozac)

 

Please let us know if you want help tapering.

[FinleyDog]

I don't know why the title of this topic was changed/ I am trying to taper off prozac. Not changing to anything. Just off meds. 

[ChessieCat]

On 8/25/2022 at 10:21 PM, FinleyDog said:

I don't know why the title of this topic was changed/ I am trying to taper off prozac. Not changing to anything. Just off meds. 

 

 

I have checked the history of your topic title and this is the original name:

 

hesitantly switching from prozac to pristiq

 

This is the current name:

 

FinleyDog: hesitantly switching from Prozac to Pristiq

 

The only differences between the name you original gave it (the first one) and the final:

 

member name was added

drug names where capitalised.

 

If you check the information you provided when you joined the site (which is only visible to you and staff) you state:

 

I am currently tapering off prozac and switching to pristiq