Komp: Advice Needed

[Komp]

I am still on Pristiq and busbar. Gabapentin is not agreeing with me. I need to go off if it. Becky

[Shep]

There are a number of drug interactions, including a MAJOR drug interaction between Buspar and Pristiq and Moderate interactions between Gabapentin and the other two drugs. Please see:

 

Drug Interaction Report - Buspar, Pristiq, Gabapentin

 

What time(s) of the day are you taking each of your drugs? You may be having drug interactions more than a side effect of the Gabapentin, so you may want to space your drugs out so they're at least 2 hours apart from each other. This will help with drug interactions. 

[littlebird]

Just wanted to pop in and say that Shep suggesting that every 2 hours schedule to me made a huge difference! I was on all these too, and taking them together in a handful every day. It took a little bit for my body to get used to the lack of interaction, and for my brain to get used to taking pills every 2 hours, but I started feeling better right away when I started spacing everything out.

 

Didn't even know Buspar was interacting with Pristiq, tapered off that before I found this site, but it makes sense. I had no idea how much the drug interactions from all of these were affecting me until they weren't. Hope you find relief soon!

[Komp]

4 hours ago, Shep said:

There are a number of drug interactions, including a MAJOR drug interaction between Buspar and Pristiq and Moderate interactions between Gabapentin and the other two drugs. Please see:

 

Drug Interaction Report - Buspar, Pristiq, Gabapentin

 

What time(s) of the day are you taking each of your drugs? You may be having drug interactions more than a side effect of the Gabapentin, so you may want to space your drugs out so they're at least 2 hours apart from each other. This will help with drug interactions. 

I Take Pristiq and Buspar together in the morning. I can take them 2 hrs a part. What order would you recommend?

[littlebird]

1 hour ago, Komp said:

I Take Pristiq and Buspar together in the morning. I can take them 2 hrs a part. What order would you recommend?

 

The mods probably have better advice than I do, but for me I had to look at which one I needed. I tend to get anxious easily, so I start the day with Gabapentin to soften the blow of the activating antidepressant I take later.

 

Personally, Pristiq makes me super sleepy and foggy (which I was reading is not typical) so I moved it to later in the day. It was really messing up my workflow! Now I take it at night.

[Shep]

7 hours ago, Komp said:

I Take Pristiq and Buspar together in the morning. I can take them 2 hrs a part. What order would you recommend?

 

The worse drug interaction in your cocktail is Pristiq combined with Buspar because it increases your risk of developing serotonin syndrome. 

 

How do you feel in the mornings before you take Pristiq and Buspar and how do you feel after? 

 

It looks like you started Buspar after you were already on Pristiq. Is that correct? Was Buspar added on to help with anxiety from taking Pristiq? 

 

We recommend tapering the stimulating drugs first and leaving the sedating drugs to taper last. This helps preserve sleep. Please read at least the first post in this thread: 

 

Taking multiple psych drugs? Which drug to taper first?

 

You may want to taper Pristiq first. By moving these two drugs apart, you'll be able to see how each one effects you. 

 

Please post your thoughts on this. 

[Komp]

2 hours ago, Shep said:

 

The worse drug interaction in your cocktail is Pristiq combined with Buspar because it increases your risk of developing serotonin syndrome. 

 

How do you feel in the mornings before you take Pristiq and Buspar and how do you feel after? 

 

It looks like you started Buspar after you were already on Pristiq. Is that correct? Was Buspar added on to help with anxiety from taking Pristiq? 

 

We recommend tapering the stimulating drugs first and leaving the sedating drugs to taper last. This helps preserve sleep. Please read at least the first post in this thread: 

 

Taking multiple psych drugs? Which drug to taper first?

 

You may want to taper Pristiq first. By moving these two drugs apart, you'll be able to see how each one effects you. 

 

Please post your thoughts on this. 

I am going to Take Pristiq with breakfast and in 2 hrs take busbar. See if it helps to lessen with drug interaction.

[Komp]

I took 25mg of Pristiq at 8 am   At 8:30am I could feel an increase in my heart rate with brain fog. Do you think I’m having adverse affects to this medication?  Today was the first day I took it by its self. Usually paired with 7.5mg of busbar and 200mg gabapentin. 
Becky

[Shep]

7 hours ago, Komp said:

I took 25mg of Pristiq at 8 am   At 8:30am I could feel an increase in my heart rate with brain fog. Do you think I’m having adverse affects to this medication?  Today was the first day I took it by its self. Usually paired with 7.5mg of busbar and 200mg gabapentin. 
Becky

 

The busbar and gabapentin may be damping down some of the activation from the Pristiq.

 

That's a sign that you'll want to taper off the Pristiq before coming off the other drugs. 

 

 

Tips for tapering off desvenlafaxine (Pristiq)

Why taper by 10% of my dosage?

 

How many hours are you sleeping at night? Are the morning doses of Pristiq, gabapentin, and busbar the only drugs you take? Do you take any drugs in the afternoon or evening? 

 

[Altostrata]

@Komp it would not be unusual for you to find Pristiq stimulating. It could be this effect was masked by the gabapentin and buspar that you were taking with it.

 

If you don't like this effect of Pristiq, I agree with @Shep, you'll want to reduce it instead of piling on drugs to mask it.

[Komp]

I’m so confused and not doing well. I think taking Buspar is causing me great anxiety. My dr said to try reducing the dose from 15mg to 10mg daily. My poor brain. 

[Komp]

I am sleeping ok I take other meds after dinner. Buspar, vit D, Lisinopril, metformin, Atorvistan and multivitamin. I take 200mg of Gabapentin at bedtime. 

[Altostrata]

@Komp you started this topic in December 2021. Since then, we've had to ask you many times if your intention was to reduce your drug burden. Since then, you've increased your drug burden.

 

You and your doctor are mixing up drug cocktails that seem to make you feel awful. You have been doing this continually since December 2021.

 

As we've told you many times, we do not provide free peer support services to get you comfortable on your cockamamie cocktail, that's your doctor's job.

 

We have identified Pristiq as causing an adverse reaction. It's your decision if you want to continue to take Pristiq despite this adverse reaction. It's your decision to play with your Buspar dose instead if you want to. 

 

This topic provides links to how to taper most psychiatric drugs. You can look up each of your drugs and if you want to reduce one, talk with your doctor about the appropriate tapering techniques.

 

Please do not bring your questions to us. Your needs are beyond peer support here.

 

[Komp]

I agree. My current doctor sucks. He will not take me off of Pristiq b/c it’s too difficult and it’s helping me with my depression!!  What I’m I suppose to do??

[Altostrata]

You can decline your doctor's recommendation of new psychiatric drugs. We can't talk to your doctor, and we can't prescribe. If you want to go off Pristiq, you'll have to figure out how to make it happen. Maybe get a different doctor. Read Tips for tapering off desvenlafaxine (Pristiq)

 

[littlebird]

7 hours ago, Komp said:

My current doctor sucks. He will not take me off of Pristiq b/c it’s too difficult and it’s helping me with my depression!!  What I’m I suppose to do??

 

You can request a new doctor. I stuck with bad psychiatrists way too long, but if he's not on the same page as you, you're allowed to request a new one.

 

In the meantime, you can tell him you want to try a lower working dose then taper slowly and safely to it. You're on 50mg, and it comes in a 25mg, so there are options. I tried listing all the ways Pristiq wasn't working for me, and saying, "I want to find a lower dose."

 

No matter what, I've had to take things into my own hands. Even if I convinced a doctor to taper me, he'd always take me way too fast or do it in an unsafe way (like taking Pristiq every other day, not a good idea). 

 

It's hard to not feel heard by your doctor! You aren't required to take more meds, he can't make you take another one.

 

20 hours ago, Komp said:

I think taking Buspar is causing me great anxiety. My dr said to try reducing the dose from 15mg to 10mg daily. My poor brain. 

 

The doctor that prescribed me Buspar told me lower doses can be better for anxiety, and higher doses can have a paradoxical effect and make it worse. Going from 15mg to 10mg right away seems fast though.

 

Whatever you choose to do, please just pick one to start with!

[Shep]

@Komp This thread may help:

 

How do you talk to a doctor about tapering and withdrawal?

 

The Mad in America website is a site dedicated to moving psychiatric care away from the drugging model. They have a recommended provider directory here:

 

MiA - Provider Directory

 

And here is SA's list:

 

 

Recommended doctors, therapists, and clinics

 

Unless you're on forced treatment for some "mental illness" (whatever that means), it's up to you whether or not you want to continue on with your doctor's reckless prescribing. The information to taper is here on this website for the taking. 

[Komp]

Thank you Shepherd and littlebird. I have a new doctor on board. I will let her know how I feel about my current drug “cocktail”.  I want off of all of them. I appreciate all your help. I will keep you updated. Thanks! Becky

[Komp]

Thank you Shepherd and littlebird. I have a new doctor on board. I will let her know how I feel about my current drug “cocktail”.  I want off of all of them. I appreciate all your help. I will keep you updated. Thanks! Becky

[Komp]

Current doctor has suggested that I stop Pristiq at 50mg and start 10mg Prozac in order to go off of Pristiq. What do you think?

[Altostrata]

 

Tips for tapering off desvenlafaxine (Pristiq)

 

Make a switch to Prozac at your own risk.

[Komp]

Tapering off Pristiq with prozac

 

What is the success rate of tapering off Pristiq by bridging Prozac?

Edited April 15, 2023 by manymoretodays
merged from tapering, title added

[manymoretodays]

@Komp your new topic in tapering has been moved back here, and post here please Komp.  Thank you.

 

I don't think anyone has come up with hard data on bridging from any drug to Prozac and then success with tapering off the Prozac after that.

 

Is this what you are planning to do now with your doctor, as it's not something that we'd recommend you do on your own. 

 

And then.......... from the- Pristiq(desvenlafaxine) tapering topic:

"Bridging" with Prozac or another antidepressant
Any drug change incurs additional risk. A switch to Prozac from Pristiq may not work -- they are very different drugs -- or you might have adverse reactions to Prozac.

Prozac is regularly used to "bridge" off Effexor. Given that Pristiq is a sibling of Effexor and Effexor XR, it is possible that one can, similarly, use Prozac to withdraw from Pristiq.

Attributed to Joseph Glenmullen, the "bridging" technique is described by a doctor here http://www.bipolarworld.net/Phelps/ph_2005/ph1354.htm

Read this entire topic before attempting a switch to Prozac: The Prozac switch or "bridging" with Prozac

Later, taper off Prozac. At least Prozac comes in a liquid.

To do this, consult a doctor knowledgeable about this technique.

 

Sorry, we just don't have hard data on Prozac bridging to any drugs.  No luck getting started with a Pristiq taper then?  You came in on Effexor and Prozac, you can scroll back to see if need be....and so, I think you'd just be going in circles with a Prozac bridge now.  Anyway.......are you getting any of this, the concepts of tapering, and any ideas around how you might be able to start a Pristiq taper yet?  Oh.....I hope so.  Hang on and in.

 

Best, L, P, H, and G,

mmt

[Altostrata]

On 4/10/2023 at 10:04 PM, Komp said:

Tapering off Pristiq with prozac

 

What is the success rate of tapering off Pristiq by bridging Prozac?

 

We don't know. Sometimes it works, sometimes it doesn't.

 

It makes more sense to substitute venlafaxine XR for its sibling drug Pristiq, then taper by bead-counting.

[Komp]

On 4/15/2023 at 4:10 PM, manymoretodays said:

@Komp your new topic in tapering has been moved back here, and post here please Komp.  Thank you.

 

I don't think anyone has come up with hard data on bridging from any drug to Prozac and then success with tapering off the Prozac after that.

 

Is this what you are planning to do now with your doctor, as it's not something that we'd recommend you do on your own. 

 

And then.......... from the- Pristiq(desvenlafaxine) tapering topic:

"Bridging" with Prozac or another antidepressant
Any drug change incurs additional risk. A switch to Prozac from Pristiq may not work -- they are very different drugs -- or you might have adverse reactions to Prozac.

Prozac is regularly used to "bridge" off Effexor. Given that Pristiq is a sibling of Effexor and Effexor XR, it is possible that one can, similarly, use Prozac to withdraw from Pristiq.

Attributed to Joseph Glenmullen, the "bridging" technique is described by a doctor here http://www.bipolarworld.net/Phelps/ph_2005/ph1354.htm

Read this entire topic before attempting a switch to Prozac: The Prozac switch or "bridging" with Prozac

Later, taper off Prozac. At least Prozac comes in a liquid.

To do this, consult a doctor knowledgeable about this technique.

 

Sorry, we just don't have hard data on Prozac bridging to any drugs.  No luck getting started with a Pristiq taper then?  You came in on Effexor and Prozac, you can scroll back to see if need be....and so, I think you'd just be going in circles with a Prozac bridge now.  Anyway.......are you getting any of this, the concepts of tapering, and any ideas around how you might be able to start a Pristiq taper yet?  Oh.....I hope so.  Hang on and in.

 

Best, L, P, H, and G,

mmt

Currently on 25mg of Pristiq and 20mg Prozac. Still on gabapentin 400mg and Buspar 15mg daily. The goal is to get off all these medications. Wish me well. Komp

[Komp]

Currently going off of Pristiq with 25mg for the past 2 weeks and 20mg Prozac. 
still on buspar 15 mg and gabapentin 400mg daily. The plan is to go off of all these medications. Komp

[FindRest]

6 hours ago, Komp said:

Currently going off of Pristiq with 25mg for the past 2 weeks and 20mg Prozac. 

This makes me nervous for you. To me, that sure seems like a large dose of Prozac to begin your bridge with, especially after doing a 50% drop in Pristiq. Did you read the whole link on bridging w Prozac? I think one or two others referred to it in the above posts.
 

https://www.survivingantidepressants.org/topic/19373-the-prozac-switch-or-bridging-with-fluoxetine/#comment-13616

You can see by my tapering history that I have experience with Effexor, Prozac, and Pristiq. Our situations are different, but I sure am glad I switched from Pristiq to Effexor XR in order to taper. Just 10mg of Prozac after my system was destabilized by my Effexor ct resulted in some very scary symptoms. I wasn’t going to try that again. I realize your system may not be as destabilized, but many others have had problems bridging to Prozac from Pristiq. It’s a delicate process.
 

Do you know what your doctor’s plan is for the rest of the bridge? Please read the ENTIRE link above for your own safety. Also, if you haven’t read the entire link on tapering Pristiq, you’ll find some valuable advice in there as well.  

 

Wishing you the best.

Edited April 19, 2023 by FindRest

[Komp]

Hello!  I am currently off of Pristiq for the  past 9 days and on 30mg of Prozac daily. Never know how I’m going to feel each day. I also can take Clonazepam.5mg 2 times daily as needed. Mostly anxiety, acid reflux and insomnia. Hope I survive!

[Shep]

20 hours ago, Komp said:

Hope I survive!

 

We hope you do, too, Komp. Why are you adding in periodic clonazepam? You risk kindling due to your previous benzo use (you have Ativan in your signature and you've also posted about taking Valium).

 

Taking .5 mg Klonopin twice a day is a lot of clonazepam - it's a very potent benzo, 20 times more potent than Valium. 

 

All of these drug changes are likely to backfire.

 

Hypersensitivity and Kindling

[Komp]

Thanks for your response. I am taking .25mg of clonazepam each am while I am going off of Pristiq. Short term. I also went off buspirone  your wisdom and sharing are much appreciated. Thanks. 

[Altostrata]

Which came first, 30mg Prozac or the clonazepam?

[Komp]

April 3rd I was prescribed the clonazepam. Only took as needed. Now.25mg in am. 30mg Prozac started on April 25 when I went off of Pristiq. 

[Shep]

 

 

On 1/3/2023 at 8:19 PM, Komp said:

I think that kindling is most likely happening to me.

 

 

You wrote this at the beginning of the year, and I think this is a large part of your problem, Komp. Your cocktails have been full of not only drug changes leading to kindling, but also dangerous drug interactions. All of this takes a toll on the nervous system. 

 

The best advice we can give is to STOP MAKING DRUG CHANGES and give your nervous system time to catch up to these changes by holding. And then do a slow taper off these drugs without trying to fix withdrawal symptoms by adding in other drugs. There is no magic fix to withdrawal. 

 

The end result of kindling is crashing your nervous system. 

 

Please re-read your thread before posting again. I think it will help you see the numerous drug changes you've made along the way.  I don't see you getting off these drugs if you continue to do what you're doing. Unfortunately, we're not able to help everyone who comes to the forum. 

 

If you believe you need to be on psychiatric drugs in order to function and you believe your doctor knows what he or she is advising, then please continue to work with your doctor and not an online forum. Your drug changes are too complicated to sort out when you're constantly making changes. 

[Komp]

I agree. I plan to go off psych medications. They are causing me more harm than good. Thank you for your advice. You have helped me a great deal. Becky

[Komp]

Two weeks off of 25mg of Pristiq. High anxiety. 30mg Prozac to help go off Pristiq.  Doctor said today that my  anxiety is not from going off of Pristiq and that the Prozac should take over. Is she correct?

[FindRest]

8 hours ago, Komp said:

Two weeks off of 25mg of Pristiq. High anxiety. 30mg Prozac to help go off Pristiq.  Doctor said today that my  anxiety is not from going off of Pristiq and that the Prozac should take over. Is she correct?

I believe your dr is incorrect.

 

I already shared my opinion with you that 20mg Prozac during/after a bridge is a lot. Far more than is recommended. Yet, you are now taking 30 mg. Prozac is activating, especially with an unstable CNS. Increased anxiety would be the least I would expect.
 

I believe you are experiencing the after-effects of a Pristiq taper + Prozac bridge that wasn’t done in the best manner. 
 

I agree with Shep. Please go back and re-read your thread. You have been given lots of guidance, yet seem to ignore much of it. I’m not trying to sound mean or disrespectful. It’s your choice to do whatever you want with the information presented to you. We all must decide for ourselves. I just hate seeing someone suffer unnecessary consequences. I know you will eventually figure things out, as we all do.
 

Wishing you the best.

Edited May 10, 2023 by FindRest