Mattie: tapering off Pristiq

[manymoretodays]

5 hours ago, Mattie said:

I’m in a panic!! I accidentally doubled my dose last night!! Will this hurt me and set me back? How could I have been so careless ugggh!!😭

 

And oops......it happens Mattie.  You'll just have to ride it out.  It may or may not cause much disruption to your healing now.  How is today going?

 

4 hours ago, Mattie said:

When you take so many antidepressants in a short period of time as I have, are the withdrawals from the current medication you are tapering off of or all the antidepressants you’ve taken in the last couple years?

 

A little bit of both.  The protracted WD that you are already in, and then new WD symptoms perhaps on top of that.  Expect the Windows and Waves pattern of stabilization.

 

And.......fortunate, in that you might feel some further stabilization as you get into splitting your Pristique dose soon.  Hopefully, you won't suffer symptoms all day, until evening anymore.  So, keep us posted/updated as you get that going.

 

And tips in the way of non-drug coping you can begin to practice,  that may help you with that "worse than it ever felt before" symptom of anxiety/fears.  WD anxiety is often very different from what ever symptoms you first encountered when going on meds/drugs.  Just know it won't last forever either, with current intensities.

Symptoms and Self Care forum

Non-drug techniques to cope with emotional symptoms

and there is all kinds of good stuff with links to indexed in the first post ^

More anxiety specific:

https://www.survivingantidepressants.org/topic/13669-ways-to-cope-with-daily-anxiety/

 

*https://www.survivingantidepressants.org/topic/10964-the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system/

 

https://www.survivingantidepressants.org/topic/6122-relaxation-exercises-guided-meditations-calming-videos-sleep-hypnosis/?/topic/6122-good-links-for-anxietyworry/?hl=%2Bmindful%2B%2Bmeditation

 

L, P, H, and G,

mmt

 

 

[Mattie]

Many more todays, thanks for your response, I already feel so horrible all morning that it didn’t make much of a difference although my fear and anxiety was worse today, my depression is horrible everyday, I have to use extreme mindfulness to get through till late afternoon, it’s 3pm now and the wave is less intense but I felt drugged all day long from the extra dose, I started reading the different self help etc on this site every evening that I get a window. So grateful for this group, it’s very lonely to go through this since family and friends can’t truly understand and having you all makes it more bearable, thanks again 😊

[Altostrata]

On 9/19/2022 at 5:55 PM, Mattie said:

also is it normal to feel lightheaded and loopy all the time especially when my anxiety kicks in?

 

On 9/21/2022 at 6:36 AM, Mattie said:

Sorry for all the questions but I feel you good people are all I have to hold on to my sanity, I forgot to mention I tried HRT for 19 days and I think it was making me feel worse so I got off of them, could that short duration on them be also why my withdrawals are so bad? I’m 101 days and can’t seem to stabilize even a bit. My last drop I would have bad days and a bit better days but this go around I feel no relief until around 7pm , I’m only existing 

 

@Mattie you have been taking a drug with a very short half-life once a day when you should have been taking it in split doses. You probably have had interdose withdrawal every day. Taking Pristiq in split doses 12 hours apart may reduce your symptoms.

[Mattie]

Thanks, that gives me hope! I had spoken to my Pharmacist a while back and he said they do add a time release and he said it covers 24 hrs so I assumed it did 

[Altostrata]

No, whatever they add does not cover 24 hours.

[Mattie]

Wow I’ve been tapering that way for over 7 months, so glad I joined this knowledgeable group, hope this helps me , fingers crossed! Thank you and the others for your responses , still waiting on psych for my new script, should hear by tomorrow 

[Mattie]

Will I eventually stabilize? Is 3 1/2 months a long time not to stabilize?

[Altostrata]

23 hours ago, Altostrata said:

you have been taking a drug with a very short half-life once a day when you should have been taking it in split doses. You probably have had interdose withdrawal every day.

 

You were destabilized every day, when the drug wore off. Your stabilization period will start when you are taking split doses.

[Mattie]

So because I have to take one of my doses 1 hr earlier everyday until I get to 12 hrs apart does that mean I won’t begin to stabilize for another 12 days? And how long after I get to an even split will it take to hopefully feel a difference? Thanks 

[Altostrata]

If you take the compounded Pristiq only once a day, you will not stabilize because you will get interdose withdrawal every day.

 

Dividing the dose should make you feel gradually better. Once you get to doses 12 hours apart, it will take about a week to get to steady-state.

 

I cannot predict how long it will take you to stabilize after that, but you should feel better than you feel now.

[Mattie]

Thank you so much 😊 

[Mattie]

I have not started my twice daily dose yet, still waiting for them to come in the mail however I did get a window of sorts yesterday for the first time in months but today I’m back in a wave ,I guess I should be hopeful that it will happen again soon especially after I start my twice daily dose 

[Mattie]

Any thoughts on magnesium l threonate ,I read it was good for brain health of transmitters, plasticity, etc and crosses the blood brain barrier 

[ChessieCat]

Post #1 of this topic has information about different types of magnesium:

 

Magnesium

 

It is suggested to only make one change at a time and to start with a small dose to see how you react:

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

[Mattie]

Thanks 

[Mattie]

I’m concerned that my compounding pharmacy had to consult with someone else to find out how to divide my dose, I’m extremely sensitive and I’m also concerned as I get lower they will only be able to do 1/2 mgs as the smallest amount, so I’m currently on 18 mg divided by 2 doses 9+9 so my next drop would have to be 17mg(  8.5x2) etc, what will I do when i get lower and lower? Should I have stayed on pristiq 25 and weight and fill my own? Feeling panicked!

[ChessieCat]

When it comes to getting what we need to do a careful taper we sometimes have to do some extra work.

 

If a pharmacy does not know how to compound the drug they can contact the compounding association in your country.  My compounder was able to make 0.125mg capsules.  He said they can make any dose required however below 0.125mg it takes a lot of time and therefore the cost goes up.

 

Please have a look at this topic, especially Post #1 which includes information on how the prescription needs to be written (in the USA):

 

getting-compound-custom-dosages-at-compounding-pharmacies-us-uk-canada-and-elsewhere

 

There was an SA member whose pharmacist told them that the drug they were taking could not be compounded (and I know that it could be) so I contacted the association directly and got the following response:

 

getting-compound-custom-dosages-comment=416313

 

[Altostrata]

Ordinarily, a compounding pharmacy can make up any dosage for a capsule.

 

A decrease of 1mg from 18mg is only 5.5%, reducing by 1mg at a time might be a tolerable taper that's 10% or less until you get under 10mg.

 

Even if the smallest capsule they can make is 0.5mg, you would not have to decrease from 18mg to 17mg per day, you can decrease to 17.5mg per day, less than a 3% decrease. Your doctor should write a prescription for split doses, such as "9mg in the morning and 8.5mg in the evening".

[Mattie]

@altostra, thanks, that eases my mind, I would have never thought of that, thankful for your help 

[Mattie]

This may sound like I’m being I obnoxious but I just got a new pair of prescription glasses and I can’t bring myself to go through the phase of adjustment because it makes my withdrawals and especially anxiety feel worse. I looked it up and it says your brain has to adjust to them, could what I’m feeling sound real to you? All the normal things I had to face before is so extremely difficult leading to a constant feeling of despair. On a good note my meds are finally in and I will be taking my devided dose tonight. Should I wait till my devided dose settles before I try to adjust to my glasses? 

[ChessieCat]

11 hours ago, Mattie said:

Should I wait till my devided dose settles before I try to adjust to my glasses? 

 

It is very stressful changing to new prescription glasses (your brain has a lot of work to do) and yes I think it would be a good idea to wait.

 

My glasses provider also told me not to switch back and forth between the two sets of glasses.  Put on the new ones and stick with them.  When you first start wearing them I suggest that you do so in a familiar and safe environment; perhaps put them on first when you are not moving around.  So for example, start using them at home at the beginning of the weekend whilst you are doing your normal routine things.

 

I observed this recently and I think it is a good example of how the brain works.  I had to dig a hole in my front yard and it was muddy and I got clay on the bottom of my shoes.  I had a thick clump on one shoe but not the other.  My front yard is very uneven (it has never been leveled) and I had no issues walking around the yard with the lump of clay on one shoe.  However, as soon as I walked into the garage which has a level concrete floor it was very weird how immediately I had difficulty walking with the clay on my shoe.

 

Also, recently, I've had times where my eyes just couldn't seem to adjust properly (I have graduated multifocal lenses) when I have been driving.  I fiddle around trying to get them in the correct position but I can't get them right.  I have found that taking them off completely and looking without glasses for a few seconds (yes I am very careful) then putting them back on my vision seems to go back to being okay straight away.  I have done this quite a few times now and it happens every time.

[Mattie]

@CheesieCat thanks, I have multi focal lenses as well so I’ll definitely wait 

[Mattie]

I took my split dose last night 9 mg 6:30 and 9 mg 7:30 (normal time) I feel horrible this morning, I hope they compounded it right. Is this to be expected feeling more off than usual? Will my body have to adjust? I’ve been suffering for so long just feeling hopeless, need encouragement please, depression is the worst 

[Mattie]

Since I’m extremely sensitive to any med change, can I hold for a few days each time I change the hr that I have to go down on my 1st of 2 daily doses or it’s better to  just get it over faster

[manymoretodays]

Hi Mattie,

You could hold and move by an hour every couple of days.

Don't make the possible mistake of thinking that one days symptoms are something permanent though.

Do you have any soothing calming anti fear/anxiety practices in place yet that you find helpful?

 

I just am hoping that once you do get your dose split, and have settled into a 9 mg dose every 12 hours, that you WILL see and feel improvement overall.  So I don't like to see you delay too much.

It is however, your body, and nervous system........and you perhaps are more the expert on that than I.

So.  You will be the ultimate authority and deciding factor now in how you continue to work the split dose.

 

Okay, you are doing good.  Maybe it's just a bump, or a wave right now that is happening and it will pass soon.  My fingers are crossed.  Our nerves do tend to be up and reactive early on in this process.  So hang in there.

 

Best, L, P, H, and G,

mmt

[Mattie]

manymoretodays thanks, I do have to work on my fear and anxiety any suggestions? My anxiety leads me to believe I’ll be like this forever 

[ChessieCat]

https://getselfhelp.co.uk/anxiety-self-help/

 

the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system

There are YouTube videos.  Do a search on YouTube for Claire Weekes.

 

Non-drug techniques to cope

[ChessieCat]

I did a search on YouTube and found this.  They are NOT in  chapter order:

 

"Hope and Help For Your Nerves" by Dr. Claire Weekes

 

[Mattie]

@ChessieCatthanks I’ll definitely read 

[Mattie]

I feel so horrible, like when starting a new med and I’m so spaced out feeling, extreme fatigue and no reprieve of symptoms at night is this normal to feel this way when starting a divided dose? Last night was night 2 of divided dose , going down 1hr every night 

[Mattie]

Took 3rd split dose today. I’m at 530 and 730 pm. I was gonna hold each hr going forward for 2 days each but decided to do like you suggested. My question is will the sleepiness I feel after my earlier dose level off? I always took it at night and I slept all night, I hope it levels off because I don’t know if I can handle this on top of what I’m already feeling ugh 😩 

[Mattie]

I’m now at 3:30 and 7:30 pm of a split dose, I did have a bit of a window earlier today but after I took my 3:30 dose I could feel the effects of the meds ( drugged feeling and also depression) I really believe this medication is the reason I’m depressed. I’ll keep going down till I hit my 12 hr apart doses, hopefully when it reaches steady state I’ll not notice as much, thanks for continued support ❤️

[Mattie]

@ChessieCat, is it normal to feel worse during this transition from one dose to divided dose? 

[Mattie]

please someone reply, I’m totally unfunctionable since making this switch, I was told by a group member on another site that she got information here about compounding pharmacy adding Methocel (she learned from surviving antidepressants ) and her daughter has been tapering for a year and a half and is fine at a single dose and is fine. Can anyone please explain about Methocel and tell me if it covers 24 hrs or not? My CNS must be extremely destabilized that I’m reacting so poorly, thanks for your help 

[manymoretodays]

Hi Mattie,

So you started splitting the dose by 1 hour on October 1st, last Sunday?

And now have it at:

3:30 pm- 9 mg Pristiq (compounded)

7:30 pm- 9 mg Pristiq (compounded)

 

Are you spending too much time online and reading negative reports by any chance?  That can affect things for some, as far as if you expect the worst.....what do you think you might get?

 

Methocel.  I have zero experience with.  Here's what I found by googling survivingantidepressants.org methocel

https://www.google.com/search?client=firefox-b-1-d&q=survivingantidepressants.org+methocel

 

It sounds like it is just a thickener, not anything that makes it extended release.  I could be wrong.

 

3 hours ago, Mattie said:

please someone reply, I’m totally unfunctionable since making this switch, I was told by a group member on another site that she got information here about compounding pharmacy adding Methocel (she learned from surviving antidepressants ) and her daughter has been tapering for a year and a half and is fine at a single dose and is fine. Can anyone please explain about Methocel and tell me if it covers 24 hrs or not? My CNS must be extremely destabilized that I’m reacting so poorly, thanks for your help 

 

And okay......try not to over compare with someone's daughter who is fine on a single dose each day. 

Were you fine on a single dose each day Mattie?

 

Stay put for now.  And show us what a day looks like for you right now.  Do this in a objective way via NOTES.  It's just that I have no idea what your completely un functional means.  And it is really helpful to see how symptoms go, both before and after you take your drugs, and in a 24 hour period.  So please give a try.

Recording drug schedule and symptoms to track patterns and progress

Here's a sample/example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

 

And no doubt Mattie, that you are pretty sensitive now to any little drug change or addition, you had so many changes happening prior to arrival.  So hang on. 

 

Anything else you've done, or that you've added to your regimen since beginning the split?  Drugs, supplements, alcohol, or any life stressors that have arisen?

 

Oh sweetie,  best,

L,P, H, and G,

mmt

[Mattie]

Thank you so much for your reply, I will make a 24 hr report and post tonight before bed or tomorrow morning, thanks again, I was so relieved to hear from you ❤️