Rachael - tapering Pristiq

[rachael]

Hi all,

 

I'm new and have been reading the forums for a couple of months and I have to say everything I have read so far has given me hope and a new found attitude towards my health and well-being. I'm ready to take control and be accountable for what I do and do not do to my body.

 

I have always trusted in doctors and medical professionals; it gets instilled in many of us from a young age that if you're sick, the doctor will help. Unfortunately for me, and probably many others, it was like a "blind faith" and I never thought to question my doctor's opinion and trusted he/she knew what they were prescribing; that they had taken the risks and/or side-effects into consideration before they scribbled away on their pad and had me tottering off to the pharmacy. 

 

I realise now that this is, sadly, not true of the medical professionals that I have trusted with my care.

 

I lived at home until I was 21. My childhood had a rocky start with my father abusing (beating) myself and my siblings. It went on for years. I was about 5 by the time I told my mother, and 6 by the time he had gone to prison. I had good support, my mother took me to a child psychologist to talk about what had happened and I think I dealt ok with it. I often had nightmares, or imagined things had turned out differently and I would work myself up and cry, but I didn't feel truly sad or depressed about it; it was what it was.

 

I think the hardest part for me came a lot later, years later. When I was at uni and out in the real world, dealing with real relationships and people and stress and responsibility. My family never talked about what had happened with my father, we all knew it had happened, but whenever any conversation came close to the subject, someone steered it away. We just, never talked about it. All this time I still had, on occasion, fantasies about what had happened, what might happen, and eventually I had convinced myself that it hadn't happened. No one wanted to talk about it, so maybe it didn't really happen the way I remembered. Maybe I made it all up? Did I ruin my family by making it all up? So many maybes and no way to sort them out.

 

My self-esteem was never great. I was very shy and had a lot of problems talking to people. Add to this my conviction that my childhood hadn't happened the way I thought it had, that I had made it all up, and you get me 10 years ago: low self-esteem, self-doubt, guilt. 

 

I guess this wasn't so bad on its own, a lot of people suffer from these things; they aren't pleasant, but they aren't the end of the world. The real problems started when I began a romantic relationship. I had dated guys before, but I saw this as my first adult relationship. It all went well at first, but I had massive, MASSIVE, blinkers on (hindsight huh!). In short, he was manipulative and emotionally abusive. I knew the entire time I was with him (4 years) that he wasn't good for me, that I deserved better, but my bags of low self-esteem, self-doubt and guilt convinced me that it was better to be in a relationship than be alone.

 

When I was still living at home and going to uni, we had a big bust up which sent me into a guilt and shame spiral, even though he was the one that did something wrong, he manipulated me into thinking it was my fault. My friend found me at my desk, head down, exhausted. She suggested I talk to a doctor and I did. He prescribed me Zoloft and I didn't sleep for two weeks. 

 

That was my first contact with anti depressants, and after not sleeping for two weeks (not literally of course, I'm sure I fell asleep at some point each night, it just didn't feel like it) I was a zombie. I chucked those pills away, not thinking about the consequences of going cold turkey. I figured it was fine because it had only been two weeks, and they're just "happy pills", right?! What could go wrong. 

 

I was ill. I felt like I had a really bad flu and was in bed for a few days until my body adjusted. I didn't realise I was having withdrawal symptoms, I didn't know there was such a thing, my doctor had said nothing about it. I got over it after a few days and didn't think of it again.

 

My boyfriend planned to move states, back to his home-town, and me being me, I followed. Things were ok for a while, but he wore me down slowly. I let him. I didn't stand up for myself and one day I was standing in the shower crying and I didn't know why. He told me there was something wrong with me and that I had to go to the doctor. So I did.

 

The doctor I found was quite good. We talked about how I was feeling, what my options were, how he normally deals (medically) with these issues, and we decided to start me on St John's Wort. He told me of the risks involved and that I had to be careful taking it. I took it for about 6 months, but didn't notice any significant improvement, so I went back to the doctor again, but because it was a Saturday and I was desperate, I had to make do with the on-call doctor.

 

My first impression of him was horrible. He was rude and arrogant, and made me feel like I was wasting his time by "being a little bit sad". He was completely flippant about how I was feeling that it made me feel worse. Nevertheless, he prescribed me 20mg Cipramil (Citalopram) and said I should talk to the clinical psychologist that worked at the practice.

 

I left feeling like s**t. I went to the pharmacy, got the prescription filled and drove to the beach. I sat in my car and watched the waves crash against the sand. I pulled a pill from the box and just stared at it in my hand for the longest time. Eventually I just shoved it in my mouth and swallowed.

 

And that was the start. I was on 20mg Cipramil for a few years as well as seeing the clinical psychologist which helped a bit, but I don't think I really, truly had a grip on what was wrong with me, so I was just "going through the motions", thinking I was getting better.

 

I ended up finally standing up for myself and getting out of that relationship. I met my current (wonderful) partner, who is now my fiancé a few months later. Things were great, I felt great, but I still hadn't dealt with my initial problems, and when work became stressful, I unravelled.

 

I went back to the doctor, yet another new one (same practice though), and she had me fill out a quick form about how I felt and then gave me a few sample boxes of 100mg Pristiq (desvenlafaxine) and sent me on my way. There was no talk about the drug itself or possible side effects, and at the time I was still naive enough to not question. When I got my prescription filled, there was no information leaflet in the box - there still isn't today (Oct 2013) - and I didn't think to research it.

 

I started taking the Pristiq and after a few weeks I felt ok. I didn't feel like laying in bed all day, I wasn't crying at the drop of a hat, I was better able to manage the work stress. Overall I felt better than I had in months. I continued taking the drug and at subsequent doctor visits I would get a new prescription. I remember asking about when to come off the drug, and my doctor said I had to be on it for at least a year if not more. I don't remember if she offered any reasoning behind this length of time, but me being me again, I blindly accepted it as truth.

 

I eventually switched to another doctor within the practice after my current one left, and although she is nice, my first appointment with her didn't fill me with confidence. All I took from that first appointment was yet another prescription and the advice to get some exercise and read "the good book". I don't know which book she was referring to, I can only assume she meant the Bible. I'm not a religious person, and while I didn't take offence, I was pretty angry and baffled by the suggestion and that the Bible would "cure" my depression, like it was a misunderstanding or that a lack of religion was the cause of my depression. (Now that I think back on it, I'm getting offended by it.....calm blue ocean, calm blue ocean...rainbows and puppy dogs...).

 

Anyway, over the last two years, every time I have had an appointment with this doctor, I have had to correct her case history of my prescriptions. She is constantly under the impression that I have only been taking Pristiq for a "couple of months". I find this pretty annoying, but I'm not a confrontational person, so I don't say anything other than to correct her.

 

She wrote me a prescription for 50mg Pristiq about a year or so ago and said that I could start taking this when I felt better. I was really apprehensive as I was still going through stress and I hadn't sorted out or dealt with my underlying feelings of inadequacy and low self-esteem, etc. So I kept going.

 

It wasn't until my fiancé and I had a rough patch that started in late 2012 and ended just recently that I realised I needed to get a handle on things. I was just drifting through life, not really engaging and as I thought more and more about it, I realised that I was a zombie, a robot, and it was really, really difficult to remember things. Even now, I can't remember most of the conversations I've had with people over the last few months, it's like the words reached my ears, and I engaged with them, but there's no record of it. Sometimes I will have just spoken with someone and have no idea what it is they said; I remember the context, but not the actual words. It's pretty scary. It's like there is a warm fuzzy blanket over my brain.

 

During our rough patch, I was seeing my psychologist and a counsellor. The counsellor really, really helped. My psychologist has helped a great deal too, but I found the counsellor to be a much better resource for me. She helped me to figure out and really focus on how I was feeling, which has led me to where I am today.

 

Once I started feeling better and more in control, with the help of the psych, counsellor and my wonderful fiancé, I decided that I no longer wanted to take antidepressants. If I am going to be stressed, or sad, or frightened or anxious I want to face it and deal with it. I don't want to put a warm, fuzzy blanket over the difficult feelings anymore, because they're still there, they haven't gone away. I want to talk about things, really talk, really understand, really deal, and be here, for real.

 

I got my prescription for 50mg pristiq filled and started taking it. I think it was a Sunday. I felt fine all week until Friday night. It was raining and our electric gate becomes dodgy in the rain. We ordered pizza for tea and after about an hour I picked up my phone, which I had left on silent and there were 3 missed calls from the delivery driver, saying he couldn't open the gate to deliver our pizza. I managed to call the company and get him to come back, and by that time it was fairly terrible pizza. In rushed the guilt - I had missed the calls because my phone was on silent, it's my fault the pizza was terrible, what must my fiancé think, I can't even get a pizza delivered...and on and on down the irrational road my brain skipped. I Iay on the couch and cried over pizza. My fiancé didn't know what to do. It was a fairly quick episode and I went on watching TV, not thinking much of it.

 

The next day I couldn't focus on one thing for more than 10 - 30 seconds. Literally. I was fidgetting, picking things up to put them away, only to abandon them somewhere between where I picked them up and where I got distracted with something else. I picked up 4 books to read, only to put them down again, I started to get my old knitting project out, put it back, cross-stitch project out, put it back, start a computer game, quit, start another, quit. It drove my fiancé crazy. Eventually I settled on watching some TV and calmed down. The next day (Sunday) we talked and I decided to go back up to 100mg. It was only then that I realised that the headache that had been in the background all week was getting worse. I went to the chemist and they gave me the strongest over-the-counter pain killers (1000mg paracetamol and 12.5mg codeine I think), and I took them for a week before the headache went away.

 

I started researching coming off antidepressants and found a new term: antidepressant withdrawal. What I had gone through the last week was a real thing and I wasn't the only one suffering. I read more and found the 10% taper method in these forums and read associated links and materials and finally had a good idea about how I needed to do this.

 

I went back to the doctor and told her that I had gone down to 50mg and had suffered headaches, fidgetting, and mood swings and that I wanted to come down slower. All she heard was "mood swings" and told me that it meant I had to be on the higher dose. After all the reading I had done, I finally realised that even though she was a doctor, she didn't really know how to deal with depression or the medication she had been prescribing me. But I knew what I wanted, I wanted out. So I managed to convince her that I was ok and still wanted to come down, and that my crying episode was just because I felt crappy having had a headache all week.

 

She then told me that I should cut the 50mg tablet in half and take 75mg. I know there have been some success stories posted here where people have done this (cutting Pristiq tablets), but at this point, I felt she was reaching at straws; uninformed. I didn't want to be an experiment anymore, "try this, see how you go". If I was going to try anything, it would be my way.

 

I mentioned the compounding pharmacy I had found and asked if that would be a better way to go. She just said they wouldn't be able to make my medication for years to come because it isn't a publicly available formula. I had already done some research and suggested that they could just crush the 100mg tablets and make me a dose of 90mg instead. She waved me away, saying "no no". 

 

This was my last attempt, so I accepted her prescription and went to the compounding pharmacy the next day. They were a little skeptical at first too: "oh yes I've been there too honey, it's not nice, but you're doctor knows what they're doing", "you should be fine with this dose". But I was insistent that I was tapering in 10% doses. They spoke to the pharmacist and it was all agreed and my 90mg tablets were ready to pick up a few days later.

 

It's gone very well so far, I have been taking the 90mg for a month now. I have had 3 "brain zaps" so far, which have been in the evening, and not too serious or unpleasant - I was disoriented for a couple seconds and my brain felt kind of heavy (if such a thing is possible!).

 

I have ordered my next batch at 80mg which should be ready this week.

 

I'm feeling so good at being in control!

 

[Jemima]

Hello, Rachael, and welcome to the forum.  Please keep in mind that a slow taper means tapering by 10% of the current dose, not 10 mg. at a time. If I were you, I think I'd wait to make another cut until you're certain the brain zaps have stopped. Apparently a 10% cut was a bit much for you.  Lots of our members have found that cuts of 5%-7% work better.  10% is the merely the upper limit for any one cut, not an amount that works for everybody.

 

Here's our discussion on the basics of tapering:

 

Why Taper By 10% of my Dose?

 

And here's a specific one regarding tapering off Pristiq:

 

Tips for Tapering Off Pristiq

 

Some people have found it helpful  l to switch to Effexor and make their own liquid from the tablets, but I'm not sure if the tablet form of Effexor is available in Australia.

 

 

In any event, I'm glad you found us.  You'll find lots of good information and friendly support here.

[rachael]

Thanks for the welcome, Jemima, and thanks for the advice! I have decided to stay at 90mg for now - managed to catch the chemist before he had started making my prescription. I was sick over the weekend and ended up missing a tablet which threw me for six - dizziness and nausea ensued, and I'm still feeling the effects a bit.

 

Last night I was really stuffed up with hayfever-like symptoms. I do suffer from hayfever, so I'm not 100% sure if it was hayfever or a withdrawal symptom. So, better safe than sorry, I'll stick to the 90mg for now.

[Altostrata]

Welcome, Rachael.

 

Good for you, you got the tablets compounded. Please continue to let us know how you're doing!

[rachael]

Update for 23 Oct 

 

Was SO fatigued yesterday. I was tired all day, but managed to make it through work without falling asleep. My fiancé picked me up from work about 4pm and I slept all the way home - about 40ish minutes - I just couldn't stay awake. As soon as we got home I went to bed and slept until about 7.30pm, got up, had some cereal for dinner and went straight back to bed and slept until 6am this morning.

 

I have had this sort of fatigue before - my doctor had told me to take 4 Vitamin D tablets daily since December last year, because my levels were dangerously low, and I have done that religously and felt much better for it. I think I can attribute this episode to missing my tablet over the weekend, but it still sucks.

 

Feeling a lot more energized today, not back to my "normal" levels yet, but getting there. 

[rachael]

Update for 29 Oct

 

Feeling much more stable than last week - missing tablets really screws with me.

 

Haven't had anymore brain zaps, feeling much more energized and no mood swings. I've had a (minor) headache since yesterday afternoon, so I'm keeping track of it and making sure I drink lots of water.

 

Overall: Feeling good

[rachael]

Been doing really well the last 2 months, no brain zaps or headaches, so I have gone down another 10% starting today 

[mammaP]

Hi Rachael, I just read your story, what a time you've had! Well done for sticking to your guns and getting the

compounding pharmacy to make up what you need, I take my hat off to you for being strong enough to

stand your ground. I'm glad you are feeling better and hope your taper goes well for you. Thank you for

dropping by to keep us udated.