ktp: weaning from 4yrs 50mg Pristiq

[Petunia]

I am happy to cross post an abbreviation of my taper history and observations to wherever you like; please say exactly which topic? there seem to be lots of pristiq threads here!

 

 

This is the main pristiq tapering thread:

 

http://survivingantidepressants.org/index.php?/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/

[ktp]

well this thoroughly sucks! I've written up my observations, edited like crazy, and have what I think is a worth-while 2 paragraph something worth posting to <that url you'll let me copy but not paste> but this editor won't let me paste that or my paragraph.  

 

Come on, admins!  Pasting is not a crime, and it's pretty obvious it's allowed for some users.  Come on, admins, lighten up for functionality.  There are much better limitations to impose, such as max characters or force plain text etc etc. 

[mammaP]

Alto, are you suggesting that I'm going to want smaller than 1 mg doses??   I really can't imagine why I'd want to make a liquid.  Why?

 

I am happy to cross post an abbreviation of my taper history and observations to wherever you like; please say exactly which topic? there seem to be lots of pristiq threads here!

 

 

mammaP, you could ask your generic supplier (mine is too) for TEVA-manufactured Effexor XR caps - TEVA's beads are mostly the same size and 1mg each, very handy.  I would mail you just one 150mg cap that would last you over a month but I'm not licensed for that sorry;-)

You will be surprised at how you need to taper that last 1mg!  I am now down to just 3 beads, less than 1mg but still can't quit yet!

The tiniest drop causes withdrawal symptoms.  400 beads to a 75mg capsule and have dropped only 2 beads in 1 year!  Drop 

very slowly and you will be fine, try and cheat and you only cheat yourself. There are no fast ways for most of us, I thought I was going slow

but was actually going far too fast and not accurate enough trying to count those beads! I am still paying the price. 

[Altostrata]

There are no limitations on copy and paste. Sorry you ran into a glitch. Try again.

[Hudgens]

You'll find out about the difficulties of tapering as you go along, how could you know at this point.

Because of this, though, it's crucial to listen to others who have more experience.

I mean, the more you take heed, the less suffering you'll have to do.

I'm not saying you're not listening, just emphasizing how important it is.

 

My current dosage is so small I need a magnifying glass to measure it accurately. And

I still get withdrawal symptoms when I reduce.

I'm talking about below the 1/10th of a mg range.

Stopping at 1mg for me would've been like dropping from a 10 story window. Probably the equivalent of cold turkey.

I've been tapering for almost 4 years-the last 2 below 5 mgs.

I don't think there's any way to do this and not experience some pretty unpleasant withdrawal, but there's a big difference between

tolerable and horrendous symptoms. Impatients is the enemy.

 

The other problem with counting beads is that even getting down to one bead only gets you to about a 1/4 mg, which, for me would've been way to high to end the taper on. Especially with Effexor-tiny amounts of the drug are quite powerful.

I'm not ending my taper until I'm down to one granule of finely ground solid Effexor. I want the drop into the post taper to be more like climbing out of a first story window. I want to be able to feel my feet firmly on the ground before I let go.       

[Petunia]

well this thoroughly sucks! I've written up my observations, edited like crazy, and have what I think is a worth-while 2 paragraph something worth posting to <that url you'll let me copy but not paste> but this editor won't let me paste that or my paragraph.  

 

Come on, admins!  Pasting is not a crime, and it's pretty obvious it's allowed for some users.  Come on, admins, lighten up for functionality.  There are much better limitations to impose, such as max characters or force plain text etc etc. 

 

I've run into this glitch a few times and have got around it by going 'more reply options' and using the full editor and/or using ctrlV rather than right clicking.

 

This site is free to use, run and maintained by volunteers, funded by donations only. We are doing the best we can, please try again.

[ktp]

drat and double drat time for a setback.  developed insomnia over past two weeks; I've tried adding a bit of xanax before bed and it's helped a little a couple times.  this insomnia is getting old fast, jumping back to 37.5 mg venlafaxine OPD.

[mammaP]

Hi KTP, have you been at 6mg since the 3rd?  I have a feeling that 37.5 may be too much for you.

You have tapered very fast and it has caught up with you, leading to withdrawal, but jumping back

to 37.5 is a huge increase. I would try 10 and have a long hold to allow your nervous system to stabilise.

It could take a while but you will get stable and feel better again. Please read the topic for tapering

effexor. It really is best to go slow, I found that out the hard way too! 

[ktp]

Thanks mammaP.  from my sig...

> 20140819 15mg 0821 13 0903 12 0911 11 0918 10 0921 9 0927 8 1001 6 1021 5mg/day **** symptoms!  did i skip a day? 

 

you are right, I went from 10 to 8 to 6 to 5 very quickly.  I think i may have missed a dose 1019 or 1020, too.  

 

> 20141103 back to 6, bit o xanax, insomnia getting worse, call it a setback: 20141111 back to 37.5mg venlafaxine.

 

agreed 37.5 is too much, i'll go back to 8mg.  20141112 8mg venlafaxine XR OPD.  

.  

[mammaP]

You need to leave a few weeks between cuts and you are cutting every few days which is far too fast.

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Please do your brain a favour and hold for at least few weeks before any more cuts to allow your brain

to stabilise. I know it's hard when you just want to be off but patience really does pay when it comes to

tapering these drugs. 

[ktp]

OK after my too-fast weaning screwup in october  i went back to 37.5mg Venlafaxine ER on 1115: Figuring that the doc would say to get back on and don't screw around about it, and 37.5 is the smallest ER Rx, it's a good compromise and was also easier to believe in than 8mg for knocking down symptoms asap.  Sleep is better again but not best yet; again i will slow down my wean and avoid getting too excited about it.  

BTW Thank you Hudgins for your post 8/22/14, lots of fair warnings from you and mammap..

[mammaP]

You would be wise to hold for at least a couple of months before starting to taper again. 

Glad that you are feeling better KTP. 

[ktp]

wow, tough lesson.  insomnia and anxiety continue, 1214 I doubled my Venlafaxine dosage to 75mg OPD, taking one in the afternoon.  Felt better 10 mins later, maybe placebo effect but maybe the encouraging sign that depression is gone, just get off  the meds.  Did that twice, same result 2nd time too.  Then I got a doc appt, at which he decided

1) back to 37.5mg OPD, MORNINGS.  xanax needed 10 mins later. 

2) force sleep a week with Lunesta, inconclusive results but felt better 10 mins after taking the extra 37.  

[ktp]

I've been pretty lucky to have got away with minimal use of the Lunesta and xanax; I'm now pretty stable at 47mg venlafaxine XR in the morning, and plan to stay at this dosage at least a couple months before trying to wean again.

 

question for anybody who reads this: is duloxetine (Cymbalta) easier to wean from than venlafaxine (Effexor)?

[Altostrata]

Hello, ktp. Sorry for the late response.

 

Seems that some people have just as much difficulty tapering Cymbalta. Are you thinking of switching to it?

[ktp]

thanks for attention; we're keeping you busy;-)  after screwing up my wean (see sig), 4 months later I'm currently at 50mg Venlafaxine XR and nearly stable but still seeing anxiety every morning.  I could kill it with a xanax but i'm really afraid of it, it's just sooo effective and so addictive.  so i would like to find a milder xanax, one I'll actually take.  

 

as for the Venlafaxine, I seem to get conflicting reports - 

    "some snri's are easier to wean than others"  

    "venlafaxine is THE most difficult wean"

 

okay, what's easier to wean than venlafaxine?  

and the obvious next question: can I switch?

[peggy]

hi ktp,

i am on venlafaxine too and agree that its very difficult to get off, even counting beads, but i wouldn't want to switch - better to stick with the devil you know!

 

I have had a difficult time following your withdrawal signature - how long does your anxiety last in the morning?  When i have had morning anxiety due to withdrawal and have updosed i have had to wait a few weeks for the anxiety to settle. It sucks but i try to exercise it away.

 

hope you feel better soon

[ktp]

thanks for your reply peggy.  sorry the sig is difficult, lots of abbreviations: GAD=general anxiety disorder, PD=panic disorder.  I started on pristiq 50mg in 2009, clumsily switched to venlafaxine 125mg when i started my wean feb2014 and the wean went well until mid-october 2014 when down to 6mg i reduced too fast.  Took Ambien and Lunesta for sleep for a while; thank gawd that's over.  Now I'm back at 50mg venlafaxine XR once per day and almost stable with only the morning anxiety problem..

 

Morning anxiety seems to last 2 or 3 hours, sometimes longer.  It doesn't seem to matter when I take the Venlafaxine.  It's annoying enough that I can't sit down, need to go walking, but not quite bad enough to make me take a xanax, which I admit I am hesitant to do because it is soooo effective it puts me to sleep.  even 1/4 of a white xanax can be a lot so I'd sure like to find something that works but just not quite so darn well.  

 

feeling better already, thank you!  

[ktp]

first i wanna say thanks again to everybody here, especially mammaP petunia and hudgins, whose posts i re-read every chance.  

no screaming need for attention today, just logging.  the morning anxiety bit is my new "normal", i expect it and deal.  getting shaky hands, too, wonder what's up with that.  

made appt to discuss meds with my support doc, carefully specifying i want to talk to the doc, and sure enough I got the interview with an intern counselor who glommed onto blood pressure and disappeared and returned with an rx for "propanolol T'-T'T' po q day prm anxiety #60".  (and she "really wants me to come back";-) this is the third time i've been shuttled into the practice's counseling services despite asking very specifically for med discussion with the doctor, pretty disappointing visit; looks like I'm on my own again.  at least i have you folks!

So since the anx isn't subsiding on its own, I need to change something, so I'm ready as ever for a 10% reduction, see what happens and hope it's improvement.   (btw I totally missed last Thursday's 50mg venlafaxine, didn't even notice until friday dose time.  irrelevant maybe.)  anyway today I dropped 10% to 45mg venlafaxine xr opd in the morning.  still had today's anx jolt but now better.  steady as she goes.  thanks again.

[ktp]

morning anxiety mostly subsided; sleep is better.  reducing from 45 to 42 mg venlafaxine xr opd mornings.

[ktp]

Almost a year after i screwed up weaning, I'm now down to 25mg/day venlafaxine, and can't really blame my daily morning anxiety on anything more than no structure in my day (no job) and experience knowing how easily high anxiety can be achieved just thinking about it.  When I have something to do it's not a problem.

 

I finally gave up on the psych practice I've been using; they have MFTs (therapists) giving med advice they know nothing about; I've switched therapists twice trying to find one who's not simply full of sh**; the last one was telling me "no, antidepressants are not used to treat anxiety"; last straw was the MFT, who knows very well the whole idea is to wean, saying "that little dose you're on is nothing, just stop taking it" at which point I simply stood up mid-session and said "thanks very much for all your help I quit" and walked.

 

So now I'm on my own again, no support group, so I'm looking for a psych practice where I can actually talk to the doc, wishfully hoping to find something to which I can safely switch that will be easier to wean than venlafaxine.  I have good insurance but I don't even care about doctors being in-network any more, this is my brain and whole life and I will gladly pay through the nose to get off this stuff and see normal.  buspar maybe?  ideas anybody?  

[ktp]

hooray finally found a shrink who's listening and gets that i want to wean.  to my current 22mg/day effexor venlafaxine snri, eff 11/25/2015 i'm adding 10mg/day prozac fluoxetine ssri, will then taper the venlafaxine to nothing and then wean from the fluoxetine, allegedly less brain pain. 

[ktp]

Effective 12/13/2015 continue 10mg Prozac and reduce from 19mg to 17mg Venlafaxine xr.  

 

The daily anxiety battle seems to have gradually relaxed since starting the P on 11/25, and has been nearly quiet last couple of days.  

Second visit to new doc was tuesday 12/8; he started to encourage more prozac and hastier V reduction but left it in my hands so for now I'm staying on the 'baby dose' of Prozac and continuing with careful weaning off the V (counting beads).  10% as often as every 10days seems reasonable.

 

Reduction details in my sig, abbreviated but accurate; anxiety battle status there too unless significant enough to post here.

I'm mostly just checking in to say i'm finally feeling like there might be an end to this 13 month daymare, I feel almost human, back on track, feet touching if not quite on the ground.  moving forward again but avoiding the rush - i've had better years;-0

[ktp]

life is better, anxiety mostly gone, weaning continues (see sig), and on 3/28 I should cut 10% from my 9mg/day dose of venlafaxine xr.  I'm using (TEVA brand) capsules with 1mg beads, so easy-peasy so far, but now removing 1 bead is more than 10%, so it's time for liquid.  I got an Rx for non-XR Venlafaxine, and I'm ready to do liquid and twice-a-day dosing.  Would someone reading this who's actually done venlafaxine solution please point me to details of your solutions?  magic volume to get 1/10 mg in an eyedropper or similar would be sweet.  looking for easy-to-find precision tricks - i have a kitchen cup but not a graduated cylinder.  all ideas are welcome, experience is even more welcome.  thanks in advance, wonderful people!

[Fresh]

Hi KTP ,   try reading the following threads:

 

How to make a liquid from tablets or capsules

 

Using an oral syringe and other tapering techniques

 

Tips for tapering off Effexor and Effexor XR (venlafaxine)

 

You've tapered extremely fast and may experience some fall-out.

" (decreases) 10% as often as every 10days seems reasonable."

I understand that you added prozac  around 29 November , with view to doing a switch.  

However , if you read the thread on "Switching to Prozac" you'll see that the transfer is recommended

to be done over 2 weeks.

As you've now been taking both venlafaxine and prozac for the past4 months , you may need to slow

down your ven. taper in order to avoid w/d syndrome.

 

bw ,  Fresh

[ktp]

Thanks! your refs led me to the best actual experiential account I've found, it's from Rhiannon who says

"I dissolve my Celexa tablet (it does have to sit a while, maybe ten or fifteen minutes) in water plus a little ethanol (you can skip the ethanol though). I dissolve it in a shot glass. I draw up the now-dissolved contents with a pipette, then put the pipette in a jar of water and draw up enough more water to make 10 mL. I add another 10 mL of water for a total of 20 mL."

 

Which is a great start.  I have a shot glass, and I have a syringe and can follow this procedure easily, so I'll give it a try.  I have learned that my venlafaxine (non-XR) is easily soluble in water to better than 25mg/ml, far more than i need.  I'm getting 100mg tablets so i'm interested in storing it for a week or more, too.  anybody with experience?

 

re my prozac + venlafaxine use, please say at what point you see "extremely fast" in my taper?  i want to be very cautious, not extremely fast.  please see my sig and prior posts, in which you'll find that i'm continuing to take the venlafaxine wean seriously despite its being supplemented by 10mg prozac since 11/2015.  yes the idea is to switch to prozac for an easier-than-venlafaxine final wean.  And sure, the doc thinks "just switch over two weeks" to which i say that's nice now exactly what do you mean by that? (Seriously: exactly how would you make said switch?  i have to suggest visiting surviving antidepressants dot org before advocating any major change in SSRI SNRI drugs in two weeks;-)  Having already experienced too fast withdrawal from this drug I am taking it easy with the venla weaning despite the two weeks 'theory'.  I read that too.  i think my 10% every 10 days is a lot slower and better aligned with SA.org dogma than any "just switch over two weeks" which sounds like an MD who would have me bounce half doses and quit, just doesn't get how these drugs work.  

 

while i do believe it will be easier to wean from prozac than from venlafaxine, i do not believe it's because prozac has a longer half-life.  (it won't hurt, but it doesn't mean you can just quit, it just means slower riddance from your body.  When i'm finished quitting venlafaxine, i'll wean from prozac too, not just quit in two weeks.  but for now, my theory and my doc's theory both hold that i should be able to ACcelerate my venlafaxine weaning, not slow it down.  but i'm not chancing that, i've already seen hell and i am sticking to 10%/10days max reduction.   i have to wonder where do you see "extremely fast" in my taper, please?  i do wish to apply maximum caution, thank you!

[Fresh]

Question: "please say at what point you see "extremely fast" in my taper?"

Answer: " (decreases) 10% as often as every 10days seems reasonable."

              " i am sticking to 10%/10days max reduction. "

 

I don't know how to say it any clearer than this: 

" you've now been taking both venlafaxine and prozac for the past 4 months "

" if you read the thread on "Switching to Prozac" you'll see that the transfer is recommended

to be done over 2 weeks."

 

From Altostrata in "The Prozac Switch or Bridging with Prozac"  here

http://survivingantidepressants.org/index.php?/topic/1463-the-prozac-switch-or-bridging-with-prozac/?hl=%2Bbridging+%2Bwith+%2Bprozac

 

"Prey 2012 method for Prozac switch
Another knowledgeable doctor (whom I trust) explained his technique to me (this is the technique I personally would prefer if I had to do it, it seems much gentler):

• For a "normal" dose of Effexor (150mg per day or more) or Paxil or Cymbalta, he would switch to 10mg Prozacwith a week of overlap. In other words, take both medications for a week and then drop the Effexor. Lower doses of Effexor or other antidepressant require lower doses of Prozac as a "bridge."
• The lower dose of Prozac reduces the risk of excessive serotoninergic stimulation from the combination of the two antidepressants during the overlap period.
•  
• Do not stay on the combination of the first antidepressant and Prozac for more than 2 weeks, or you run the risk of your nervous system accommodating to the combination and having difficulty tapering off both antidepressants."

[ktp]

okay, you're right about that, I'm reducing weekly rather than monthly.  I'll split the difference, make it two weeks.  The reasoning here is that my gradual reduction of Venlafaxine (V) should be a lot easier to take than suddenly dropping the entire 19mg V load after 2 weeks of 10mg Fluoxetine (F): effectively I'm stretching out the 2 weeks to 6 months or more.

 

consider, please, the lack of logic in following the instruction to switch from 150mg V to 10mg F?   10mg is a "baby dose" of F, 150mg is thoroughly therapeutic dose of V.   Even at my pretty low 19mg V dose, this strikes me as a huge ugly switch that would quite possibly hospitalize me with anxiety.  so what I'm doing is a slowed-down switch from V to F.  and yes it's taking longer than 2 weeks.  

 

yes i see the recommendation by the doctor alto trusts.  that's a good start, but i'm not into making big sudden changes, having seen where that leads.  

 

Thanks for the heads-up and concern, I will try to avoid getting excited and reducing too fast.

[Altostrata]

Please read The Prozac switch or "bridging" with Prozac carefully.

 

No matter what our theories might be, you need to listen to your body to determine if your taper is too fast. You will need to negotiate with your own nervous system, not your doctor or anybody here.

[ktp]

Thank you.  i've read  http://survivingantidepressants.org/index.php?/topic/1463-the-prozac-switch-or-bridging-with-prozac/ quite carefully, and have lots of issues.   I hope you've taken a moment to consider the lack of logic in each of the the "2 week switch to prozac" methods cited.  EXACTLY how should that work?   consider the details of any one case, mine is fine.  on Pristiq 5 years, switched to effexor aka venlafaxine (same active drug = odesvenlafaxine) and weaned.  blew it with too quick wean 10/2014, got restarted and was down to 19mg when I found my prozac guy.  

 

Given all that, what would YOU do when making the switch to prozac?  1 week of prozac then just stop the 19mg venlafaxine?  no freaking way, I added the prozac, noticed no effects, but will hope it lets me reduce the venlafaxine more quickly.  That's the biggest risk i'm willing to take, i've already seen plenty of mental hell in 2015.

 

the docs obviously do not get how these drugs work - basing prozac's "easier wean" on its longer half-life makes little or no sense to me, and I plan to wean off of prozac, too.  

[ktp]

updating this my journal.  

and looking for opinions, ideas.

'weaning from pristiq' is still its title, but i've progressed and am currently taking 10 mg prozac and down to 4 mg Venlafaxine; it's now 30 days since drop from 10mgP+5mgV, (yes, 20% of the V in that drop), stable, and about time for next reduction.  if i go from 4 to 3 beads that's a 25% reduction, scares me.

 

so my mom died 8/1, i felt bad of course, couldn't cry, and thought maybe the shrink can make me cry, so i called and wow got an appt in 30 minutes!  well he didn't make me cry (i still haven't) but he continued to suggest a bigger Prozac dose to 'really knock out the anxiety', that weaning won't work until the anxiety is gone, not just under control.  that is i can't be fighting it all the time, just makes it worse.  past experience seems to indicate that you have to forget the anxiety before it will really subside, but here i've been battling it directly since october 2014, it's part of my normal day.  

so tuesday 8/2 i added 10mg prozac to the 10P4V.  I think I felt better the next couple days.  so today i'm trying it again, took an extra 10mg prozac to make it 20mg.

 

so, here i am again, doing a 'switch' from effexor to prozac.  i believe the 'trusted doctor' method is take prozac 2 weeks then just stop the venlafaxine.  is this crazy, or will i be able to just cold turkey stop the venlafaxine after 2 weeks like the 'trusted' prozac doc suggests?  or should i continue weaning off that nasty venlafaxine as slowly as possible?

 

it would be just great if i really believed i can just quit the V after the P is up to normal dose, but i feel like i'm pushing it with whole bead reductions at this point.

 

Has anybody REALLY DONE the venlafaxine - to -prozac switch as recommended in two weeks?  and survived as an out-patient?   any brilliant ideas are welcome.  yes i've read all the links you see in this entire thread, now seeking somebody who's actually done it that way.  or any way.  what works, please?

[scallywag]

KTP:  Sorry to hear about your mom.  Please take extra care of yourself.
 
Have you checked out SA's topic on the Prozac switch or bridge:

Prozac switch or bridge

 

There are a number of approaches to handling the doses listed there. 

 

You may also want to do a search (use google or other web search engine) using the terms: (you can cut and paste the next line in to google)

 

survivingantidepressants.org "prozac switch" OR "prozac bridge"

[ktp]

thanks scallywag especially for the google tip.  yes i'v'e checked and rechecked lots of raving here and elsewhere re prozac bridging but I still want to find a lot more about the Actual Experience of switching from JustEffexor to EffexorPlusProzac to JustProzac, especially suddenly after 2 weeks of 10mg prozac.  Somebody must have done it and survived, maybe even written about it.

 

currently at 10mgP, the doc suggested go to 20mgP and continue weaning the 4mgV but that seems like a big step backward.  and what about weaning from prozac?  "easier" doesn't mean easy!  

 

anyway, it's time for a reduction.  I didn't really feel any better this latest 10mg prozac add, so for the time being i'm staying at 10mg prozac and reducing the venlafaxine by a bead (4 to 3).

 

and yes, that's a huge 25% reduction in the venlafaxine, but bear in mind i'm supplementing it with 10mg prozac, alleged by some to be roughly equivalent to 37 mg effexor.  so my reduction is more like 1/40.  

 

and i will have to make a decision about the prozac pretty soon - i will run out of 10mg prozac caps in a couple weeks; my latest refill is 20mg caps so i'm either going that route or visiting the doc again for more 10mg.  i hope for the latter.  fingers crossed.  thanks everybody for your support.  

[scallywag]

When you're below 10 beads, every reduction is > 10%.  I'm not going to try to cut the beads.

[ChessieCat]

Hi ktp,

 

I use google and type in survivingantidepressants.org + topic.  In this case topic = prozac bridge.  Link to search I did.

 

After the SA Prozac Bridge topic results there are links to members asking or doing the prozac bridge.  If you want more specific add Effexor to the search query.

[ktp]

left you all in suspense since 8/18 ;-) as you can see in my easy to read sig i stayed at 10mg Fluoxetine despite Dr's suggestion to increase it.  

that reduction went okay and now it's time for another, this time a single bead is 33% of the Venlafaxine which again sounds huge but it's along with prozac 'equivalent' to 37mg venlafaxine so i'm good to go it's more like 1/38 or 3%.  reducing to 10mg prozac + 2mg venlafaxine.