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Author Topic: Going to try to switch from lexapro to pristiq  (Read 2339 times)

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Offline 2sungo

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Going to try to switch from lexapro to pristiq
« on: February 20, 2014, 07:33:59 PM »
So its been over a year of fighting the anxiety/depression, using klonopin and Lexapro (1mg/day and 15 mg/day for most of this time respectively).  Had some better days but never felt like Lexapro was working as it has in the past.  I did get a great 10 years or so out of it, but I think the clonazepam has been doing more for the anxiety and I also felt this time the depression has been stronger than before at times.  Therapy helps, but I know there is more to life that what I've been dealing with, so today I got a sample pack of Pristiq from the pdoc while I was at the therapist (same bldg), and I see the pdoc tomorrow anyway.  The pdoc said to continue the lex for a couple of days (I take it in the evening) start the pristiq tomorrow morning then we cut back (or go off, I forget which) the Lexapro if I have no bad effects from the pristiq.  She says there wont be a problem with the overlap, but that if I didn't react well to the pristiq I wouldn't have to go back on the lex after going off, its still there.  Both the pdoc and my general doc say pristiq seems to be pretty low on the side effect profile and works well.  I was also at the regular docs today over a cold and some other stuff and she told me not to be afraid of taking the pristiq, she has lots of patients on it too.  Naturally I am med phobic but I have to bite the bullet and just do it, it would really be nice if this was the answer.  After my disastrous experience taking one pill of Sapphris last summer to augment the Lexapro (passed out cold that night in the bathroom then off to ER to get blood pressure raised back to normal with IV fluids), I have reason to be med phobic, but at least Pristiq is actually fda approved for depression and being that it is a metabolite of Effexor I guess its pretty well studied.   So my wife will stay home with me tomorrow, I will see the pdoc in the late afternoon, and I have the weekend before work begins again so I am hoping for good results.  I especially hope it improves my mornings so I want to do something other than hide under the covers as long as possible on my days off.  I will update here as well.  If anyone has any good stories about Pristiq, do tell, I can use reassurance and good stories right now.  I also hope that if it works it will work a long time, I have a brother in law on Effexor for similar issues who has done well for over a decade. 
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Re: Going to try to switch from lexapro to pristiq
« Reply #1 on: February 20, 2014, 10:28:59 PM »
Good choice. IMHO, Pristiq (desvenlafaxine) is a far better antidepressant for anxiety than its parent Effexor (venlafaxine), though the latter is great for very deep, dark depression.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #2 on: February 21, 2014, 11:13:32 AM »
Thanks Ian, good to have some encouragement.  I took the 50 mg Pristiq at 7 along with .25 clonazepam as I got up, then took a nap on the couch.  Its late morning, I do feel a bit jittery but I was also jittery yesterday morning and in a much worse mood.  So far no significant effect on bp, pulse is a bit high but not because of the pristiq, it was high yesterday when I was not feeling good, so I will bear with it knowing things will get better.  I hope the beneficial effects kick in soon, seems from what I have read when it works it tends to do so pretty quickly.  Keeping my fingers crossed.
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Re: Going to try to switch from lexapro to pristiq
« Reply #3 on: February 21, 2014, 04:12:35 PM »
So far no significant effect on bp, pulse is a bit high

You need to not dwell on either. It serves no good purpose. BP and pulse rate may tell you a lot about your state of anxiety, but not much about the effects of any medication.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #4 on: February 21, 2014, 06:08:54 PM »
Ian thanks for the reminder about anxiety and bp/pulse rate, I had been checking and the bp went up again this evening to more than what I usually experience but it very well could be anxiety--and of course bp is something I worry about.  Oddly aside from when I am really anxious my bp is on the low side, I am the only one in my family without sustained high blood pressure and not on medication for it.  Considering both of our parents died of heart related stuff Id' like to keep it that way if possible.
 Spoke with the pdoc, she wants to do a slow taper off Lexapro while on the 50 mg of pristiq, it would take about 5 weeks to complete, first alternating 15/10 the first week, then 10 the second week, then 10/5 the third week, etc till down to 5/0 the fifth week.  She says we can go faster if needed, but the idea is to keep me from having any dips as the pristiq takes effect. She does not seem concerned about bad interactions between them, and has had plenty of patients on Pristiq.  I asked (future disastrous thinking, as my therapist calls it) what if it didn't work I heard its so hard to withdraw from. She said they would taper onto something else, which should avoid a horrendous withdrawal if that ever was needed.  Often if its going to work it will show effects in a week or two she told me, and I have seen similar sentiments on the net.  If I can get thru whatever side effects there are (so far just the jitters and this evening a bit dizzyish or something not quite right when walking and my eyes feel weird (could be tension)) and it works I will be so happy.  She agreed I can also use a bit more klonopin if needed, I remember I needed it when I got on Pamelor many years ago when I was first sick.  I could never seem to get on any AD at the time at a therapeutic dose (this is just about the time Prozac first came out--that one in particular made me so anxious I was a total mess) and this great pdoc I found at that time told me I wasn't taking enough klonopin to put a cat to sleep.  So he gave me like 1 and half or maybe 2 mg to get me on Pamelor and it worked, though I slept for the first three days.   I can't say I really liked Pamelor though as it tended to make my heart go fast and I was tired on it, though I remember sleeping well.  I also would get pretty angry if I had a good reason, so I went to Zoloft when it first came out, that was better at the time. 
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Re: Going to try to switch from lexapro to pristiq
« Reply #5 on: February 21, 2014, 06:42:09 PM »
The cross taper is good. Pristiq is usually easier to quit than its parent Effexor. Not much worse than the SSRIs except Paxil which can be as hard to discontinue as Effexor.

If it's any comfort, the serotonergic antidepressants (SSRIs, SNRIs, most TCAs) slightly 'thin' the blood which reduces the incidence of heart attacks and ischemic stroke.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #6 on: February 22, 2014, 11:58:05 AM »
Ian, good to hear that pristiq isn't too bad to quit, I did see enough scary stuff on the net (a bad idea to look, I know) about it but there are always ways to deal, and brain zaps don't frighten me as they do some. I've never had a real problem coming off an SSRI, though I have only done that a couple of times or so.   Of course it would help if the company to make a pill that could be cut in half (its time release, and not in a capsule) but apparently at least some people do that anyway when trying to go off.  One person even had his pharmacist remake the pill into smaller doses with some kind of time release matrix.   I guess need can make some people quite clever.  I did notice that I didn't sleep deeply last night (but that has been going on for a while, but I felt more awake than usual), and was quite drowsy when I got up to take the medicine, then went back to sleep.  I felt a bit  tensed up again, did take another quarter of a .5 klonopin pill to reduce that, it seems to help.  Felt a bit spacy too (cant quite describe how it can make my head and eyes feel weird, especially when standing/walking), but that should pass at some point I imagine--and could very well be a result of more tension.  I did know that antidepressants generally thin the blood, so its good to know there is some way they can be beneficial for body systems other than the brain.   
There's also a couple of family stressors to deal with, an aunt is in hospice and one of my sisters who is morbidly obese is having some serious issues and is stressed over them, she will see a bariatric surgeon in a couple of weeks.  So I have to be a comfort to her and my cousins as well. 
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Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #7 on: February 23, 2014, 03:08:31 PM »
Update on third day.  Feel a bit spacy/lightheaded especially when standing/walking, eyes feel funny, sometimes head, but jitters seem lower today overall.  Not quite normal happy but not depressed either.  I think I am still adjusting to this med plus the slow taper off lexapro.  BP is down or normal, pulse rate still highish (90s), but it was doing that before when I wasn't feeling good.  Went for a long walk with family today, enjoying our thaw before the cold comes back. 
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Re: Going to try to switch from lexapro to pristiq
« Reply #8 on: February 26, 2014, 04:50:05 PM »
Update on 6th day.   Side effects seem to be diminishing, no more foggy head eye pressure stuff.  Do get a bit of insomnia, waking up after 3 hrs of sleep, but can deal with that for now by staying in bed and drifting in and out of sleep until time to get up.  BP has come down and is even low in the afternoons, pulse seems to be getting lower too, with highest one in the morning, mid to upper 80s.  Mood decent, even though I am dealing with yet another loss, my aunt passed yesterday, though we were expecting it for some time.  Jitters definitely gone it seems. 
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Re: Going to try to switch from lexapro to pristiq
« Reply #9 on: February 26, 2014, 06:01:48 PM »
BP has come down and is even low in the afternoons, pulse seems to be getting lower too, with highest one in the morning, mid to upper 80s.

You really should stop checking this all the time.

Quote
I am dealing with yet another loss, my aunt passed yesterday

My condolences on your loss.

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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Re: Going to try to switch from lexapro to pristiq
« Reply #10 on: March 03, 2014, 05:30:11 PM »
Doing less checking of bp as I am convinced it is alright for now, felt slightly down yesterday but nothing really bad, today was better at work, though I am tired. I seem to have gained a couple of pounds, I know my appetite has been strong, so I have to start watching what I eat.  Lex now at 10 mg, as I work my way down and off of it. 
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Re: Going to try to switch from lexapro to pristiq
« Reply #11 on: March 05, 2014, 08:52:39 PM »
Now nearing 2 weeks of Pristiq, lex is down to 10, will start alternating 10/5 for next week tomorrow.  Did not feel great much of day today, but took off work with my wife to drive relatives to airport (an annoying drive in the best of circumstances) and also drove rather far afterwards to pick up some stuff we needed.  Mood seemed variable today.  Wonder if that's coming down on the Lexapro, I would hope the Pristiq would have kicked in fully by now, its side effects are much diminished from the first few days I took it.  Is it the case that when taking a new med while tapering off another med it might take as long for the new med to work as if I were taking it after a long time without medication?  I guess I will have to wait and see.
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Re: Going to try to switch from lexapro to pristiq
« Reply #12 on: March 05, 2014, 09:32:24 PM »
Is it the case that when taking a new med while tapering off another med it might take as long for the new med to work as if I were taking it after a long time without medication?

Maybe not as long, but some time, especially on the norepinephrine reuptake inhibition.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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Re: Going to try to switch from lexapro to pristiq
« Reply #13 on: March 29, 2014, 08:27:07 PM »
Another update on the Pristiq.  By now I am off Lexapro for about a week, I also cut my 4 oclock .25 klonopin down (not the morning .25 nor nighttime .5) to nothing for 2 days but took some crumbs today as I felt rather poor today.  Most days though have been pretty decent.  I have had some zaps when turning my head or walking around the afternoon, I am not sure if that is the lack of Lexapro or the fact that I reduced the 4 oclock klonopin.  I may go back to the .25 klonopin at 4 if I don't feel good again soon, today my mood wasn't great getting up, my stomach is bothering me, and I had some light headaches.  There were times I did feel better so I did venture out to mail a package and pick up some stuff at the grocery store.  The weather isn't helping, cloudy with rain, and my sister with the health problems has been in the hospital for over a week due to an intestinal obstruction that is probably a hernia type thing.  I haven't been too bad overall though, so I keep hoping for more good days.
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Re: Going to try to switch from lexapro to pristiq
« Reply #14 on: March 29, 2014, 08:38:58 PM »
I haven't been too bad overall though, so I keep hoping for more good days

It is still early days and setbacks can be expected, however, it does seem that you're making progress. Just keep hanging in there.  :happy0151:

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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