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Author Topic: Going to try to switch from lexapro to pristiq  (Read 2641 times)

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Offline Shurl102

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Re: Going to try to switch from lexapro to pristiq
« Reply #15 on: March 30, 2014, 09:35:57 AM »
I've been switching from 40mg Lexapro to 50 mg Pristiq the past 3 weeks.  It's been rough.  I've had angry outbursts, anxiety, racing thoughts & plenty of crying moments.  Wondering if this is a good decision.  We didn't think Lexapro was working hard enough at keeping my anxiety at bay.

This what my pARNP suggested I try.   She's sending me to one of the pdocs in her office for a second opinion over all my meds.  April 11th can't come soon enough. 

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Re: Going to try to switch from lexapro to pristiq
« Reply #16 on: March 30, 2014, 04:50:32 PM »
Wondering if this is a good decision.  We didn't think Lexapro was working hard enough at keeping my anxiety at bay.

Your Lexapro dose was double the maximum, so if it still wasn't working then your options were limited. Switching to another SSRI might have been easier, but if others have failed in the past then trying a SNRI was a good call.

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 #17 on: March 30, 2014, 06:42:18 PM »
Thanks Ian, alas today wasn't much better.  I did take some more klonopin a bit around noon and about 2.3 of a .25 at 4, as I had some troubling anxiety symptoms today.  First I had night sweats around 4 or 5 in the morning, they went away.  So I got up at 7 went to the couch and sort of zoned out there after eating a little bit for breakfast and taking the pristiq and various supplements (fish oil, deplin (which I am alternating every other day as it costs so much and I don't know if its doing anything), coQ, and vit D) plus the usual .25 klonopin.  Had the arm tingles, lots of stomach gurgles and not happy stomach feelings, then later on during the day I get light headaches and eyeaches, could be sinuses, who knows.  When I ate lunch when a couple of friends came over the stomach felt better but not great, so I just had yogurt for dinner.  I also have felt cold all day, but it is a damp cold day anyway. Got a little upset a bit ago, ie teary for a bit, over the frustration of just trying to move past this once and for all.  I hope adding back in the four oclock dose of klonopin will take care of it, otherwise it must be from coming off the lex a week ago, maybe I needed it with the pristiq or I need more pristiq which would risk more side effects, or maybe I need more time to get used to not having lex in my system--though I thought the taper while taking Pristiq would have prevented any problems.  My bp was on the high side when I checked last but that could be because I was not feeling great, I can't tell what is due to Pristiq vs what is due to anxiety/depression.  I should be better at work tomorrow, and will try to get better sleep, we were up a bit later than planned both nights this weekend, so that didn't help.  I was glad the company came over though, and my sister sounds a bit better today but it will be a while before she is out of the hospital.  I feel like I shouldn't have to need klonopin if the damn ADs would work as they have before but I guess I do need it and am not ready to reduce it (and its not exactly high at 1 mg total per day).  I hope it is just another setback and I will have some great days this week again. 
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Re: Going to try to switch from lexapro to pristiq
« Reply #18 on: March 30, 2014, 07:47:37 PM »
deplin (which I am alternating every other day as it costs so much and I don't know if its doing anything)

I'm not convinced that Deplin is significantly more effective than other folate supplements, and the evidence for folates isn't that strong anyway, IMHO.

Quote
or maybe I need more time to get used to not having lex in my system--though I thought the taper while taking Pristiq would have prevented any problems

It may be easing them, but getting the balance right between two ADs is difficult as there is so much difference in individual responses to each that some problems are almost inevitable.

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 #19 on: March 31, 2014, 04:15:31 PM »
Well today was kind of a disaster, I had major sweating problems last night, felt very anxious when I got up, bp already up but when I got to work (school) I was so keyed up I was working on something with another teacher then forgot my first class.  I also had major stomach pains last night which morphed into chest and back pains when I was getting up.  Ended up with my friend walking me to the nurse, she took my bp (I was quite upset by this point, a mix of anger, frustration, and teariness) and it was 160/100!  Later it came down significantly, but not quite to normal while I was there.  Got an emergency apt with my pdoc and was taken there, she told me to up the Pristiq to 100 mg and take more klonopin to keep the pressure down, which she felt was due to anxiety.  Other options were to take 5 mg lex on top of it but she didn't think that was a viable solution in her experience, and to consider taking remeron to help with sleep and supplement the activity of the Pristiq.  She felt for now the cleanest option was to take more Pristiq b/c it did help initially when I took it while still on lex, and many of her patients take 100 anyway, a few higher.  I told her I was scared and really frustrated, but I guess I need to keep trying.  If my bp gets nuts I can always go to an emergency room I guess, and it is most likely due to anxiety anyway.  A curious thing I noticed is that when I did get emotionally upset, the stomach pain tended to go away, its like this illness seems to find either a physical or mental way to torture me, but not necessarily both at the same time.  I also took an extra .25 klonopin in her office, it made me sleepy as I waited for my wife to come get me, and when I got home my bp is still high but not ridiculous.  After eating lunch late my stomach seems to have calmed down at least for now, a bit of a headache and eye ache but I am hanging in there.  Will try again tomorrow, I have to take both Pristiqs at the same time when I get up.  I really hope it works, and I know it might be a few days, she told me of a patient for which 50 did nothing and then that one felt much better on 100 within less than 2 weeks.  This stuff is so complicated, I wish there were easy answers. 
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Re: Going to try to switch from lexapro to pristiq
« Reply #20 on: March 31, 2014, 07:40:01 PM »
A curious thing I noticed is that when I did get emotionally upset, the stomach pain tended to go away, its like this illness seems to find either a physical or mental way to torture me, but not necessarily both at the same time.

The brain can only juggle so many balls at the same time and anxiety puts some of its circuits under heavy load, plus the vagus nerves which link the brain with the GI tract (and heart and lungs), seem to carry much more data to the brain than from the brain to these organs. A lot like the internet, faster downloads than uploads.

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 #21 on: March 31, 2014, 09:03:46 PM »
Ian I definitely think my brain has been on overload this day. Praying tomorrow is a better day, I will follow the pdocs recommendation and take extra klonopin if I need to and hope to get thru work.  I'm not going to say I have no worries but I have to move forward, eventually something must work, and I know my med fears are exacerbated by the anxiety anyway.  Thanks for your replies, I will keep updating my progress.
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Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #22 on: April 01, 2014, 09:44:37 PM »
Well some good news, despite being deathly afraid of doubling my pristiq dose to 100, I was able to go to work and function well.  Yes I had all kinds of torturous med increase effects, anxiety, stomach pain, headaches, eyeaches, and a feeling of general malaise and weakness, but I managed.  My bp was a bit high in the am, my pulse even more so, but when I got home the bp was back to normal or lower though pulse was around 90.  I am guessing these are the effects of increasing the drug, but one good thing is that it seemed to improve my depression part.  I am hopeful it will all work out and the side effects will disappear soon.  One day at a time I guess, and I have the klonopin to take if thing get hairy, I took small crumbs a couple of times at work to calm myself, though it might have been a placebo effect.  Don't care, as long as it works. 
Keeping my fingers crossed and grateful for a decent day (even if I felt like I had the flu without a temp).
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Re: Going to try to switch from lexapro to pristiq
« Reply #23 on: April 01, 2014, 11:27:05 PM »
even if I felt like I had the flu without a temp.

This is a common withdrawal symptom so the Pristiq still may not be quite compensating for the Lexapro loss. But this is understandable given you've only been on the higher dose for a day.

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 WCS

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Re: Going to try to switch from lexapro to pristiq
« Reply #24 on: April 02, 2014, 11:13:13 AM »
2Sungo,
I'm new here, but would still like to chip in. 

First, I went through that thing of checking the BP all the time.  I have panic attacks at the doctor's office (hence my moniker White Coat Syndrome), and so the doc would have me check it at home.  I became a bit obsessed with it, checking it multiple times a day.  Now, I just check it occasionally, like once or twice a week, and report that to the nurse when I go into the doctor's office, rather than having them take it and freaking out because it's really high.

Here's one thing that has helped me with the health concerns - exercise.  I used to be a good exerciser, always hiking or bicycling, then about six years ago I slipped on a hike and injured my knee.  One thing led to another and I spent the next 5+ years doing almost no exercise, was on Lexapro and gained quite a bit of weight.  Several months ago I started exercising again, just indoor treadmill and recumbent bike, do one of these at least once a day for a total of about 40-50 minutes, started out slowly and have built up, and that made me realize that, if something were truly wrong with my cardiovascular system, it would show up during the exercise.  I push it enough that I have sweat dripping on the treadmill or around the bike and breathe hard, but not enough to make me dizzy.  I also drink water during the exercise so I don't get dizzy from dehydration, and I like to do intervals of slow, fast, slow, ....

So exercise has at least two benefits.  First, it's good for your cardiovascular system, blood pressure, and so forth in the long term.  Second, it gives you confidence that your body is not going to betray you.  If you do fine during exercise, then it's extremely likely you're fine when not exercising.

Maybe you are already a big exerciser and this is redundant.  If not, I hope this helps and hang in there.
WCS
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Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #25 on: April 02, 2014, 09:48:13 PM »
more good news on day 2 of 100mg pristiq, though my morning pulse was high 102 or so, and BP somewhat so, the day was better at work, no real stomach pain, less anxiety, and a feeling of calm towards the end of a busy day.  When I got home and checked bp just before taking .25 klonopin (which I was an hour late taking) it was actually low on the diastolic number and moderate for the top number, but what pleased me most was that my pulse finally returned to a normal level, I think it was lower 70s or upper 60s, would have to check my journal to be sure.  So I have reason to believe that I am passing through side effects from the upped Pristiq and possibly, Ian, continuing to feel a bit of the lex withdrawal.  I find when I get home I have more energy than usual and am able to get more done than usual.  Hope it continues to work. 
WCS, I used to exercise, mainly some weights, but since I got sick again I stopped.  I hope to resume, though probably more walking/treadmill type stuff as I am past 50 and have mild carotid plaque so I don't think heavy weights is the way to go.  My bp when not ill has always been on the low side of normal, unlike others in my family.  I also take a statin and fish oil, and my cholesterol is well controlled though I'd like the HDL to be higher, my last reading was its highest at 48 I think.  My ratio is good though, as the Lipitor and weight loss from anxiety both have brought my LDL down.  Hopefully Pristiq wont mess that up, last read my total cholesterol was around 120ish (usually around 140-150 when on Lipitor w/o fish oil and weighing about 20 lbs more).  From past experience, when I feel better for an extended period of time, I will end up doing some kind of exercise.  In fact the first time I got sick (a panic attack) decades ago was right in a gym while a grad student, I was probably in the best shape of my life.  Had this damn illness never reared its ugly head, I am sure I'd have maintained those good exercise habits continuously.  It took some years for me to start again, only to be interrupted a decade later by panic again, then a couple of years later I began to exercise again.
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Offline Shurl102

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Re: Going to try to switch from lexapro to pristiq
« Reply #26 on: April 03, 2014, 09:38:21 AM »
I made the switch from lex to pristiq.  Started pristiq March 11th.  Tappered off the 40mg off Lex & am done now.  (Thought it wasn't working.) It's been soo hard in the morning.  Now I'm anxious & depressed.  It seems to lift around 1:30ish,, then i feel better.  Kind of want to stop pristiq, but trying to wait until my second opinion with a new pdoc on April 11th.  It's so hard to wait it out.

Other current meds:
Wellbutrin 150mg
Seroquel 25mg 3x/day
Klonopin .5 3x/day
Buspar 10mg 3x/day
Lamictal 200mg (mood stab)
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Re: Going to try to switch from lexapro to pristiq
« Reply #27 on: April 03, 2014, 05:11:14 PM »
trying to wait until my second opinion with a new pdoc on April 11th.  It's so hard to wait it out.

Other current meds:
Wellbutrin 150mg
Seroquel 25mg 3x/day
Klonopin .5 3x/day
Buspar 10mg 3x/day
Lamictal 200mg (mood stab)

A second opinion is a very good idea. I do not believe you should be on even a quarter of what you're taking.

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 #28 on: April 06, 2014, 01:49:50 PM »
well here I am at nearly one week on 100 mg of the pristiq, and its still not quite where I want to be yet.  I noticed some more fatigue as the week went on, then this weekend my mood has been anxious and a bit down at times. I took an extra crumb of klonopin later this morning, my pulse is running around 99/100 so I know I am anxious.  It doesn't help that my therapist will be out of town for a couple of weeks, though she has a stand in I can call or possibly set up an appointment with.  I read a 29 page series of posts on pristiq yesterday, seems for those for whom it works it may take some time, and side effects can include anxiety though some of the posters really encouraged folks to keep with it, that it does lift eventually.  My stomach has in general been better, so that's good.  But it was hard to get up this weekend, except to go take the pristiq on time, just crawled back into bed till my wife decides to get up (I used to be the early riser before all this began, now I get that little dread feeling waking up again, like I don't want to move).  I hope things get better again soon, it seemed better when I was on both the lex and the 50 pristiq, but the doc didn't think that was a viable long term option, and who knows, maybe it was placebo effect as I get hopeful that something will finally work once I get past my fears of trying it.   
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Re: Going to try to switch from lexapro to pristiq
« Reply #29 on: April 06, 2014, 06:17:36 PM »
I read a 29 page series of posts on pristiq yesterday, seems for those for whom it works it may take some time, and side effects can include anxiety though some of the posters really encouraged folks to keep with it, that it does lift eventually.

They are right, the side-effects, including heightened anxiety, usually do lift, so hang in there. The biggest problem with antidepressants is that folk give up on them before they have a chance to work.

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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