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Author Topic: Going to try to switch from lexapro to pristiq  (Read 4162 times)

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Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #40 on: April 13, 2014, 09:08:03 AM »
So far so good, anxiety pretty much non existent, one morning check of bp/pulse shows excellent results (been a while since pulse rates got down into the 70s), sometimes a bit tired, but all in all really good.  Did some gardening work yesterday, very few zaps, no other symptomology that I can recall.  I do get vivid dreams at night though, almost like movies.  Saw my pdoc on Friday, we will keep this regimen for the foreseeable future to see if things stay good.  Sometimes I almost forget to take the klonopin so sometimes I am late, but I will not attempt to go off of it for now, I just want to enjoy the peace and calm without any chance to disrupt it for now. 
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Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #41 on: April 22, 2014, 05:38:29 PM »
Another update, so far so good.  I was a bit tired after our week off ended and I had to get up early again, but I didn't mind my week off and had some fun and relaxation, normally since this illness began I would be focused on worrying when I wasn't working, so the combo has helped greatly with anxiety and depression.  I can't say I am really excited back at work but I am fine, nothing out of the normal beyond some fatigue.  I still get vivid dreams, and sometimes may snack more than I should when I get home, but otherwise things are okay and I hope they stay that way.  One day I forgot the 4 oclock dose of .25 klonopin, and seemed none the worse for missing it, though I resumed taking it the next day, don't want to rock the boat till I see how this pans out for a long while.
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Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #42 on: April 24, 2014, 08:13:54 PM »
Ok, so it was bound to happen, today was not such a great day.  I noticed myself feeling more tired and a bit down this week, then last night I had some kind of nightmare in the late hours before I get up, so that kind of didn't help set my mood right for the day.  Was able to work fine but wasn't happy, saw therapist and mentioned it, I guess these things happen and I need to not get worried about it meaning a relapse is imminent.  I did take a tiny bit more of klonopin this evening since I felt anxious and depressed and my bp and pulse (I know, I shouldn't check, but it kind of comes with the territory) were up, but I rationally keep telling myself this was because of my mood state, not something else, especially since it is usually fine.  Its just that I felt so anxiety free for a good stretch after starting the remeron and backing down on the pristiq, but if it doesn't resolve I will ask the pdoc what to do next.  My therapist also has said that recovery is not often a smooth process, there are often setbacks along the way, and I've seen that on this site as well.  And today wasn't a total loss at all, I did what I had to do at work, and could function well, I just don't like the sad or anxious feelings when they appear for no reason, but it also was not a total anxiety attack either, just a fair amount of unease.  Hopefully this too shall pass and I can continue on the road to recovery. 
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Offline insights

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Re: Going to try to switch from lexapro to pristiq
« Reply #43 on: April 24, 2014, 09:28:09 PM »
My therapist also has said that recovery is not often a smooth process, there are often setbacks along the way, and I've seen that on this site as well.

True. Also, even people without anxiety or depression have the odd bad day, or days. Stuff happens. It is all part of the rich tapestry of life.

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 #44 on: April 26, 2014, 07:15:59 PM »
Well yesterday was a bit better than the day before, minus a short bout of sweating when I was in the dept office, maybe it was hot, maybe I just had to go to the bathroom,  sometimes I can't tell what is a normal reaction and what is not to temperature or intestinal feelings on these meds.  Then today I did not feel so well, took an afternoon nap after going out for a bit for the morning.  I was tired driving back, and more so after eating a light lunch.  Just felt out of sorts this afternoon, a bit anxious, depressed, sort of vague uneasiness feeling, along with a mild headache and some stomach discomfort which the remeron seem to have killed pretty quickly when I first started it.  I spent some time looking thru my journals about the last two times I was sick, and a lot of it seems the same, especially the first time was long (like 2 years or so) and rough, with ups and downs, but eventually it ended and I had years of "normality" though on medicine.  Second time it was a much shorter road to recovery (not easy, but way shorter) also followed by a decade of good times. This time is more like the first time, minus lots of heart palps which seemed to be something that was much more frequent and disturbing at that time.  I also seem to have been more short of breath back then too.  This time I have more sweats at night or at other times, though I can go a long time without them, and when anxious sometimes my upper arms have an unpleasant sort of pins and needles feeling which is distinctly unpleasant.  Also have gone weeks without that but had some this afternoon but its gone now.  Left a message earlier with the pdoc, she wont get it till next week, I wouldn't call her cell unless it was a dire emergency which it is not.  I really did enjoy some nice anxiety free days this time, hope they come back or if we have to tweak something they stick around longer, maybe I am already habituated to the tiny dose of remeron (still fall asleep fine, and still get vivid dreams, but I am definitely not excessively hungry right now).   May tomorrow be a better day.
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Offline 2sungo

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Re: Going to try to switch from lexapro to pristiq
« Reply #45 on: April 27, 2014, 07:38:02 PM »
Today (Sunday) was definitely not good.  As I lie in bed my wife puts her head on my chest and notes that my pulse is rapid.  My eyes were open around 6 but we didn't get up till 830 or so, all that time I didn't feel like moving, I am sure others know that morning unease.  Of course I did deep breathing, meditation, prayer, etc, but its still was hard.  Got up and felt a bit angry about it all, then went to a store with my wife, felt bad cramps and had to tend to that, later on couldn't find my wife in the large store, cell phone service was not great in there, meanwhile she is looking for me, and concerned that maybe I passed out in the bathroom (memories of me passing out on Sapphris still haunt her) so she asked someone to look and see if I was in there.  Finally we found each other, and both of us weren't feeling too great.  Back home I just felt more anxious, reading stuff on the net about the meds and depression etc (a sure sign I am not doing well, if I feel well I do that much less or not at all except for an occasional check in at this site), then we went to go to a barber (who was closed) by that point I am shaking I am so upset/agitated/anxious.  I took a quarter extra of .5 klonopin when we got to the barbers, (I also had a quarter extra in the morning, usually I am pretty strict in sticking to my 1 mg max for the day but not today), got home and just lost it, crying, cursing this damn thing, breathing too fast, just really not feeling well and venting my considerable frustration.  On my wife's urging I went and worked out some of my anxiety on a stepper machine for a few minutes (very light, I am not in the shape I was in before this began), then I called my therapist, left a message.  She called back and I was calmer by then, then I called the pdoc cell phone just to ask if I should take 15 mg instead of half of that of the remeron, as it seems to have lost its initial calming effect.
Just got a call back as I was writing this, my pdoc says to go up to 15 mg on the remeron, expect that I might be foggy a couple of days  given my sensitivity to medicines but it should help.  I know it will probably stop the stomach/intestine discomfort, it did when I started it.
I feel calmer right now but not real happy.  I truly hope raising the remeron works and it works for a good long while, she said it might have to go to 22.5, but its quite possible the 15 will do the trick.  I'll keep updating this journey.  If anyone has experience with this combination (with or without klonopin, which I will take until I am well stabilized for long time) feel free to chime in. 
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Offline insights

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Re: Going to try to switch from lexapro to pristiq
« Reply #46 on: April 27, 2014, 09:46:17 PM »
So to summarize your day as I understand it:

You woke up feeling a bit crappy, but only mildly anxious/uneasy, then you wife mentions your high heart rate which kicked the anxiety levels up considerably, you then lose contact with your wife at the store which sends anxiety levels into the stratosphere, but apparently not high enough because  on arriving home you then go on-line to find stuff with which to mentally self-flagellate yourself with boosting your anxiety levels into orbit, followed by the stress of the barber being closed at which point you're into melt down mode. CBT could teach you techniques to nip these escalations from unease to meltdown in the bud. If it's possible I urge you to consider doing a course.

Quote
Just got a call back as I was writing this, my pdoc says to go up to 15 mg on the remeron, expect that I might be foggy a couple of days  given my sensitivity to medicines but it should help.  I know it will probably stop the stomach/intestine discomfort, it did when I started it.

So are you thinking of using Remeron to do the heavy lifting instead of upping the Pristiq dose?

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 #47 on: April 28, 2014, 10:19:13 AM »
Hi Ian,
not exactly like that, I have been sliding backwards for several days.   First some out of nowhere depression feelings, pit in stomach stuff, then comes the anxiety, then the health ocd, etc.  I actually was scared to go to the barber, I was already feeling crappy, I didn't get worse b/c he was closed.  It was already stressful for me to even go.  I have done some CBT, and I have books on it, maybe I should practice more and I do spend a lot of time trying to reassure myself, but it can take on a life of its own.   I did do a meditation yesterday morning, but that seems not to do a whole lot for me, at least not yet.  There are some upcoming situations that can stress me out, but here's the thing, they would not stress me out before all of this, for example I have an endoscopy in a couple of weeks, I had it a couple of times before and even though they found something that is probably harmless, I could deal with it.  This time another doc who is closer and in the medical group I joined since moving here will be doing it and will use ultrasound to better characterize it, so I will have more reassurance than "its probably just a lipoma", but one of the things the new doc mentioned as a possibility was a carcinoid (of many things) which of course got my bells ringing--even though he said it would not cause my symptoms (I kind of wish it was something they could cut out, but realistically it is unlikely). 
The remeron and the pristiq are supposed to work as a combo, I guess with the remeron offsetting some of pristiq's agitational effects that I seem to experience at 100mg. It was plan B, plan A was Pristiq alone.  I did not sleep well last night, which was a surprise, but I did take a day off work with my wife and got up late, I do feel a bit out of it today but less anxious to a degree.  I'm not gonna lie, I am scared of too much at this point, but I also know somewhere deep in my brain that I can and will have good days again. 
BTW which CBT technique could nip one of those anxiety/depressive/frustrated attacks before it happens, they don't happen unless I am already feeling poorly and during them I often think of how could I try and get out of it other than letting it pass.  I tried some deep breathing without success and I did do some exercise when I got home to try and get the shaky angst out of my system with maybe partial success. 
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Offline insights

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Re: Going to try to switch from lexapro to pristiq
« Reply #48 on: April 28, 2014, 06:30:55 PM »
BTW which CBT technique could nip one of those anxiety/depressive/frustrated attacks before it happens

There are several, but the main one would be reframing what is happening from the often default catastrophizing.

You also need to work hard at not monitoring your bp/heart rate. You're deciding how good you feel emotionally based on your bp and/or pulse rate, and often setting up your day by what they are first thing in the morning. This is nutz. It is not "part of the territory" as you wrote earlier, your letting it rule your "territory." How you feel should not be determined by how fast/slow your pulse is during a random 30 seconds.

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 #49 on: April 29, 2014, 06:20:57 PM »
Well today was better than yesterday.  As per pdoc instructions I took the whole remeron pill 15 mg on Sunday night, but I did not sleep well, had a very hungover feeling (expected), and unlike when I first took half a pill, I was very anxious and depressed.  So I took off from work, stomach was a mess, etc, went with my wife to the city and saw a family friend who is also a general doctor and got blood taken , among other stuff that my wife had to do, etc.  Its amazing I could drive that far considering how I felt, I have to give credit to myself for that.  I texted the pdoc and left a message that I was going to cut the remeron back to half a pill for now because I found the side effects (remember this is on top of 50 mg Pristiq) intolerable, even for one day.  She called back and basically will pull my chart and do a review, to see if we can work with the Pristiq or I need another option all together.  Last night I slept better than Sunday but still not great, sweated like crazy when I woke up in the middle of the night, before drifting off into dream sleep before having to get up and go to work.  In spite of stomach aches I went to work and that was a good decision, I almost always feel better at work when I am busy, despite it being a rather stressful time of year for my job. 
Ian I do know about the catastrophizing and I am certainly guilty of this at times, so I tried really hard to remember what my therapist has told me, that the worst outcome is very unlikely for any given situation.  So when I was sweating last night (gee, now I know what hot flashes must feel like for women), I put it down to a side effect rather than some lethal disease.  When my stomach was bothering me, I reminded myself of all the times ADs or anxiety have bothered my stomach, and in any case I am having my stomach checked out in a couple of weeks for something that I have known for  about 4 years is in there but now they can ultrasound it and give me a more definite description of what it is (I do know its not stomach cancer, its soft and below the surface layer where that happens).  Its most likely nothing of consequence.  As for bp/pulse, I try to remember that anxiety can increase both, but its more of a problem when I am on an AD that can also raise them, I was not checking bp/pulse for a long time while I was on Lexapro after an initial bout of too much of that, since I know it doesn't do much to them.  It will be harder to control, but at least for today I can rationalize that whatever it is it is either a reflection of my mind state or the Pristiq. 
So who knows what tomorrow brings, but at least today wasn't too bad. 
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