Chad: Switching from Pristiq to Paxil

[Chad]

Hello, I'm Chad. I'm 28, male.

History:

My current diagnosis' are major depressive disorder, panic disorder with agoraphobia, and social anxiety disorder. I'm on disability, no longer go to college or work.
I've been on anti-depressants since 2001 starting with Zoloft.

In 2009, returned to a psychiatrist for re-evaluation, switched to various other anti-depressants, finally settling on Pristiq (desvenlafaxine) at 100mg.
Also was put on benzodiazepines, with 3 slow taper attempts, I've always ended up reinstating. I've battled addiction with strong painkillers but for me, nothing could compare to the horrors of benzo withdrawal and I was hospitalized at the end of my last taper attempt for making an attempt on my life only to be put back on 4mg of clonazepam inside the facility. I've been on this dosage ever since and have not considered any further taper attempts since.

Why Pristiq to Paxil:

My quality of life is at a minimum. I'm not suffering from any withdrawal but I'm also not getting any better. Things are incredibly dark for me. I can't imagine anyone else who could hate themselves more than I do. I have a fear of death but also a fear of putting my family in any similar situation that I'm in now if I were to end my own life. That may be the only thing I respect about myself, the willingness to endure in the most harrowing times.

Pristiq isn't working anymore so why should I be on it? The first action I took was adding mood stabilizers/anti-psychotics to my cocktail but I didn't tolerate any of them well whatsoever. The one I was on the longest with Abilify and I ended up with frightening hand tremors where my psychiatrist at the time called me and told me to stop immediately (cold turkey) and I was put on a drug called Congentin. The tremors went away but I guess that fear was that I could have been developing a potentially permanent side effect called tardive dyskinesia. It also caused weight gain.

The other option was to speak to electro-convulsive therapy specialist. I denied twice. MAOIs were ruled out for their dangerous side effect but to be honest, I would have tried an MAOI before ECT.

I did try to switch to another SNRI at one point, it was called Cymbalta. Another terrifying experience that I could not handle. Instead of trying to switch to Cymbalta again, I asked my doctor about switching back to an SSRI and asked if that could even work and his reply was something along the lines of "of course..." so I he suggested Prozac or Paxil as I've never tried either and I chose Paxil.

The schedule he gave me was:

Week 1- 20mg of Paxil w/ 100mg of Pristiq (my normal dosage)
Week 2 - 20mg of Paxil w/ 50mg of Pristiq
Week 3 - 20mg of Paxil w/ no Pristiq

It's rapid and I cannot make cuts with this drug, I cannot dissolve this drug, there is a lower dose of 25mg but for whatever reason, he did not add that to the schedule and changing doses is also a financial issue right now. He only had samples of 50mgs and he gave me those for week 2. I am going to follow this schedule and try to document (journal) it here as coherently as I possibly can.

I've also ordered a supplement called Phenibut that could ease anxiety as I feel tolerant to 4mg of clonazepam. I've decided to try the lowest dose and only once a week.

I currently live with my mother as I cannot afford housing on disability. She is aware of the situation. Neither of know what could possibly happen but I do know that it could be similar to/ or worse than the transition to Cymbalta that I tried about 5 years ago. I'm terrified but the only place I have to drive to is my next doctor's appt. which is in mid February.

The one symptom that worries me most is brain zaps/shocks. I experience them if I miss even a day of Pristiq and they are debilitating, you're not able to do much.

So this is day 1. I've taken my first 20mg of Paxil about an hour ago.
Please feel free to add your input, comments and I could absolutely use any support or encouragement to get through this.

My main goal is to be off all medications one day but unfortunately, it's not such an easy path. I don't know if it's a possibility to do it and live normally either.
 

Edited January 11, 2017 by scallywag
tags

[nz11]

Hi Chad

Welcome to sa, welcome home.

I'm sorry its been one big revolving door to the doctors office.

Breggin wrote a book 'your drug may be your problem' and i think your drugs have been yours.

 

You have asked for input here is mine:

In my opinion i have a bad feeling about what you are about to do.

 

If i was you and unless you have serious heart and liver issues caused by the pristiq (you havent mentioned this ) then i would not do it.

I would refuse the paxil and stay on the pristiq and taper the pristiq slowly as rec in the link below.

 

Two moderators Fresh and Chessiecat are having success tapering pristiq. Check out their intros.

Hopefully they will pop in soon to comment.

see

symptom. A too fast taper will trigger that. Its not you its the drug.

 

Doctors have been misinformed on how to get people off these drugs safely and invariably taper people too fast over weeks when in fact many may have to taper for years. (As per the recommendations here to get off 100mg pristiq at 10% of previous dose per month with a 4 week hold one would be looking at 3.5 years and thats if all goes well. )

 

I did try to switch to another SNRI at one point, it was called Cymbalta. Another terrifying experience that I could not handle. Instead of trying to switch to Cymbalta again, I asked my doctor about switching back to an SSRI and asked if that could even work and his reply was something along the lines of "of course..." so I he suggested Prozac or Paxil as I've never tried either and I chose Paxil.

 

Unfortunately we all assume the so called medicines the doctor has are safe and will not harm us.

Here are my reasons why i think doing this switch is not a good strategy and you should consider not going any further with it staying  on the pristiq and not taking the paxil.

 

1. The most recent switch (to an snri) failed. I guess no one knows what will be the outcome of this switch but based on prior outcomes i sense this will be similar.

 

2. Pristiq is a more potent version of effexor. My understanding is Effexor boosts the neurostranmitters serotonin and noradrenalin.

Cymbalta does the same yet it didnt stop the withdrawal from the previous switch attempt.

Paxil only boosts serotonin so you can only hit one destabilized target now not two.

What im saying is the paxil may not cover the wdl off the pristiq.

 

3. 100mg of Pristiq is potentially significantly more in equivalent dosage than  the 20mg of paxil.

Even at the lowest end of the equivalence continuum (100mg Pristiq is  approx 150mg effexor which is approx 34 mg paxil), you are going from 34 mg paxil to 20 mg paxil. I believe after many years use this kind of paxil cut would trigger significant withdrawal symptoms. (Worst case equivalent dose scenario you are going from 68mg to 20mg of paxil).

 

4. Paxil may have start up side effects all of its own.

 

5. By taking pristiq and paxil at the same time you are opening yourself up to serotonin syndrome.

 

6. You run the risk of being trapped (at quite a height) on two potent chemicals. And if you cant get relief from the resulting destablized cns you run the risk of the medical profession defaulting to 'double the dose' option or worse. 

 

Are you able to do a drug signature?

 

Running your drugs through the interactions checker may be revealing.

People are asked to copy and paste the result into their intro thread. Are you able to do this?

 

'Of course..' at the end of the day its your choice. I am sorry you are in this situation. (Your  doctor seems very cheerful confident and positive about this move ....).

 

My main goal is to be off all medications one day but unfortunately, it's not such an easy path. I don't know if it's a possibility to do it and live normally either.

What an awesome excellent goal i reckon you can do it. Many people here are getting out from under these drugs but they are doing it by tapering safely yes its not easy it was the hardest thing i have ever done. You are lucky you can read up on this site and get informed and then proceed in a safe manner. You can do it.

 

Thanks for adding your voice to this forum.

nz11

[scallywag]

Chad -- Welcome to Surviving Antidepressants (SA)
 
I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.
 
It sounds as if you are comfortable with and have confidence in your doctor's advice.  Please correct me if I've misinterpreted.
 
Are you saying that Pristiq once delivered the intended and desired effects of reducing panic, anxiety, agoraphobia, and symptoms of depression?
 
Your doctor's approach is better than some docs who stop medication and start another med the next day. He's a bit aggressive on the starting Paxil dose of 20 mg; some would have you start at 10 mg then go up as your Pristiq comes down. Please be very attentive to your symptoms during the cross-over weeks. As nz11 mentioned, taking two medications that act on the serotonin process risks serotonin syndrome.

When a someone is taking multiple medications, we ask that that you get, review and post an interactions report. For now, please include Pristiq, Paxil, and alprazolam Klonopin (clonazepam). Follow the link below to get your report. Just select the text, copy it and paste it in a post here.
Drugs-dot-com Drugs Interactions Checker.  

Reading the drug interactions report can be eye-opening. Knowing what interactions effects you may experience is good information to have.

Edited to add:

It's probably not a good idea to add another neuro-active substance such as Phenibut. Our CNS (central nervous system) does best with stability. Adding a nootropic to deal with symptoms caused by another medication *may* perpetuate the cycle of symptoms arising and then treating them with another substance, whether prescription, over-the-counter, herbal, nootropic, etc.

 

A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly?

• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Any drugs prior to 18 months ago can just be listed with start and stop years.
• You don't need to include symptoms or diagnoses other than the initial condition that led to prescribing the first drug.
• We ask for this information in your signature so that we can see it at a glance. A list is easier to understand than one or multiple paragraphs.
• You can find instructions in this topic: Please put your withdrawal history in signature
• If you are using a phone or mobile device, you need to switch to the "full" or desktop version of the site. Instructions are in Post 8 and Post 9

How is day 2 going for you?

[Chad]

Hello,

I want to thank you both for replying. I will try to work on my signature to the best of my ability.

So today I did not take the Paxil. I caught nz11's post last evening and I think in the back of my mind, these were (vaguely) my concerns. I think I'm just desperate for a positive change in my life and I want something now. I am constantly wondering if there's an answer for me. I've even joined ECT groups on Facebook because I don't want to feel this way anymore. I think my diagnosis' could be incomplete as well. I've been suffering from symptoms of borderline personality disorder and a lack of empathy for others as well. And I'll be completely honest with you, I think the clonazepam has clouded my memories so badly that I only remember fragments of my past before I dropped out of college. So I don't know if I've always been like this. I know it's hard to make sense out of what I'm saying, that's why it feels useless to find a therapist or talk to my family (ha!)

There's more than just depression and anxiety going on here and the fact that I don't know what to do about it is so harrowing. As badly as I want to lead a normal life off of medication, I could be one of those people who need them. So yes, this is really an act of desperate nature, just as last year, I went with my doctor's suggestion to try to amphetamines like Adderall to conquer symptoms of depression and that literally made me into a crazy person. I felt normalcy whilst it was active but when it would wear off, I would turn into a monster, become delusional, panic, and say some of the most horrible things. And then I developed an addiction to it even with those consequences. What a mess. I'm glad to be off of it now but I miss that feeling of normalcy and even anti-anxiety (yes, it took away my anxiety!) when it worked.

 

 

 

Breggin wrote a book 'your drug may be your problem' and i think your drugs have been yours.

About five years back, I was all for this way of thinking, especially being in all of the benzo communities. I still believe drugs are a problem for me but I am not willing to take on the benzo beast again anytime soon. I have my doubts about ever being off of anti-depressants. I've been on them since I was 11. There was definitely something different about me before I was medicated, though. I don't know remember who that child was or what he would have grown up to be had he not taken meds. It's kind of like, a "it's all I've ever known" sort of thing- I guess.

 

 

. Pristiq is a more potent version of effexor. My understanding is Effexor boosts the neurostranmitters serotonin and noradrenalin.

Cymbalta does the same yet it didnt stop the withdrawal from the previous switch attempt.

Paxil only boosts serotonin so you can only hit one destabilized target now not two.

What im saying is the paxil may not cover the wdl off the pristiq.

Yes, I'm terrified of that. It didn't make sense in my head but I'm hanging by a thread and desperate for change but for the time being, I'm not doing it.

 

 

 

By taking pristiq and paxil at the same time you are opening yourself up to serotonin syndrome.

My psychiatrist has prescribed me so many drugs that had moderate to severe interactions on various drug interaction checkers. I feel like I'm at a point where these risks just don't matter IF it's possible there's a positive outcome. A truly horrible way of thinking. I've been fighting for so long now...
 

 

 

It's probably not a good idea to add another neuro-active substance such as Phenibut. Our CNS (central nervous system) does best with stability. Adding a nootropic to deal with symptoms caused by another medication *may* perpetuate the cycle of symptoms arising and then treating them with another substance, whether prescription, over-the-counter, herbal, nootropic, etc.

You're absolutely right. But I wonder if it could act as a catalyst of sorts. I kind of thought of Adderall as being the catalyst to finding the answer. I never did. I doubt Phenibut will do anything for me but I am going to try the lowest therapeutic dose at least once.

 

 

 

Your doctor's approach is better than some docs who stop medication and start another med the next day. He's a bit aggressive on the starting Paxil dose of 20 mg; some would have you start at 10 mg then go up as your Pristiq comes down. Please be very attentive to your symptoms during the cross-over weeks.

He said I absolutely have permission to start with 10mg if I was worried about side effects and to break it half.
 

 

 

Are you saying that Pristiq once delivered the intended and desired effects of reducing panic, anxiety, agoraphobia, and symptoms of depression?

I remember being able to work, have relationships (thought not particularly stable but I was young), get out and do normal things but I started Pristiq along with benzodiazpines. It was a combination. And there were add-on drugs that I'd go on and off of along the way like Remeron, Wellbutrin, all these mood stabilizers. But still, it's all very blurry. It definitely wasn't as bad as what I'm experiencing now. I'm mentally AND physically drained, exhausted, and often go to sleep in hopes of waking up in some other dimension where everything is normal or not at waking up at all. That's if I can get proper sleep.
 

 

 

It sounds as if you are comfortable with and have confidence in your doctor's advice.  Please correct me if I've misinterpreted. 

Yeah, it came off that way. In truth, no. I think over the past 9 years, he's given me the tools to ruin everything. I just need an answer. I'm so tired of the struggle and wish someone could help me understand what is actually going on that is making me the way I am and give me a long-term solution to save me from it.

[nz11]

Chad you can get off these drugs and get your life back.

Moderator Shep was on for something like 30 yrs and is now drug free. So it can be done.

 

I just need an answer.

Can you go to the library and get hold of this book by Whitaker 'anatomy of an epidemic' .

pg 353 "Those who end up on drug cocktails can be said to be suffering from an iatrogenic illness"

Whitaker talks about how these drugs have given children and youth a new career path - disability cheques...and "a path of lifelong illness" pg246

This book is a must read. It will join a lot of dots for you.

 

I am so sorry you were drugged since the age of 11 years. Something very tragic has occurred in society. 

 

i kind of thought of Adderall as being the catalyst to finding the answer

Swallowing more drugs or ECT is not the way out of this.

Slowly (we are talking years here to get your head around this takes a big shift in thinking) and safely tapering of the existing drugs is the answer.

 

I would seriously doubt every diagnosis given to you. The anxiety and depression you describe im also willing to suggest are iatrogenic (doctor caused) in nature and are really side effects and withdrawal effects.

 

Ive been suffering from symptoms of borderline personality disorder and a lack of empathy for others as well. And I'll be completely honest with you, I think the clonazepam has clouded my memories so badly that I only remember fragments of my past before I dropped out of college. So I don't know if I've always been like this.

Its very wrong to be diagnosing a brain when brain altering drugs are in play. These drugs are notorious for causing lack of empathy. I dont know anything about BPD but i just looked up the symptoms and oh my goodness im reading all the symptoms i suffered in withdrawal. So i would push the delete button on that diagnosis as well.

Psychiatrists operate under a syndromal inclusiveness concept  that is every one who comes in to see them gets a diagnosis regardless.

Breggin talks about seeing a psychiatrist as one of the most dangerous things a person can do. I totally agree. I went in to see one just to make a complaint and left with a covert diagnosis (which later left me outraged when i requested a copy of the notes and saw it) and an attempt to push drugs on me (i refused them).   

 

I know it's hard to make sense out of what I'm saying, that's why it feels useless to find a therapist or talk to my family (ha!)

 

Trust me its not hard a all to make sense of what you are writing. You are making total sense. WE get it. You are talking to people who understand. You are not alone.

 

I think you are very wise to not go ahead with this switch.

I just noticed my drugs interaction link i gave you was already completed and i should have given you an empty one to complete for yourself. oops. Sorry about that.

 

Here is a great piece to read about what has happened to the brain

Brain remodeling

 

Here is a link about which drug to taper first if taking multiple drugs 

 

And here is the link about tapering pristiq again. 

Tips for tapering off Pristiq (desvenlafaxine)

 

Why taper by 10% of my dosage?

 

Keep it simple keep it slow  keep it stable the 3KIS's

 

there were add-on drugs that I'd go on and off of along the way

This is like dropping your brain off a cliff then picking it up walking to the top of the mountain and repeat

 

So glad you found sa

 

nz11

[scallywag]

You may be interested in the information in the link nz11 just posted, Tips on Tapering Pristiq.  The first post talks about the formulation used to make Pristiq tablets and how to reduce dosage safely by carefully cutting the tablets.

 

 

Please run a report on the interactions between alprazolam (Xanax) clonazepam (Klonopin) and Pristiq.

• Drugs-dot-com Drugs Interactions Checker
• Just copy and paste the report here in your intro topic as a new post.

[nz11]

SW i might be missing something here but where are you getting xanax/alprazolam from.

 

Im only seeing pristiq, congentin/benztropine, clonazepam/klonopin, phenibut and  paxil mentioned.

 

Maybe you are privy to more info than me .

regards

nz11

[Chad]

SW i might be missing something here but where are you getting xanax/alprazolam from.

 

Im only seeing pristiq, congentin/benztropine, clonazepam/klonopin, phenibut and  paxil mentioned.

 

Maybe you are privy to more info than me .

regards

nz11

That's correct, alprazolam is one benzodiazepine I've never been involved with but I imagine combinations would be similar.

 

I think you're both very kind and mean well. I've decided not to switch to Paxil. But I am concerned with trust more than ever and it's not limited only my psychiatrist.

 

I have to place doubt on everyone it seems. It makes me wonder why I've even joined this message board. Perhaps it was only to get the confirmation I needed that my psychiatrist is being negligent with me once again. Beyond that, I don't know if I'm willing to believe I'd ever be alright without the use of medication or that there is even a proper exit strategy out of the hole I seem to be in. I know I've spent years in support groups and I'm aware of what many of the people are capable of it. I feel unwary around the self-assured, the ones certain medication is what is what destroys lives. It's disheartening to be referred to only certain doctors, such as Breggin, certain people, such as Gwen Olsen, and certain books, certain websites, certain videos from CCHR, though indirectly funded by Scientology, has ties.

 

It was all very reassuring while I suffered but I cannot sit here and assume it will all be better after I've quit the medication and healed from the withdrawal because I do believe I possess personality traits similar to those with borderline, I do believe I suffered as a child far before I was ever medicated, and I don't believe that there's anything out there that could serve as an answer.

 

To be frank, I don't want to be removed from this website. I want to be others in limbo, who are very unsure and perhaps feel damned staying on medication or going off of them. I've spent most of my 20s fighting the agony of trying to quit a medication that took away all of my life qualities and I'm not sure if I'm willing to approach it again less than two years away from being 30.

 

Please don't tell me I'm still young and there isn't a better time. I was the minority in many of these support groups and it was frustrating to hear how young I was as if it made anything better-- as if it weren't going to take away my youth that I'll never get back. If someone could only understand how defeated I feel, or how undecided I am about go forward... I cannot be the only one in this world or else there's no reason for me not quit.

 

My mental illness is real, and the harm from medication is real. Do you think that's anything a therapist could understand? I need to find someone who can be on the same page as me.

[ChessieCat]

Hi Chad, and welcome to SA,

 

I have been taking ADs for 25 years.  I ended up on 100mg Pristiq and have been able to get down to 32.5mg.  As my dose lowered I started feeling more like my old self and have been able to laugh.  I didn't realise what the drug was doing to me whilst I was on it.  My memory has also improved and I started learning Hebrew 2 months ago.  For many years before I ever started taking an antidepressant I did suffer from bouts of depression.  Whilst I've been on the ADs I have still suffered from times of depression but also felt very numb emotionally.  Even now, with my dose getting lower, I am still having times of depression and because I got depressed before I ever started the drug I think I probably always will but I have decided that I would prefer to be free of the drug, not have my brain numbed and experience the side effects of the drug, and suffer from the depression naturally and learn non drug coping techniques.

 

There are links in my signature to my website, which gives a brief version of my story and links to things I have found on the internet, and also to my SA intro/update topic.  This one is very good Simple Truths About Psychiatry.

 

baroquep is another member who had been on Pristiq but she switched to Effexor.  And this is the link to Fresh.

 

If you click on the drug tag for Pristiq at the top left of this page it will bring up other members' topics with Pristiq as a tag.

[nz11]

Thanks for posting cc i hoped you would.

 

My mental illness is real, and the harm from medication is real. Do you think that's anything a therapist could understand? I need to find someone who can be on the same page as me.

If you think that you have a mental illness then by your very own words the medical profession will have no trouble agreeing with you, no diagnosis required. Many therapist don't understand the psychological distress which is caused by withdrawal and in fact because of that many may well  imo be unhelpful people to talk to.

You are right the harm from these drugs is real and studies show that staying on long term causes worsening outcomes on all measures.

 

What do you think about doing a drug signature

And what do you think about a slow taper off pristiq. You could follow in cc's footsteps.

 

I have to place doubt on everyone it seems. It makes me wonder why I've even joined this message board.

Maybe its not a coincidence that you joined this forum

 

It's disheartening to be referred to only certain doctors, such as Breggin, certain people, such as Gwen Olsen, and certain books, certain websites, certain videos from CCHR, though indirectly funded by Scientology, has ties.

So have you been for a consultation with Breggin?

A lot of the info out there is very absent of specifics about how to get off these drugs but this site doesnt talk in vagaries it provides tapering advice that is giving many the chance to get off these chemicals. I see no reason why if you follow the advice here you cant get off and get your life back. 

 

Just look at cc she is slow tapering off pristiq

Don't despair you can do this too