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Jaco2016: How do I do a 10% taper?


Jaco2016

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On 6/6/2017 at 4:44 PM, miT said:

Even though it's not polite from them, I think it might be a good thing that they didn't call. We really should minimize external stress factors. Our lives are already tough enough.

The ego boost of getting a tough job is short-lived, while the stress it brings is long-lasting.

I'm just transposing myself in your situation. Who am I to say what is best for you...

My anxiety has been worse on pristiq - I'm seeing my doctor again next week.  Everyday it's getting worse - why???

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

Jaco, I've moved your post to your introductions topic from a topic in the "Finding Meaning" forum so that more people will see your question.  This topic, your introduction, is the best place for you to post questions about your situation.

 

You're asking about Pristiq. I don't see any note about you having introduced a new medication. Would you take a moment to let us know when you started taking Pristiq and what was the dose?  What dose are you taking now?

 

One of the best guides about what to do next are our symptoms.  Have you been keeping track of your symptoms?  Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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Scallywag I updated my signature. I also set it to allow me to see others signatures but I still don't see them on this new format it's really annoying !  I haven't been formally tracking my symptoms but maybe I should start ...

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

Thanks for updating your signature with the recent addition of Pristiq.

 

About your symptoms: In the last 18 months,  you've gone through 7 medication changes -- fast tapers or drug switches. It's possible that your CNS (central nervous system) has reached its limit and the symptoms are a message to SLOW DOWN AND HOLD STEADY. 

 

Please think carefully about your conversation with your doctor.  Virtually the only tool doctors have to deal with these symptoms is drugs, either more of the same drug, add a second drug (aka "adjuvant treatment"), or switch to a different drug.

  • The worst part is that prescribing psychiatric medication is entirely guesswork. No doctor can truthfully tell you with certainty that a medication will work for you.
  • From a symptoms point of view, you might be able to smother the symptoms with a sufficiently high dose of some medication, but then you'd likely be dealing with lethargy, apathy, and the dysfunction that arises from that and you'd still want to taper SLOWLY off that medication at some point.

Waves of symptoms occur when the CNS (central nervous system) has been destabilized, as it seems has happened for you by the medication changes. Even though you're taking Pristiq it may take some time for your symptoms to settle down.  You started Pristiq in June; reading this topic may be helpful:

How long to stabilize after reinstating or updosing.

 

I encourage you to give yourself more time to stabilize than 4 weeks. You may be looking at another 8-12 weeks before you have noticeable improvement. I'm sorry to bear such bad news.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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  • 1 month later...

So I've been on Pristiq50 mg  almost 11 weeks now - it finally started helping the anxiety at about 4 weeks..then came insomnia which is still a problem unless I take extended release melatonin (doc prescribed hydroxyzine for short term use and I sleep but don't feel rested so I stopped taking it).  The other problem now is constipation along with slightly blurred vision and some 'nervous tics' where I do this "pill rolling" thing with my fingers almost without thinking. On the positive side I haven't gained any weight and my sex drive is ok.  

I recently read about someone who cut their pills down to the minimum dose needed to manage anxiety but lessen or eliminate s/e. Would anyone advise dropping down to 25mg (lowest dose they make; can't cut Pristiq tablets) to get the lowest dose available and hope it helps with anxiety but less side effects?Or  switch to a medication that can be cut ? 

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

I've experienced constipation with Pristiq.  I used to eat weetbix for breakfast but changed firstly to rolled oats and then to muesli.  I also add a handful of chopped dates.  I found that has helped.

 

The insomnia might be a withdrawal symptom from going off Wellbutrin so quickly and recently.

 

Because your've been on 50mg for 11 weeks, which is almost 3 months, and you were on psychiatric drug/s before that, dropping from 50mg to 25mg may be too much in one go.  It is possible, but can be difficult, to cut the tablets evenly.  If you have a scale you could weigh the pieces to get better accuracy.  We can't get 25mg in Australia and I've been taking compounded Pristiq since I got past 50mg and haven't been having any issues and I'm now down to 20mg taken in one capsule.  Member Fresh, also an Aussie, was taking Pristiq and managed to cut and weigh hers until she started getting them compounded.

 

If you want to reduce to 25mg I suggest you could try cutting a 25mg into half and then cut one of those halves into 2 quarters and take 25mg + 1/2 of 25mg + 1/4 of 25mg for a few weeks and then drop to 25mg + 1/2 of 25mg for a few weeks and then 25mg + 1/4 of 25mg for a few more weeks.  I think doing that would be a better option than jumping straight to 25mg.

 

If you have a scale you could weigh the pieces to get better accuracy.

 

Because you will be taking 25mg as slow release, the faster release of the smaller part of the dose shouldn't be a problem.  As I said I haven't had any problems taking compounded.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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10 hours ago, ChessieCat said:

I've experienced constipation with Pristiq.  I used to eat weetbix for breakfast but changed firstly to rolled oats and then to muesli.  I also add a handful of chopped dates.  I found that has helped.

 

The insomnia might be a withdrawal symptom from going off Wellbutrin so quickly and recently.

 

Because your've been on 50mg for 11 weeks, which is almost 3 months, and you were on psychiatric drug/s before that, dropping from 50mg to 25mg may be too much in one go.  It is possible, but can be difficult, to cut the tablets evenly.  If you have a scale you could weigh the pieces to get better accuracy.  We can't get 25mg in Australia and I've been taking compounded Pristiq since I got past 50mg and haven't been having any issues and I'm now down to 20mg taken in one capsule.  Member Fresh, also an Aussie, was taking Pristiq and managed to cut and weigh hers until she started getting them compounded.

 

If you want to reduce to 25mg I suggest you could try cutting a 25mg into half and then cut one of those halves into 2 quarters and take 25mg + 1/2 of 25mg + 1/4 of 25mg for a few weeks and then drop to 25mg + 1/2 of 25mg for a few weeks and then 25mg + 1/4 of 25mg for a few more weeks.  I think doing that would be a better option than jumping straight to 25mg.

 

If you have a scale you could weigh the pieces to get better accuracy.

 

Because you will be taking 25mg as slow release, the faster release of the smaller part of the dose shouldn't be a problem.  As I said I haven't had any problems taking compounded.

Thanks Chessie that makes a lot of sense . Is your compounded slow release ? Did your constipation, or any other side effects, stop when you got down to 20? 

God bless

Jaco

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • 2 weeks later...

My pdoc suggested I alternate 50mg of Pristiq with 25 mg every other day and if I'm doing well then eventually just use 25mg. Any thoughts on this strategy? 

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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Hi I'm taking 50 mg of Pristiq but want to lower my dose because the constipation is too much.   My pdoc thinks I could try alternating 50 w/ 25 mg every other day then eventually try just 25mg. Being that this med cannot be cut and 25 mg is the lowest dose what other choices do I have and is this pdoc idea acceptable? 

Thanks 

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

Not sure if this answers your question:

 

On 12/09/2017 at 10:46 AM, scallywag said:

 

 

Marsha, are you using a desktop/laptop computer to view the site or a mobile device (phone or tablet)?  If you're using a mobile device, you can't see the signatures. It's an arbitrary decision by the forum software publishers/developers to allow mobile users to see more actual content.  It's something that probably works for many sites but doesn't mesh well with SA using signatures to convey important rather than "nice to see" information.

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

Alternating doses is not recommended.  This graph is about skipping doses but gives the idea of different dosing:  Skipping Days vs Every Day Dosing Graph

 

Also SA recommends reducing by no more than 10% of the previous dose with about a 4 week hold to allow the brain to adapt to not getting as much of the drug.  Because you have not been on Pristiq for very long you may be able to go faster, however because you have been on psychiatric drugs previously I would be very cautious about trying to reduce too quickly.

 

It is possible to cut and weigh Pristiq tablets.  Fresh did this before she started getting hers compounded.

 

I have my Pristiq compounded with a slow release formula added.  In Australia we cannot get 25mg tablets so I have been taking all capsules since getting under 50mg.  I am now down to 19mg and have had no difficulties.

 

Post #1 provides some information about compounding in AmericaCompounding pharmacies

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

 

4 hours ago, Jaco2016 said:

Ok after reading this thread it's not clear if the consensus is that the matrix is in fact the "outer shell" OR if it's what "binds the medication" inside the shell. If I cut this stuff is there any potential for dangerous side effects? I'm taking 25mg ER combined with 3/4 (1/2 + 1/4) cut up 25mg and feeling a little off... maybe this wasn't the best decision 😾

 

I have responded in here:  tips-for-tapering-off-pristiq-desvenlafaxine

 

You have made a dose reduction, reducing from from 50mg to 43.75mg.  This is most probably why you are feeling a little off.  It is withdrawal symptoms.  Changing the way you take your drug can sometimes cause minor issues but these generally settle fairly quickly.

 

Edited by ChessieCat

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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18 hours ago, ChessieCat said:

 

 

The matrix is inside the tablet, not the shell.

 

 

 

 

You have made a dose reduction, reducing from from 50mg to 43.75mg.  This is most probably why you are feeling a little off.  It is withdrawal symptoms.  Changing the way you take your drug can sometimes cause minor issues but these generally settle fairly quickly.

Ok good to know .  I think I'm a little better today on the 43.75mg. I'm trying to take my time to cut as precisely as possible .  So just give myself a few weeks to stabilize before another reduction right? It'll be interesting trying to get my doc to give me another 25mg refill "early" since he specifically told me not to cut them. I'm hoping he'll understand though. Thanks for your reply

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

I suggest you check out these topics before you speak with your medical professional.  It's good to be assertive.  Of course medical professionals most probably don't like being told that a patient "read it on the internet" so it can be good to practice ways to word it before seeing them.

 

How do you talk to a doctor about tapering and withdrawal?


What should I expect from my doctor about withdrawal symptoms?

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 2 weeks later...

Does anyone know of a good pill cutter for square shaped pills ? It’s hard to cut Pristiq precisely with a regular pill cutter and I’d really prefer not to have to weigh it. Compounding is not an option...

Thanks,

Flaco Jaco

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

Hi Jaco, I've merged your new topic back into your introduction thread and would ask that you post any new questions you have about your own personal situation into this thread, rather than starting a new topic.  I allows moderators to see all of your information in one spot and would ask that you post here when you have a question.  

 

Regarding Prisitiq, have you thought about crushing and weighing your doses?  You can find more information at the links below:

 

 

Pay particular attention to the information in the link which I've copied below:

 

Crush Pristiq tablets, weigh powder with a digital scale
This is similar to cutting up tablets -- Pristiq is a "do not crush" medication, as it is a time-release drug.

Conceivably, dividing the dose and taking a measured amount of powder more than once a day, like regular Effexor, may make this method feasible.

Crushing the tablet and making sure the shell fragments are evenly distributed in the powder would be a more precise way of tapering than cutting up tablets.
 
As Pristiq's extended-release mechanism is part of the tablet matrix, or the glue that holds the tablet together, when the tablet is crushed, the matrix is completely destroyed. The particles should be assumed to have NO extended-release capability.
 
The Pristiq powder becomes desvenlafaxine, with an 11-hour half life. If you pulverize the tablet, you might take smaller divided doses of Pristiq, more than once a day, like immediate-release Effexor, to mimic an extended-release dose.

Peer discussion of this method starts here http://survivingantidepressants.org/index.php?/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/page__view__findpost__p__27417

Current Prescription Drugs for Hypothyroidism:  Synthroid 100mcg / Cytomel 5mcg (15 years Pristiq/Effexor)

Tapering Schedule
September 15, 2016 - switched from Pristiq 50mg to Effexor XR 75mg; November 10, 2016 - reduced to 67.5 Effexor XR
December 9, 2016 - reduced 60.75
January 5, 2017 - reduced 54.67
January 30, 2017 - reduced to 49.0
February 20, 2017 - reduced to 44.0 
May 20, 2017 - reduced to 40.25 (holding for additional month due to late onset of withdrawal symptoms after this taper)
July 17, 2017 - reduced to 38.24
August 15, 2017 - reduced to 37.5 (50% of my original dose)

October 15, 2017 - reduced to 35.6

November 12, 2017 - reduced to 33.8
December 15, 2017 - up-dose to 35.6
December 28, 2017 - up-dose to 37.5

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  • 2 weeks later...

So I was down to 37.5mg (25 + 12.5) of Pristiq using the cutting method (bought a $30 splitter online so I could make more precise cuts) . I took 37.5 for maybe a week to 10 days and was feeling good so I am further reducing now to one 25mg pill + 1/4 of another 25 pill for a total of 31.25.

Now on day 2 of this dose and feeling slight headache and very slight anxiety... Goal is to be on just one 25mg pill by December so no splitting needed and few side effects as possible with still some coverage for my anxiety !

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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Help this is hard. I’m getting a bit tearful especially since yesterday when my son brought home an F on his report card and my other son a D.  This a first in our Home and I’m blaming partly myself because I’m gone so much (I have to work 50-60 hours a week to support my family). And both boys fight with my wife and I daily about screen time limits.  It’s a constant battle and I’m afraid I’m wearing thin especially with this taper ☹️

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

 

On 2017-09-16 at 9:14 PM, ChessieCat said:

Also SA recommends reducing by no more than 10% of the previous dose with about a 4 week hold to allow the brain to adapt to not getting as much of the drug.  Because you have not been on Pristiq for very long you may be able to go faster, however because you have been on psychiatric drugs previously I would be very cautious about trying to reduce too quickly.

  

Jaco2016, while you haven't been on Pristiq for very long, you do have a history of being on psychiatric drugs previously and you need to be mindful that you may not be able to reduce the Pristiq as quickly as you'd like. You'll need to start listening to your body, which is now letting you know that you are reducing too quickly.  If I were you, I would hold at 31.25, provided the symptoms are manageable and throw away your calendar.  You can only go as fast as your central nervous system will allow and right now it's telling you that you need to hold.  Please have a look at the links below to help you understand the process a little better so that you can avoid further disruption to your already sensitized central nervous system.

Stabilising After a Reduction - What Does That Mean?
Before you begin tapering what you need to know
Why taper by 10% of my dosage?
How Psychiatric Drugs Remodel Your Brain aka Brain Remodelling

Current Prescription Drugs for Hypothyroidism:  Synthroid 100mcg / Cytomel 5mcg (15 years Pristiq/Effexor)

Tapering Schedule
September 15, 2016 - switched from Pristiq 50mg to Effexor XR 75mg; November 10, 2016 - reduced to 67.5 Effexor XR
December 9, 2016 - reduced 60.75
January 5, 2017 - reduced 54.67
January 30, 2017 - reduced to 49.0
February 20, 2017 - reduced to 44.0 
May 20, 2017 - reduced to 40.25 (holding for additional month due to late onset of withdrawal symptoms after this taper)
July 17, 2017 - reduced to 38.24
August 15, 2017 - reduced to 37.5 (50% of my original dose)

October 15, 2017 - reduced to 35.6

November 12, 2017 - reduced to 33.8
December 15, 2017 - up-dose to 35.6
December 28, 2017 - up-dose to 37.5

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On 10/13/2017 at 10:42 AM, baroquep said:

 

  

Jaco2016, while you haven't been on Pristiq for very long, you do have a history of being on psychiatric drugs previously and you need to be mindful that you may not be able to reduce the Pristiq as quickly as you'd like. You'll need to start listening to your body, which is now letting you know that you are reducing too quickly.  If I were you, I would hold at 31.25, provided the symptoms are manageable and throw away your calendar.  You can only go as fast as your central nervous system will allow and right now it's telling you that you need to hold.  Please have a look at the links below to help you understand the process a little better so that you can avoid further disruption to your already sensitized central nervous system.

Stabilising After a Reduction - What Does That Mean?
Before you begin tapering what you need to know
Why taper by 10% of my dosage?
How Psychiatric Drugs Remodel Your Brain aka Brain Remodelling

My CNS told me I was doing fine on 37.5 and it was time to reduce which is why I did. My hope was to be down to 25 by December but it wasn’t a rigid goal. I’m willing to go as slow as possible the problem is the smallest dose reduction I can do is 1/4 of 25mg which the lower dose I get to the higher the % of reduction which makes it much harder to adjust to! Thanks for the links I’ve already read all of them though many times before.  Really just wanted moral support.

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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So I’ve done the math to figure out the percentage decreases that occur with this cutting of one Pristiq pill (cutting one 25mg into quarters and taking the piece(s) with another 25mg tab for a total dose 50mg) and they are as follows:

Reduction #1  50 to 43.75mg =12% 

                    #2 43.75 to 37.5   = 14%

                     #3 37.5 to  31.25 = 16% 

                     #4 31.25 to 25mg = 20%

 

reduction 1 caused some minor discomfort for one day only.  Reduction2 didn’t cause any problems at all.  Reduction 3 has been a problem I’m guessing because it’s been the largest jump percentage wise but also I may be reaching “sub therapeutic” levels of this med for my body.  My anxiety was fine on reduction 1 and 2 and has been mild on reduction 3 for 5 days now and counting.  I’m hoping I stabilize soon.  The next reduction will be the hardest - I may splint the quarter piece of the pill in two if I can and make it two reductions at 10% each instead of one big jump 😫

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Moderator Emeritus

Hi again, I tried reducing Pristiq the way you are going and it didn't end well and I ended up back on the full dose.  You might be able to get away with a larger percentage once in a while but not consistently.  You are reducing by a larger amount every time you make a decrease and you are likely going to run into trouble if you continue to reduce at such a large percentage.  If you continue to taper this way, you could destabilize your central nervous system and end up having to up-dose to re-stabilize and have to do months long hold.  It's better to be cautious at the beginning so that you can successfully taper off of this drug with few if any withdrawal symptoms.

 

Surviving Antidepressants recommends tapering by 10% of your current dose with at a hold of at least four weeks before your next decrease.  The The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at an even more conservative rate.  

 

Please reread the links below so that you have a good understanding behind the recommendations made here so that you have a successful and uneventful journey off of Pristiq.

Before you begin tapering what you need to know

Tips for Tapering off Pristiq

 


Stabilising After a Reduction - What Does That Mean?
Why taper by 10% of my dosage?

 

Keep it Simple, Slow and Stable
Slowness of slow tapers

Current Prescription Drugs for Hypothyroidism:  Synthroid 100mcg / Cytomel 5mcg (15 years Pristiq/Effexor)

Tapering Schedule
September 15, 2016 - switched from Pristiq 50mg to Effexor XR 75mg; November 10, 2016 - reduced to 67.5 Effexor XR
December 9, 2016 - reduced 60.75
January 5, 2017 - reduced 54.67
January 30, 2017 - reduced to 49.0
February 20, 2017 - reduced to 44.0 
May 20, 2017 - reduced to 40.25 (holding for additional month due to late onset of withdrawal symptoms after this taper)
July 17, 2017 - reduced to 38.24
August 15, 2017 - reduced to 37.5 (50% of my original dose)

October 15, 2017 - reduced to 35.6

November 12, 2017 - reduced to 33.8
December 15, 2017 - up-dose to 35.6
December 28, 2017 - up-dose to 37.5

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  • 6 months later...

So I’m trying to get on as low a dose of Pristiq as possible due to continjed troublesome side effects like insomnia. I decided to try taking my 50mg every 36 hours instead of every 24.   That went pretty well for about a month without any withdrawal symptoms.  So now I’m trying to take it every 48 hours.  I am getting some mild withdrawal symptoms but not as bad as when I went to 25 mg/day several months ago.  I’m wondering why it’s better this time though my hunch is that I’ve been taking vitamin D supplements after finding out through a blood test that i was vitamin D deficient.  I also got a raise at work which is helping to offset financial worries.

 

I’ll thinking once these mild withdrawals abate a bit that I’ll try taking the 25mg tablets every 36 hours and then every 48 hours.  After that I may cut the 25 mg into 3 quarters (or crush the tabs and weigh the piecd to make a smaller reduction- I can’t do compounding as it’s too expensive) and repeat the process until i feel like I need to stop or just get off the medicine altogether. Does this sound like a good plan?  My theory for why it works to take the  every 36 or 48 hours is that it takes 2.54 days for Pristiq to leave your system altogether so as long as it’s taken before the 2.54 day mark your body is still ok.  I wonder if the opposite is true - because it takes that long to clear totally out of your system if you take this medication every single day it starts to accumulate so much so that it becomes intoerlable as each dose compounds the amount and effects of the previous.  That would explain why I always felt like there was too much of this drug in me even in the lowest therapeutic dose of 50mg.  Whenever i felt that way I would skip a day of taking the med and would almost always feel better!  It’s weird how these things work (or don’t work rather!).  Anyway I’m happy to report that I’m on a lower dose of this drug!  But I’d appreciate any feedback about my tapering idea. Now if I could just get some sleep!

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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So I’m trying to get on as low a dose of Pristiq as possible due to continjed troublesome side effects like insomnia. I decided to try taking my 50mg every 36 hours instead of every 24.   That went pretty well for about a month without any withdrawal symptoms.  So now I’m trying to take it every 48 hours.  I am getting some mild withdrawal symptoms but not as bad as when I went to 25 mg/day several months ago.  I’m wondering why it’s better this time though my hunch is that I’ve been taking vitamin D supplements after finding out through a blood test that i was vitamin D deficient.  I also got a raise at work which is helping to offset financial worries. 

 

I’ll thinking once these mild withdrawals abate a bit that I’ll try taking the 25mg tablets every 36 hours and then every 48 hours.  After that I may cut the 25 mg into 3 quarters (or crush the tabs and weigh the piecd to make a smaller reduction- I can’t do compounding as it’s too expensive) and repeat the process until i feel like I need to stop or just get off the medicine altogether. Does this sound like a good plan?  My theory for why it works to take the  every 36 or 48 hours is that it takes 2.54 days for Pristiq to leave your system altogether so as long as it’s taken before the 2.54 day mark your body is still ok.  I wonder if the opposite is true - because it takes that long to clear totally out of your system if you take this medication every single day it starts to accumulate so much so that it becomes intoerlable as each dose compounds the amount and effects of the previous.  That would explain why I always felt like there was too much of this drug in me even in the lowest therapeutic dose of 50mg.  

 

Whenever i felt that way I would skip a day of taking the med and would almost always feel better!  It’s weird how these things work (or don’t work rather!).  Anyway I’m happy to report that I’m on a lower dose of this drug!  But I’d appreciate any feedback about my tapering idea. Now if I could just get some sleep!

Edited by Altostrata
added paragraph spacing

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Administrator

Hi, Jaco. Skipping doses as you're doing is a good way to trigger terrible withdrawal symptoms.

 

2 hours ago, Jaco2016 said:

I am getting some mild withdrawal symptoms

 

^This is not a good sign. The withdrawal symptoms can get worse at any point. Don't aggravate your nervous system by continuing to take Pristiq irregularly. You've been cautioned several times not to rush your taper.

 

2 hours ago, Jaco2016 said:

My theory for why it works to take the  every 36 or 48 hours is that it takes 2.54 days for Pristiq to leave your system altogether so as long as it’s taken before the 2.54 day mark your body is still ok.

 

Your theory is incorrect. If you are splitting a Pristiq tablet, the half-life is probably very short, like that of regular venlafaxine, about 10 hours. If you read Tips for tapering off Pristiq (desvenlafaxine), as you were advised to do repeatedly, you will see that because of this short half-life when splitting tablets, you might have to take Pristiq twice a day.

 

Your strategy sounds high-risk to me. You might settle on a lower dose of Pristiq, such as 45mg, now -- but take it every day, please.

 

Sleeplessness can be a side effect of the drug or it can be a withdrawal symptom. Has your sleep pattern changed while you've been tapering Pristiq? What time of day do you take it?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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25 minutes ago, Altostrata said:

Hi, Jaco. Skipping doses as you're doing is a good way to trigger terrible withdrawal symptoms.

 

 

^This is not a good sign. The withdrawal symptoms can get worse at any point. Don't aggravate your nervous system by continuing to take Pristiq irregularly. You've been cautioned several times not to rush your taper.

 

 

Your theory is incorrect. If you are splitting a Pristiq tablet, the half-life is probably very short, like that of regular venlafaxine, about 10 hours. If you read Tips for tapering off Pristiq (desvenlafaxine), as you were advised to do repeatedly, you will see that because of this short half-life when splitting tablets, you might have to take Pristiq twice a day.

 

Your strategy sounds high-risk to me. You might settle on a lower dose of Pristiq, such as 45mg, now -- but take it every day, please.

 

Sleeplessness can be a side effect of the drug or it can be a withdrawal symptom. Has your sleep pattern changed while you've been tapering Pristiq? What time of day do you take it?

 

 

I appreciate your concern and I don’t pretend to know more than anyone here about tapering AD.  I do think though that for whatever reason my wd symptoms are tolerable compared to the last time I tried tapering down to 25mg. It may be the vitamin D supplement is kicking in as that’s really the only thing I’m doing differently this time.   I’m not getting cocky as I do believe I will have to crush and weigh this medication to taper below 25mg however, to move very slowly, as you and other have mentioned previously.  To answer your question I’m not cutting the medication just using 25mg ER tablets which is what I’m basing the 2.54 days figure on.  

 

The insomnia has always been a problem no matter what the dose.  I always haven taken it first thing in the morning . That’s the main reason I want to taper or get off the meds... will take it one day at a time though.   

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Administrator
25 minutes ago, Altostrata said:

Sleeplessness can be a side effect of the drug or it can be a withdrawal symptom. Has your sleep pattern changed while you've been tapering Pristiq? What time of day do you take it?

 

^Please answer these questions.

 

1 minute ago, Jaco2016 said:

I do think though that for whatever reason my wd symptoms are tolerable compared to the last time I tried tapering down to 25mg.

 

That could be because, sloppy as your method is now, it is more gradual than before. However, getting withdrawal symptoms is a red flag, not a reassuring sign.

 

Please consider whether tempting fate is in your best interest. Sometimes people have to take a few turns in the barrel before they commit to tapering properly.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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A few turns in the barrel before tapering “properly.”  A little condescending and self righteous?  Give me a break !

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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I asked a sincere question hoping to get a answer, an instead get shut down and have my post moved so no one else can read your condescending response.  It’s sad when someone going through the same struggles as everyone else here can’t get the support they need!!

17 minutes ago, Altostrata said:

 

^Please answer these questions.

 

 

That could be because, sloppy as your method is now, it is more gradual than before. However, getting withdrawal symptoms is a red flag, not a reassuring sign.

 

Please consider whether tempting fate is in your best interest. Sometimes people have to take a few turns in the barrel before they commit to tapering properly.

I asked 

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Administrator

Check it out. I counsel hundreds of people a week. I'm not going to argue with you if you want to reinvent the wheel.

 

If you don't want advice about your sleep problem, keep it up.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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No I’d rather not have YOUR advice please.  Someone else who can ALSO show respect - yes. 

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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  • Administrator

So far, you've ignored our advice. If you want to do it your way, feel free. There's no reason for any of the staff to waste their time with you.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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First off I haven’t ignored your advice - I am actually trying to incorporate what you teach and take things as slow as possible. Unfortunately I’m am currently unable to cut/crush and weigh my drugs to taper by 10% by I am feeling good despite using my unconventional method and you are unhappy about that.  Second, i never asked for you to respond to my question.   Last, I would ask that you stop punishing me with warnings and please post my question where it was in the first place where another user can respond.  Also forgive me but what credential or training do yo have to counsel people?  Very few people are able to come off these drugs, tapering by 10% or not. When someone has success with any method I would expect some support from my “team.”  If I am wrong about my assumptions than explain why and provide your reasoning instead of just shutting it down.  Is that too much to ask??

June-Current Started Pristiq 50mg 

March-June Discontinued Wellbutrin. 

February 15-March 1 2017: Taper Wellbutrin. 

December 24, 2016- Feb. 15 2017: Switched to Wellbutrin 150mg 2x/day after Genesight testing; 

August 4-December 23, 2016: Reinstate celexa

March 18-August 3, 2016: Switched to Prozac 

Feb-March 2016   Reinstate celexa

Jan-Feb 2016  Tapered 5mg/every week to 0mg

August 2015-Jan. 2016: Celexa 30mg

2008-2016: Celexa 30-40mg/day for anxiety

2006-2007: Strattera ?80mg/day + xanax

 

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