I have been on 20mg of Lexapro for a little over a year. I saw my doctor yesterday and told her that despite the difference Lexapro had provided, I was still not very "happy" (and never had been...it basically made me dysphoric rather than crying all the time), and the fact that I have gained 19 pounds from the medication alone (no change in my activity level over the time I was on the drug) did not make me too happy. So, she gave me a sample pack of Pristiq--as well as a prescription--and told me to take the Pristiq one day, and then the Lexapro the next. She wants me to alternate the two meds for one or two weeks, and then switch over to Pristiq completely.
My questions: Is this really necessary (i.e., if Pristiq is an SNRI, why would I still experience withdrawal from Lexapro)? Furthermore, isn't there a chance that I could experience Serotonin Syndrome by switching back and forth like this (or is this a common procedure)?
Could people who have switched from an SSRI to Pristiq (or anyone who has switched from an SSRI to any other type of anti-depressant) please reply and let me know how they were informed to do so, and how it worked out in the end? I would really appreciate as much feedback as possible, b/c I am considering just switching to Pristiq right away...I have tried the whole cabinet before, and never was I "weaned-off" of one before starting the other; I was always just switched over on the day of the visit.
Thank you all for your help!!
Kiera
Is this standard? Switching from SSRI (Lexapro) to Pristiq--Need feedback from similar situations!?
- Posted:
- 3+ months ago by izzothecat
- Topics:
- celexa, cymbalta, effexor, effexor xr, lexapro, paxil, pristiq, prozac, wellbutrin, wellbutrin xl, depression, bipolar disorder, post traumatic stress disorder, anxiety, panic disorder, premenstrual dysphoric disorder, fibromyalgia, generalized anxiety disorder, citalopram, desvenlafaxine, escitalopram
Answers (2)
Hi Kiera,
I've trialed several psychotropic medications throughout the past ten years or so for the treatment of Generalized Anxiety Disorder, Depression, ADHD, and Post-Traumatic Stress Disorder. In addition, I am fortunate enough to have the experience of working in the field of working with Emotionally/Behaviorall Disturbed children, which involves a great deal of researching and staying up to date with psychotropic medications.
While I have not personally taken Pristiq, I have been on Lexapro, which my physician slowly tapered me off of. In my personal and professional experience, most doctors prefer to taper off one medication prior to initiating a new medication due to the fact that if you change two factors at one time, there is no way to tell which of the two is causing a result. For example, if you are decreasing the Lexapro dosage to every other day while simultaneously starting a completely new medication (Pristiq), and your behavior or mood changes, you will have no no way of determining which drug caused that change....the decrease in Lexapro or the introduction of Pristiq?
Hence, my best advice to you, at this point is to first check out the links I attached below and possibly discuss your concerns with your doctor. If you are worried that he/she will think you are acting like you know more than him/her, it might be helpful to word your question in a similar fashion to the following statement: "I feel concerned and confused about why I need to be on Lexapro and this new medication, Pristiq, at the same time. How will I know which of the two drugs is causing any changes that might happen during this time period? Also, I read some information about Seratonin Syndrome, and I'm pretty scared about it. Do I need to be worried about the information I read?" I know it sounds a little corny, but from my experience working with colleagues and as being a patient, most physicians don't seem to like it when they're "told" what to do. They appear to prefer the "patient plays dumb" approach.
I did some research and found some links which may be of use to you. Feel free to check them out, and hopefully you will find some useful information:
http://depression.emedtv.com/pristiq/pristiq-warnings-and-precautions-p2.html
http://www.mayoclinic.com/health/serotonin-syndrome/DS00860/DSECTION=causes
and the page that follows it (see below):
http://www.mayoclinic.com/health/serotonin-syndrome/DS00860/DSECTION=risk-factors
*****If you go to drugs.com and click on "Interactions Checker," type in "Pristiq" and "Lexapro." A major drug-to-drug interaction pops up on the next screen warning of the potential of Searatonin Syndrome.
I hope some of this information was helpful. Sorry it was such a long reply.
Good luck.
Your doctor is being cautious by alternating drugs. The aim of treatment is to reduce Lexapro slowly so as to not precipitate withdrawal symptoms and to introduce Pristiq slowly so as to not risk serotonin syndrone.
You should keep in close contact with your doctor whilst you are switching medications and follow your instructions. If you experience anything unusual contact your doctor.
You may also find the forum useful in finding people who have had similar experiences.
http://www.drugs.com/forum/
Thank you so much for finally being the first to respond to my question!
I do understand why my doctor is having me switch over in this manner--particularly after reading the notes of people who had to experience such horrendous side effects from discontinuing Lexapro--but I have been worried about my doctor's lack of keeping in close contact with me. I have read that Pristiq can increase blood pressure, the amount of triglycerides and cholesterol in my blood, and also decrease my sodium levels. She gave me the script and samples for Pristiq, and then scheduled me for blood work (for the usual potential physical causes of depression--blood count, TSH, etc.--no mention of any of the possible side effects of Pristiq) in November, a week before my next scheduled visit with her. So I will not be seeing the contor who prescribes psychotropic medications to me for at least 3 months, even though Pristiq's insert advises that the patient's doctor maintain steady contact with a patient after placing him/her on Pristiq, particularly during the first month.
Following her directions of tapering--which I have been doing since Friday--is it likely that I will still experience the side effects of Lexapro-withdrawal, but in a much milder form and for a much shorter period of time?
Thank you for your help-
Kiera
The link which you provided is the generic link to all forums. Did you have one in particular that you meant to send to me, or for me to read? I have been through both the Lexapro and the Pristiq forums...they are the initial places where I learned how I managed to gain 22 pounds despite no changes in diet or exercise. I have not been able to find any information yet that describes a person's process with switching from a tapered drug to Pristiq; the Lexapro forum is mostly a bunch of people--who like me--have gained weight and are now wondering if they will even be able to get it off (even when they are off of Lexapro)--and nobody seems to offer any hope, and the Pristiq forum involves a few people who absolutely hated it, as well as the majority of the forum members who did like it because it seemed to begin working for them right away, and it helped them with their weight, essentially by making them anorexic...not too sure how healthy it is if I lose weight while on being on a drug whose primary cause of weight loss involves the side effects of stimulating the norepinephrine component of my system and inducing a rather extreme--and, yes, a false-sense of satiety--decrease in my appetite.
Again, though, thank you for at least responding.
Kiera
Thank you for all of the info. I too have been through points where doctors wanted to change 3 meds, but I stopped and explained to them that I would have no idea what was causing any increase or decrease in my mood if I were to do all of this at once (not to mention all the non-medical circumstances that could be changing my moods).
Luckily, I was able to talk to the pharmacist today when I filled the script for the Pristiq. After I explained to him the process that my doctor had planned, he thought that it would be very effective, and he thought it sounded like the best decision. He particularly alleviated my concerns of serotonin syndrome, as well as potential w/d symptoms from the Lexapro (he said that if I experience any, they should not be for long, and certainly not nearly as bad as just coming off of Lexapro). Thank you for the links...I will definitely check them out.
And no need to apologize for writing a lot...I definitely want as much info. as people are able to provide.
Thanks again, and I will keep you posted. So far, everything has been fine (i.e., no side effects, no symptoms of serotonin syndrome, and I am looking forward to finally getting off of Lexapro and hope that my metabolism reestablishes itself at some point).
Best,
Kiera