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Please help-Switching from Lexapro to Pristiq
  1. #1
    izzothecat is offline New Member
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    Question Please help-Switching from Lexapro to Pristiq

    Hi,
    I have been on 20mg of Lexapro for a little more than a year, and after reading a lot of depressing posts on this site, I am even more confused as far as what I should do. The many claims on this site further substantiated the claim I made to my doctor during our quarterly check-up: That despite my having made no changes in my diet and/or exercise habits, I have somehow managed to gain ~30 pounds of belly-fat since starting Lexapro. I don't even drink, yet I look like one of the characters from "King of the Hill" that has skinny arms, legs and chest, and then a nicely-formed beer belly. I also told my doctor how Lexapro (and many other drugs before it) has essentially changed my mood from severely depressed to a static state of anhedonia; I am pretty much emotionless (blunted affect), I go to school and then go straight home and study...never going out, relaxing, having fun, etc, and I am completely uninterested in forming any type of relationship--whether it be romantic or just a friendship--since the very start of Lexapro. So, I can honestly state that Lexapro helped me significantly in that I don't stay in bed all day and cry when I am not sleeping. However, this is not how I want to live or feel--I might as well be lobotomized...and all of the comments that I have been reading about how "the weight gained while on Lexapro is impossible to reduce even AFTER discontinuing it" really adds the finishing touch to the huge damper I now feel regarding all of the major life-style changes I have made and been planning to implement next week (work that I have been slowly building-up over the past 2 months with the help of a therapist).
    To make matters even more confusing, my doctor's solution was (of course!) to give yet another "brand-new, state-of-the-art" anti-depressant, just like Lexapro was advertised to me when I was given it (I think this brings the total medication count to 19...over a 3-year period...and yes, I am dead serious) to switch over to: Pristiq.
    So my first question is this: If Effexor (and Effexor XR) also cause weight gain as people on the forums have claimed, how come nearly every positive posting under the Pristiq forum involves another person's claim that a sustained-release form (i.e., XR) of the "active" isomer of Effexor actually helps to improve weight loss? Is the L-isomer of Effexor some sort of microscopic crystal composed of pure beef fat?
    More importantly, I experienced the pleasure of learning the horrific withdrawal symptoms of Lexapro by reading through this site's forum...of course, my doctor never mentioned anything of the sort, but you can find vague descriptions of some these w/d symptoms in the PDR, but how many people have that handy (I only have it b/c I am a medical student)? So, my doctor wants me to take Pristiq every other day (while taking Lexapro on the days in between) for a week, and then take Pristiq for 2 days (and 1 day of Lexapro in between the two days of Pristiq) for 2 weeks, and finally switching completely over to Pristiq after the last 2 weeks. Is this a common practice used when switching medication, because I have (in the past) always been given the new medication to start immediately while discontinuing the other without any tapering? Furthermore, isn't there a possibility of my experiencing serotonin syndrome by alternating an SSRI with an SNRI, since Lexapro is built-up in my system (in addition to the 2 drugs' half-lives, which I do not know off-hand)? If I were to just switch over to Pristiq completely--ignoring the tapering of Lexapro--am I still apt to experience w/d effects from Lexapro, even though Pristiq actively blocks serotonin re-uptake inhibitors? Lastly, would there be any benefit/reason for me to temporarily switch over to Prozac--for say, a week--while stopping the Lexapro altogether, and then starting Pristiq after a week of Prozac (stopping the Prozac completely when I make the switch)?
    I know this is incredibly long, but this is the last question that has been running through my mind for a long time (for at least 3 months now). I, personally, am not too big on the whole "chemical imbalance" theory of disorders such as depression and anxiety (which, btw, are my conditions), and I actually believe that throwing all of these psychotropic medications into people's brains--the most complex organ in the body that scientists do not only have a substantial lack of knowledge about, but also have no empirical evidence to base any theory of chemical imbalances as the causes of problems--are actually THEMSELVES causing chemical imbalances. Thus, I have long wondered if I should just "get-off" of these medications and hope that my brain will eventually restore itself to its 'normal' state of functioning. Regarding this last issue, does anyone have any input or advice that might help me?
    I apologize for writing such a long question, but I truly hope that some people will take the time to consider my questions. I will greatly appreciate any feedback that people are able to provide...particularly those who have switched from an SSRI that requires tapering onto another drug, how their experience went overall, and what--if anything--they might have done differently if they were able to start over (besides simply stating, "I would have never taken any of these drugs in the first place if I could do it all over again," because I already hold that viewpoint).
    Thank you to anyone who can provide me with some answers here...I am so sick of the "art" of psychiatry, and I hope that others can help me out by discussing their own idea.
    Best wishes,
    Kiera

  2. #2
    beebee76 is offline New Member
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    Default Re: Izzo the cat question about drugs "creating" chemical imbalance

    Izzo...
    Take it from me, these drugs DO NOT create an imbalance. I was incorrectly removed from Celexa by a physician and nearly died. After trying Cymbalta, Lithium, Zyprexa, Zoloft, and TEN other Rxs (I kid you not), they finally tried Pristiq, which worked like a dream, except it caused more anxiety (I have MDD and GAD in spades). We are now trying a combination of Pristiq and Lexapro.

    I suggest you try finding a psychiatrist at a university. They are usually more up-to-date on research and may have better answers.
    Don't give up!
    Beebee76

  3. #3
    izzothecat is offline New Member
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    Default

    Quote Originally Posted by beebee76 View Post
    Izzo...
    Take it from me, these drugs DO NOT create an imbalance. I was incorrectly removed from Celexa by a physician and nearly died. After trying Cymbalta, Lithium, Zyprexa, Zoloft, and TEN other Rxs (I kid you not), they finally tried Pristiq, which worked like a dream, except it caused more anxiety (I have MDD and GAD in spades). We are now trying a combination of Pristiq and Lexapro.

    I suggest you try finding a psychiatrist at a university. They are usually more up-to-date on research and may have better answers.
    Don't give up!
    Beebee76
    Hey BeeBee76-
    Thanks for the message...I can definitely sympathize with you, as I have been on the Psychiatry "roller-coaster" for far too long now. I was also put on nearly every medication they have available (including, like you, Lithium...even though the Psychiatrist stated, flat-out, that he did not think that I was Bipolar at all...after the Lithium trial, I left that one).
    Anyway, to keep this short, when I had posted my above message, I was in a current state of semi-depression (as well as anger regarding the almighty doctor's fix for everything: increase the dosage or try a new drug). Fortunately, my switch-over from Lexapro to Pristiq went amazingly well: I did not experience any of the w/d symptoms that others who had come-off of Lexapro had recounted, and after only a week or so of some minor excitation (side effects from the Pristiq that passed), it is working pretty well for me on its own.
    However, I still do question the idea about not being on any medications; I understand that in my case--right now, that is--Pristiq is helping me. However, I had never sought nor taken any anti-depressant medications before my 3rd bought of depression...and it seems that ever since then (4 years ago next Month), I have never been able to achieve a single day in which I am not unhappy. I dont mean unhappy as in the state of depression that I have been at, but in the past, I had significant periods (i.e., 4 years between the 1st 7-month depression and 3 year between the second 9-month period of depression) when I was no longer depressed. Currently, I am not depressed in the sense that I was, but I have been living a 3-year period of pure isolation...not happy, but not curled-in-a-ball depressed.
    We'll see where it all goes I guess, right?
    Take care, and thanks again for your response-
    Kiera



  4. #4
    Cleantime is offline New Member
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    Wink the roller coaster...

    WOW, where do I start. First with I understand where you are coming from. I'm not sure how big of a town you are from, but I kind of agree with the other person about finding someone up to date. A family practice doc rarely has the adequate knowledge to handle anything beyond minor cases of depression. So finding someone who does is important. I have what is called dual diagnosis. That is substance abuse along with a medical condition such as in my case severe depression. (I have so much to say I may get jumbled here; just try to stick with me... I'm really pretty smart believe it or not!!! LOL) So anyway, my savior has come in the form of an ARNP at a place called Lakeview. It is a community mental health hospital with addiction treatment too. The advantage here is that ALL my ARNP does is see psych patients, and as such, she knows and understands the meds very well. SO I would try to find someone like that in your area to see.

    On the substance abuse... well there is a family history, and depression and substance abuse can run hand in hand very often. In my case I never touched a drug until I was 28. You talk about being emotionless... well I found a medication that does just the opposite. Cymbalta. With the cymbalta, I was more loving than you can imagine. However, my family practice was doing my meds back them. He switched me from high dose Prozac (VERY blunted and zombie like) to cymbalta (VERY touchy feely and loving) during my divorce. So here I am feeling all this love and emotions I had been bottling up for years during the time when I was going through a divorce. A time I WANTED to be blunted, and unfortunately I found that through drugs. That was around this same week of 2004... It was 3 yrs 3mo and 24 days ago I used my last time. It has destroyed my life and my career. I still have my RN, Paramedic, and FF Licenses, but it is hard to get a job now with this in my past. People in the medical field typically see addiction as a weakness until they experience it firsthand.

    SO should you stop all of it? I don't think so. I tried that when I was 18 and stayed off for about 2-3 years. As long as I was in the gym a LOT then I was ok. The endorphins produced helped me out a lot!!! But when it came down to it, I was depressed and needed help. I know that we know very little about the brain or how any of this works, but I do subscribe to the imbalance theory. You know how stupid and God like we medical people can feel. I have played with enough things between illicit drugs and then using my anti-depressants to counter the "down" side when the drugs where off. That is all drugs do to give you pleasure... they release different amounts of endorphins, dopamine, serotonin, nor-epinephrine, etc... and cause you to get "high" and when you come "down" from that "high" it is because the levels of the neuro chemicals are low and hence you are depressed. SO you take reuptake inhibitors to allow you to get back to normal faster right??? Well I'm not saying it is... Just that it is what I used to do. It did help me understand a lot about how those chemicals work and make me feel.

    AS for side-effects? Coming off the Cymbalta cold turkey is Horrific. The Wellbutrin is kind of rough too. The rest didn't bother me near as much as those, and they are both SNRI's so that might be why. Your questions about serotonin syndrome? Well I am on an SSRI and SNRI at the same time. I take wellbutrin and lexapro together. For the most part they have helped me a great deal. I feel better than I ever have these days. While blunted some, it is not near as bad as I have experienced. I have thought about looking into that new medication you’re on, but just haven't wanted to change while things are working pretty well. The other secret I found was by luck or actually a blessing. I take Subutex for my pain medication due to my substance abuse issues in my past. It just so happened that my doctor that does the subutex also is a leading person in the country for HRT (hormone replacement therapy). He tested my levels and found my testosterone levels to be 108 (norm for my age about 700-1200) so he implanted some pellets into my hip (kind of like the old Norplant birth control) and they help keep my testosterone levels up. I honestly think that is what has been the missing component in my treatment over the last few years. I'm not sure your age or gender, but women can have problems with it too. I would consider being checked out.

    SO, hummm... I tried to hit everything I can. Let me know if any of this helped or you want me to elaborate on anything. I’m not sure if there are restrictions on this site or not, but if you want to contact me in private let me know and we will chat some more about it.

    I hope you have a GREAT holiday season!!!

    David
    Last edited by Anonymous; 07-04-2010 at 08:05 PM.

  5. #5
    izzothecat is offline New Member
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    Default Huh?

    Not too sure what that post is all about...I was simply replying to a friend of mine--should have sent a private message--so I apologize for that. As a note, Wellbutrin is not an SNRI...it's in it's own class ,as it works on Dopamine only.
    Best-
    Kiera



  6. #6
    shelard is offline New Member
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    Question itching on both cymbalta & pristiq?

    I haven't seen any posts on this problem but after a few years on cymbalta it started being less effective and I started itching head to toes. Dr (psychiatrist) switched me to prisiq yesterday evening took my first mg dose and the itching started about an hour later. It's even worse than on the cymbalta & I didn't think that was possible. I do not have rash or swelling except where I scratched myself raw. If I keep lotioned up I don't break the skin much. Of course it's Sunday and the Th of July so I can't get in touch of him to get the lidocane spray he said might help. any others try this?:

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