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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by BearFan on June 8, 2008, at 18:06:47
Just wondering if any patients actually did significantly better on Pristiq compared to regular Effexor XR? I tried Pristiq for a several days and just found my anxiety increasing rapidly so I discontinued it (didn't seem as calming as regular Effexor).
Posted by Molybdenum on June 8, 2008, at 20:21:55
In reply to Anyone do better on Pristiq than Effexor XR?, posted by BearFan on June 8, 2008, at 18:06:47
Hi,
Sorry - no experience on Pristiq, just Effexor + Remeron. See http://www.dr-bob.org/babble/20080606/msgs/833682.html if you're curious.
Didn't know what Pristiq was, so did 5 seconds of www research & found the following which is interesting:
"Strangely enough, lower doses (50mg) of Pristiq proved more effective than higher doses (100mg). I believe this is the first time where a drug company has shown in their own data that less of their drug works better than more of it (at regular dosing levels)!"
from: http://psychcentral.com/blog/archives/2008/03/04/pristiq-versus-effexor-xr/
Effexor + Remeron work well for me, albeit they never helped my anxiety. Strange to me that Effexor is indicated for anxiety disorders. Still, so much room for different reaction with ADs. Personally, the Effexor actually increased my anxiety at first & when I increased the dose!
I take 150mg Moclobemide first thing each day for anxiety & I was (still am) utterly astounded by how effective it is - given all the bad reports on the net. My pdoc isn't surprised. Says it's very effective. Suppose that's the difference between authoritative knowledge + years of experience vs www anecdotals.
If the Effexor ever poops out on me, I suppose I might try Pristiq then. Hope I never need to change...! ;)
Good Luck
Mr. M.
Posted by bissie66 on June 9, 2008, at 11:04:20
In reply to Anyone do better on Pristiq than Effexor XR?, posted by BearFan on June 8, 2008, at 18:06:47
Not so far . . I've only been on it about a week though. It's so new . . I wish there was more experience about it posted.
Posted by bleauberry on June 9, 2008, at 20:21:25
In reply to Re: Anyone do better on Pristiq than Effexor XR?, posted by Molybdenum on June 8, 2008, at 20:21:55
Not meaning to sidetrack the thread, but I was so curious...
you are taking effexor and remeron AND moclobemide?
Posted by Molybdenum on June 9, 2008, at 22:23:33
In reply to Re: Anyone do better on Pristiq than Effexor XR? » Molybdenum, posted by bleauberry on June 9, 2008, at 20:21:25
> Not meaning to sidetrack the thread, but I was so curious...
>
> you are taking effexor and remeron AND moclobemide?Hey bleauberry,
yeah - still taking all three but I have reduced my effexor down from 600mg to 450mg. I had some old 37.5mg caps, so I reduced it by that every 3 days. Luckily I didn't get any withdrawals and it's been a month now, so if I'm feeling brave in the next month or two, I'll try taking it down to 300mg.
Was on 225mg remeron & reduced that by one 45mg tab all in one go & had no withdrawals on that either. Just one bad night 3 days in - felt horrible but nothing since. Who knows what chemical was doing what that night! Still, I imagine the withdrawals are in line with the relative dose change. Effexor drop was 25% & remeron drop 20%.
Was a bit concerned with serotonin syndrome adding the moclobemide but 150mg is pretty low. Of all the MAOI types, this one's a reversible - so no dietary restrictions. I actually thought I was having a bit of SS 'cos my temp was pretty high, but I was using an old mercury thermometer & foolishly neglected to give it a good shake before using *doh*, so I think my temp readings weren't accurate.
And sorry for hijacking your thread BearFan. Consider all hostages released..!
And damn - all you lot with interesting usernames. I wish I'd put more thought into mine... :)
OK - I'm out...!
Molybdenum.. ;)
Posted by bluebayoula on June 18, 2008, at 23:07:05
In reply to Anyone do better on Pristiq than Effexor XR?, posted by BearFan on June 8, 2008, at 18:06:47
Hello I'm new to the board but have lurked off and on for years so I thought I might share my Pristiq experience. I too am anxious to find more information and experiences to compare mine to.
I'm a middle-aged female diagnosed with ADHD, first as a child around 3rd grade, then later as a non-traditional college student in my mid 30's. I've been diagnosed with depression and anxiety for the last 6 years.
Today I finished my second week on Pristiq. I recently started Paxil 60 mg daily took it for 3 weeks then switched to Pristiq directly without tapering. I have taken either Lexapro or Celexa for the last 6 years and recently started seeing a psychiatrist because I wanted to start being treated for my ADHD again. He prescribed Adderall 30 mg. 2x daily and had me switch from Celexa to Lexapro and prescribed Temazapan for sleep. After 6 mos. and an improvment in ADHD symptoms I asked my psych to help me with a problem I was having with anxiety and depression (this was present long before the Adderall) stating that I felt that I was angry and feeling aggressive all the time. Additionally, I'm under enormous pressure at work and I believe that I have PTSD from a pretty horrific experience in Hurricane Katrina.
I started Paxil and after a few weeks found it worked wonders on my anxiety symptoms. It had some unexpected benefits by causing me to lose weight because I no longer obsess about food. Losing weight has been a pleasant surprise. Paxil made me feel mellow and relaxed and I liked the sensation but I couldn't make myself focus on work. It became easy to piddle away my day and I wouldn't last long at my job doing that so I felt I needed to change. I noticed that people around me responded positively to my new relaxed demeanor. Nevertheless, when I returned to my psych for a med check I told him about my experience and asked to switch to Effexor.
My psych had offered Effexor initially when I asked for help with the anger/aggression but I turned it down having taken it previously and experienced the withdrawal it's known for. I did a little research and found out that it can help with ADHD and depression so I thought I'd try it again. Instead my psych offered Pristiq stating he's been getting good feedback from his patients who've been describing it as "clean".
My experience with Pristiq: Doesn't do much for anxiety, at least not at two weeks out, so that'll be discussed at next med check in a couple of weeks. I'd like to find a happy medium where overwhelming anxiety is tempered but not to the point that I don't care about much of anything.
Antidepressant effect is high-medium. Still not to the degree of Paxil but it's only been two weeks. ADHD - very good. I believe it fills the gaps where Adderall leaves off. I seem to very productive these days. I can't remember being this focused and I'm enjoying my new found productivity. Someone described me as "articulate" the other day and that's not how I would normally describe myself. I'm still losing weight because the obsessive thoughts about food are greatly diminished. Anxiety, I nearly had a full-blown anxiety attack during a fire drill last week while going down the stairs. This is a part of what I believe to be PTSD from Katrina (we were trapped for days).I hope this report is helpful and that others report their experiences too.
Thanks,
CD
> Just wondering if any patients actually did significantly better on Pristiq compared to regular Effexor XR? I tried Pristiq for a several days and just found my anxiety increasing rapidly so I discontinued it (didn't seem as calming as regular Effexor).
Posted by bissie66 on June 19, 2008, at 9:18:26
In reply to Re: Anyone do better on Pristiq than Effexor XR? » BearFan, posted by bluebayoula on June 18, 2008, at 23:07:05
Hello and welcome! I've been on Pristiq a couple of weeks and I switched from Cymbalta to Pristiq and haven't noticed a difference yet so I don't have much to report. Mainly I wanted to say thank you for your post. It was really helpful and informative. There is hardly anything posted about Pristiq (being so new) so I eagerly read anything about it - and yours was the best yet! I'll definitely keep you posted of anything I notice. The reason my pdoc switched me was because I felt the Cymbalta was pooping out, but after increasing my Remeron the combo started working again so now I think it was the Remeron that needed adjusting, not the Cymbalta. I hope this makes sense. Good luck.
Posted by bissie66 on June 19, 2008, at 9:29:39
In reply to Re: Anyone do better on Pristiq than Effexor XR? » BearFan, posted by bluebayoula on June 18, 2008, at 23:07:05
It would be great if Pristiq helped with focus, because I can't focus worth a damn either. This is hell at work. However, Adderall just made it worse or made me hyperfocus. I've never been tested for ADD. Maybe it's my bipolar illness.
Posted by bluebayoula on June 19, 2008, at 19:08:08
In reply to p.s. » bluebayoula, posted by bissie66 on June 19, 2008, at 9:29:39
Thanks Bissie, I too had the problem with hyperfocus on Adderall, I would have to drag myself away from things so I could move on to productive work. I'm trying to balance my depression treatment needs with my anxiety treatment needs and ADHD treatment needs. Pristiq is an interesting new tool for ADHD, at least that's been my experience so far, but it's new to me so who knows what the outcome will be 6 to 8 weeks from now.
I am very anxious to hear others report their experiences as objectively as possible so we can all compare notes.
Posted by dcruik518 on June 25, 2008, at 15:41:55
In reply to Re: p.s., posted by bluebayoula on June 19, 2008, at 19:08:08
I took Pristiq for three weeks and it didn't really help me. The truth is I didn't notice much of anything, other than extreme anorgasmia and more difficulty speaking. (I have a voice disorder.) I've taken Effexor in the past and had bad experiences with it. I didn't have nearly the anxiety with Pristiq as with Effexor. ~DRC
Posted by bissie66 on June 26, 2008, at 8:57:20
In reply to Re: p.s., posted by bluebayoula on June 19, 2008, at 19:08:08
So how is it going now? Is Pristiq working for you ok?
> Thanks Bissie, I too had the problem with hyperfocus on Adderall, I would have to drag myself away from things so I could move on to productive work. I'm trying to balance my depression treatment needs with my anxiety treatment needs and ADHD treatment needs. Pristiq is an interesting new tool for ADHD, at least that's been my experience so far, but it's new to me so who knows what the outcome will be 6 to 8 weeks from now.
>
> I am very anxious to hear others report their experiences as objectively as possible so we can all compare notes.
Posted by bissie66 on June 26, 2008, at 9:00:47
In reply to Re: p.s., posted by dcruik518 on June 25, 2008, at 15:41:55
I'm really sorry to hear that. I can't tell yet either how well it's working. I think if I were taking it alone it wouldn't be working, but I'm taking it with Remeron and the combo seems to ahve started worked (I hope). I've been on Pristiq 3.5 weeks. About the anorgasmia -- I must say that Remeron has the *opposite* effect.
> I took Pristiq for three weeks and it didn't really help me. The truth is I didn't notice much of anything, other than extreme anorgasmia and more difficulty speaking. (I have a voice disorder.) I've taken Effexor in the past and had bad experiences with it. I didn't have nearly the anxiety with Pristiq as with Effexor. ~DRC
Posted by bluebayoula on June 26, 2008, at 20:39:51
In reply to Re: p.s. » dcruik518, posted by bissie66 on June 26, 2008, at 9:00:47
Strangely, I've had the opposite reaction (sexual) than you dcuik518. The "O" was hard work on Paxil but everything is back to normal on Pristiq.
One thing Pristiq is doing for me is making me very productive. I was in day-long training for 4 days this week and I really got a lot out of what should have been a boring class. For that reason alone I would want to continue taking it but it has areas that it doesn't work in. Depression management is good but the anxiety thing feels like its untreated.
Posted by eebeshy on July 21, 2008, at 14:05:53
In reply to Re: p.s. » dcruik518, posted by bissie66 on June 26, 2008, at 9:00:47
Been taking Pristiq for almost about 2 1/2 weeks and have had horrible crying spells...anyone else experience this? Came off of 90 mg of Cymbalta (took that for a year and a half, did fine except for horrible night sweats I couldn't stand any longer).
Posted by Molybdenum on July 21, 2008, at 17:20:24
In reply to Anyone do better on Pristiq than Effexor XR?, posted by BearFan on June 8, 2008, at 18:06:47
Hi,
I think my Efexor (venlafaxine) brew is pooping out, so I called the pharma company - thought they'd maybe have some insight into how the mysterious poop-out works. They didn't but the person I was talking to did say something interesting.
I asked her if Pristiq (desvenlafaxine) would be worth trying. She replied that it was very similar to Efexor, in that if Efexor had lost it's power - the Pristiq would almost certainly not be useful either.
So an interesting comment - straight from the horse's mouth. I still find it amazing what some of these people will tell you once you've warmed them up a little on the phone. ;)
Everyone is different, so maybe it will have a different effect for you. This seems to be the one thing they all agree on.
Good Luck.
Mr. M.
Posted by bissie66 on July 22, 2008, at 13:21:37
In reply to Re: p.s., posted by eebeshy on July 21, 2008, at 14:05:53
> Been taking Pristiq for almost about 2 1/2 weeks and have had horrible crying spells...anyone else experience this? Came off of 90 mg of Cymbalta (took that for a year and a half, did fine except for horrible night sweats I couldn't stand any longer).
>
Not that exactly, from Pristiq, but I've had those crying spells from depression, so maybe it just means you're in a period right now where you're not covered by an a/d. i.e. the Cymbalta's not in your system and the Pristiq hasn't kicked in yet. You might want to give it a couple more weeks though. I know that seems like forever when you feel that bad. It's terrible that these drugs can take 4 weeks to kick in.
Posted by trust1979 on August 27, 2008, at 11:29:43
In reply to Pristiq Re: p.s., posted by bluebayoula on June 26, 2008, at 20:39:51
I just switched to Pristiq from Paxil. I was on Paxil for about 8 years. It pretty much ruined my marriage and I gained 50 lbs. My new girlfriend convinced me to go off Paxil about 4 months ago and after 4 months of hell, I went back on but decided to see if there was somthing different I could take. My Dr. put me on Pristiq about 5 days ago. I feel ok so far. Depression is manageable but I have more anxiety than with Paxil. It's only been 5 days though. Sex is getting better. Difficulty achieving "O" on Paxil.
Posted by dcruik518 on September 1, 2008, at 12:44:29
In reply to Re: p.s., posted by dcruik518 on June 25, 2008, at 15:41:55
I am back on pristiq. Been on it for three months now. It seems to work well with Nortripyline.
Posted by bluebayoula on September 1, 2008, at 13:04:23
In reply to Re: Pristiq Re: p.s., posted by trust1979 on August 27, 2008, at 11:29:43
> I just switched to Pristiq from Paxil. I was on Paxil for about 8 years. It pretty much ruined my marriage and I gained 50 lbs. My new girlfriend convinced me to go off Paxil about 4 months ago and after 4 months of hell, I went back on but decided to see if there was somthing different I could take. My Dr. put me on Pristiq about 5 days ago. I feel ok so far. Depression is manageable but I have more anxiety than with Paxil. It's only been 5 days though. Sex is getting better. Difficulty achieving "O" on Paxil.
Can I ask you how Paxil destroyed your marriage? I was on it briefly and I really liked the anxiety relief. I triend Pristiq for 3 months and just couldn't do it anymore.
Now I'm on Cymbalta and Trazadone.
Posted by Curiously on May 19, 2009, at 13:35:33
In reply to Re: p.s. » eebeshy, posted by bissie66 on July 22, 2008, at 13:21:37
I've been taking Pristiq two, maybe three, months. I've been trying various things over the course of about 2 1/2 yrs in order to find something that would interfere less with orgasm. Anyway, I have been reluctant to go back to effexor b/c of the withdrawal, which creeps me out. A few months ago, my dr. presented Pristiq to me as a version of effexor with a tamer withdrawal. At first, on the minimum dosage level, I found I was somewhat depressed and tense. Increased to next level a month ago. I have been experiencing a milder version of the typical-for-me depression symptoms: existential angst, a faded and somewhat colorless version of everyday reality. I got engaged a few months ago and my therapist and I are attributing these problems to the major life change.
Three days ago I was unable to get my refill as the pharmacy closed early. So, in fear of the freaky effexor w/d, I took a leftover effexor. I have taken effexor for three days now. At the same time, I've been doing both some mental and literal house cleaning and reorganization. Two days ago I watched "Marley and Me" in which the dog dies at the end. I sobbed in a way that is not altogether painful: a bit cathartic and cleansing. I felt better yesterday. And today it dawned on me that for the first time in weeks, the world seems perfectly normal and vivid. No dread lurking in the corner. Is it the effexor, the reorganization, or both? Don't know. FYI.
Posted by glad4grace on June 13, 2009, at 21:45:20
In reply to Re: Anyone do better on Pristiq than Effexor XR? » BearFan, posted by bluebayoula on June 18, 2008, at 23:07:05
Hello. I am curious about how you've done since writing this and what your reaction has been to Pristiq. I relate so much to your post. I could have written much of it myself. Most concerning to me right now is the increase in the anger and aggression I feel, particular when dealing with my small children. This depresses me greatly, in addition to an overall sense of blah that exists in my life most days. I should add that I have been dependent on prescription pain meds previously, and the post-acute withdrawal/depression could be lingering. I am a Registered Nurse and find it difficult to confide in many professionals. I do have a psychiatrist, but her visits are short and there is little, if any discussion about my personal life, but rather just about how I'm feeling and current meds (I take 300mg Neurontin 2-3 times a day for anxiety). I was given Cymbalta, but felt like I was in a daze and found it difficult to keep up with my children. My dad has been on Pristiq for several weeks with good results and I am considering taking it. Oh, I also was diagnosed with ADD when I was 34 (less than three years ago), but have never been treated. I wonder if it is true, and if it is part of the reason I feel overwhelmed much of the time. I am a perfectionist, but lack the focus or ambition to accomplish tasks, which leads to chaos in my home and makes me very anxious and depressed. I appreciate any information, insight, or experiences you have to share.
Posted by floatingbridge on June 13, 2009, at 22:56:43
In reply to Re: Anyone do better on Pristiq than Effexor XR? » bluebayoula, posted by glad4grace on June 13, 2009, at 21:45:20
Hi Glad4Grace,
Here's some of my experience:
I feel less side-effects on Pristiq. In my experience, Effexor was more energizing with a bit of jaw-clenching. I did not have a small child at the time, but I do now and feel my patience has grown as of late. I've been taking Pristiq for about four months. This is not really a boost for Pristiq: for one thing, I anticipate a nasty withdrawal if it ever comes to that. A missed dose here and there has me convinced of this.
Interestingly, I started treatment for ADD inattentive at almost the same time (previously untreated), so I can't be sure which is helping the most. I do feel that, if one can, less is more regarding meds. Maybe you might get away with *just* treating the ADD; that might lift the depression by addressing the many frustrations of ADD. (Just venturing a thought there.) Do you have some doubts about your ADD diagnosis?
BTW, for reference, my initial diagnosis was major depression and some kinda' rapid cycling bipolar NOS, which I think still stands for me in addition to ADD.
Good luck navigating the waters, and, (here comes an opinion), if you find you can't talk to your pdoc about meds to your satisfaction, you could try a new one. I'm interested to hear how this goes for you.
Posted by bluebayoula on June 13, 2009, at 23:12:48
In reply to Re: Anyone do better on Pristiq than Effexor XR?, posted by floatingbridge on June 13, 2009, at 22:56:43
Posted by bluebayoula on June 13, 2009, at 23:17:16
In reply to Re: Anyone do better on Pristiq than Effexor XR? » bluebayoula, posted by glad4grace on June 13, 2009, at 21:45:20
> Hello. I am curious about how you've done since writing this and what your reaction has been to Pristiq. I relate so much to your post. I could have written much of it myself. Most concerning to me right now is the increase in the anger and aggression I feel, particular when dealing with my small children. This depresses me greatly, in addition to an overall sense of blah that exists in my life most days. I should add that I have been dependent on prescription pain meds previously, and the post-acute withdrawal/depression could be lingering. I am a Registered Nurse and find it difficult to confide in many professionals. I do have a psychiatrist, but her visits are short and there is little, if any discussion about my personal life, but rather just about how I'm feeling and current meds (I take 300mg Neurontin 2-3 times a day for anxiety). I was given Cymbalta, but felt like I was in a daze and found it difficult to keep up with my children. My dad has been on Pristiq for several weeks with good results and I am considering taking it. Oh, I also was diagnosed with ADD when I was 34 (less than three years ago), but have never been treated. I wonder if it is true, and if it is part of the reason I feel overwhelmed much of the time. I am a perfectionist, but lack the focus or ambition to accomplish tasks, which leads to chaos in my home and makes me very anxious and depressed. I appreciate any information, insight, or experiences you have to share.
I saw there was some activity on this thread so I thought I'd follow up with my experience with Pristiq. I've been off and on it this last year, which has been a roller coaster due to career issues related to the economy.Pristiq is great for me if I want to be productive, as in really productive but I get really angry easily and it's hard for me to bite my tongue when I get that angry. In fact, I think the Pristiq leaves me with some dis-inhibition in this respect. There have been some tense moments with a boss that I said things that I don't think I would have normally. I think he was a jerk but I could have handled things better. So, I went back on Paxil, which feels great to me but I'm like a wet noodle on the stuff. Nothing bothers me and I just coast along with almost no anxiety at all, it feels great but I can't live like that. I miss deadlines, get to work late etc... I just don't care.
So, I went on Cymbalta at first 60 mgs but I've been secretly halving my dose due to what I call "the surfer dude" effect I get (like Paxil) when on the full dose. I think this is better, and I can do some work but nothing is ever going to replace the productivity I get when on Pristiq.
This is the end of the thread.
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