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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by SLS on January 31, 2009, at 7:01:42
Has anyone gone higher than 100mg?
In clinical trials, the dosages used ranged from 50-400mg. The manufacturer now recommends that 100mg is the maximum dosage, although it insists that no additional benefit has been demonstrated beyond 50mg. By comparison, the maximum recommended dosage of Effexor, the parent compound to Pristiq, is now above 300mg. It had been 225mg before reports came in stating that many patients needed 300mg and above to respond. A few people need 600mg of Effexor.
I am curious to see where doctors eventually set the top dosage of Pristiq after they have had a few years of experience with it.
- Scott
Posted by Phillipa on January 31, 2009, at 12:01:40
In reply to Highest dosage of Pristiq (desvenlafaxine) ?, posted by SLS on January 31, 2009, at 7:01:42
Scott remember cymbalta was not recommended above 60mg now many docs give 120mg . Here is one article I found Mayo Clinic and it only offers 50mg as doseage. Many listed sided effects. Thinking because it't time release???? Phillipa
Posted by uncouth on January 31, 2009, at 15:31:58
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ? » SLS, posted by Phillipa on January 31, 2009, at 12:01:40
if it means anything, i've been at 100mg for a week and a half. i've always noticed a very distinct effect on effexor when moving from 225mg to 300mg. 225 didn't hit the depression hard enough, and 300mg after a few days would make me hypomanic. i also have a quick and progressive, dose-related response to effexor.
on pristiq, so far, i haven't felt much relief even at 100mg. so for me, 100mg isn't equivalent to 300mg of effexor, at least not yet, so i may have to go higher.
i was surprised clinical trials didn't show any additional benefit to 100mg of pristiq. maybe the higher doses required of effexor is more related to metabolism differences between people.
ahh well who the hell knows with these damn things.
keep praying for me all who read this, i'm not out of the woods yet. going back for some rTMS this week hopefully to help things along.
Posted by jms600 on January 31, 2009, at 16:49:51
In reply to Highest dosage of Pristiq (desvenlafaxine) ?, posted by SLS on January 31, 2009, at 7:01:42
Posted by SLS on January 31, 2009, at 17:20:57
In reply to Is there any difference between Efexor + Pristiq? (nm), posted by jms600 on January 31, 2009, at 16:49:51
That is a hard question to answer.
Effexor - venlafaxine
Pristiq - desvenlafaxineAs an analogy, there is a significant difference between imipramine and its metabolite, desimipramine (desipramine for short), with regard to side effects. Desipramine is much milder. However, it is probably less effective than imipramine, presumably because, unlike imipramine, desipramine does not inhibit the reuptake of serotonin.
Will Pristiq demonstrate a reduced side effect profile compared to Effexor? I doubt it. Will it be more effective than Effexor? I don't see how. So far, there are no indications that there are advantages to Pristiq over Effexor. However, it will take time for the "personality" of Pristiq to be observed in a clinical setting. Maybe it will surprise all of us.
- Scott
Posted by linkadge on January 31, 2009, at 17:38:21
In reply to Re: Is there any difference between Efexor + Pristiq? » jms600, posted by SLS on January 31, 2009, at 17:20:57
I heard they kept the max dose low because people were having cardiac issues and strokes on higher doses in clinical trials.
Linkadge
Posted by jms600 on February 1, 2009, at 13:38:25
In reply to Re: Is there any difference between Efexor + Pristiq? » jms600, posted by SLS on January 31, 2009, at 17:20:57
I guess that's the unfortunate side of new antidepressants - nobody really knows the 'possible' maximum dose, although they do know the 'safe' maximum dose - in this case 100mg.
I remember my psychiatrist telling me a while back that it's not uncommon for new drugs to be released with maximum recommended dosages, only for these recommended dosages to be raised higher and higher over the following years as more and more is understood about the drug.
Hope you find something useful on Pristiq.
jms
> That is a hard question to answer.
>
> Effexor - venlafaxine
> Pristiq - desvenlafaxine
>
> As an analogy, there is a significant difference between imipramine and its metabolite, desimipramine (desipramine for short), with regard to side effects. Desipramine is much milder. However, it is probably less effective than imipramine, presumably because, unlike imipramine, desipramine does not inhibit the reuptake of serotonin.
>
> Will Pristiq demonstrate a reduced side effect profile compared to Effexor? I doubt it. Will it be more effective than Effexor? I don't see how. So far, there are no indications that there are advantages to Pristiq over Effexor. However, it will take time for the "personality" of Pristiq to be observed in a clinical setting. Maybe it will surprise all of us.
>
>
> - Scott
Posted by dcruik518 on February 7, 2009, at 14:52:13
In reply to Re: Is there any difference between Efexor + Pristiq?, posted by jms600 on February 1, 2009, at 13:38:25
In my experience, Pristiq worked better than Effexor and had fewer side effects. Effexor made me worse. Pristiq helped some,but not enough.
Posted by AussieDi on January 13, 2011, at 5:29:21
In reply to Highest dosage of Pristiq (desvenlafaxine) ?, posted by SLS on January 31, 2009, at 7:01:42
I have been on Pristiq for 3 months. I am taking 150 mg as a morning dose and another 50 mg 8 hours later. I have been feeling better on this dosage except for severe sweating. Has any one heard of this sort of dosing before? Should I be concerned?
Posted by stanlow on May 12, 2011, at 1:47:43
In reply to Highest dosage of Pristiq (desvenlafaxine) ?, posted by SLS on January 31, 2009, at 7:01:42
50mg does not work for me. So my doctor increased the daily dosage to 100mg andtaking these at night and not morning.
Do not know yet what is the effect or will this help.
Will posr again later Stanlow
> Has anyone gone higher than 100mg?
>
> In clinical trials, the dosages used ranged from 50-400mg. The manufacturer now recommends that 100mg is the maximum dosage, although it insists that no additional benefit has been demonstrated beyond 50mg. By comparison, the maximum recommended dosage of Effexor, the parent compound to Pristiq, is now above 300mg. It had been 225mg before reports came in stating that many patients needed 300mg and above to respond. A few people need 600mg of Effexor.
>
> I am curious to see where doctors eventually set the top dosage of Pristiq after they have had a few years of experience with it.
>
>
> - Scott
Posted by stanlow on May 12, 2011, at 1:48:22
In reply to Highest dosage of Pristiq (desvenlafaxine) ?, posted by SLS on January 31, 2009, at 7:01:42
50mg does not work for me. So my doctor increased the daily dosage to 100mg and taking these at night and not morning.
Do not know yet what is the effect or will this help.
Will posr again later Stanlow
> Has anyone gone higher than 100mg?
>
> In clinical trials, the dosages used ranged from 50-400mg. The manufacturer now recommends that 100mg is the maximum dosage, although it insists that no additional benefit has been demonstrated beyond 50mg. By comparison, the maximum recommended dosage of Effexor, the parent compound to Pristiq, is now above 300mg. It had been 225mg before reports came in stating that many patients needed 300mg and above to respond. A few people need 600mg of Effexor.
>
> I am curious to see where doctors eventually set the top dosage of Pristiq after they have had a few years of experience with it.
>
>
> - Scott
Posted by stanlow on May 12, 2011, at 1:53:26
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by AussieDi on January 13, 2011, at 5:29:21
Hi Di
Are you still on 150mg am follow by 50mg 8 hours later? Does this work for you ?Please share as my doctor wanted to put me on higher dosage as well but I am worried.
Stanlow
Posted by AussieDi on May 12, 2011, at 7:20:51
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by stanlow on May 12, 2011, at 1:47:43
Hi Scott,
Yeah, still taking 150mg in the morning and 50 mg about 8 hours later. My mood is much better and pretty stable my anxiety though still causes some problems. Making a change is always scary though. About 6 months ago they tried me on all kinds of things including Lithium and tranqs until I ended up in hospital with horrible withdrawals. When doctors talk to me now about changing anything I run for the door. What I'm on now isn't perfect but I can work and care for myself and my family.
Posted by jono_in_adelaide on May 15, 2011, at 18:03:13
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by stanlow on May 12, 2011, at 1:47:43
You'd get a lot more benifit by taking an SSRI (eg Zoloft, 50-100mg/day) along with Welbutrin (300mg/day)
Far more NA and DA uptake inhibition, therefor better response.
Posted by jono_in_adelaide on May 15, 2011, at 18:19:45
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by stanlow on May 12, 2011, at 1:47:43
The other alternative would be Zoloft 50-100mg/day plus Norrtriptyline 75mg at night.
The Welbutrin would be better if you feel like you need a "kick start", the Nortriptyline might be more helpful if you feel tense or anxious
Posted by WAS on May 18, 2011, at 17:04:19
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by AussieDi on May 12, 2011, at 7:20:51
Hi all. I'm a newbie on this forum, but this post caught my eye and I thought I would respond. I was on 350 mg/day of Pristiq for a little more than I year. When the "normal" dose did not seem to have any effect my Doc was willing to push it up slowly, partly based on the fact that I had needed a very high dose of Effexor to get any AD effect. On the Pristiq I had my first real AD effect at 300 mg/day, and my depression was very well controlled at 350 mg./day.
Posted by Lisalisa110 on September 24, 2011, at 16:11:07
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by WAS on May 18, 2011, at 17:04:19
Good day everyone,
I have been on pristique for about 8 months now. I felt better slowly, about 3 weeks until I really started to feel somewhat better. Around. The 5 th month I really felt like I plateaud. My doc then added Seroquel. Ist night 1 tablet, 50 mg. 2nd night, 2, 50mg (100 total ) 3rd night 3, 150 mg. From the 4th night on the 159mg pill, each night around 7:00pm. The addition of Seroquel hit me immediately. I want sure if I could continue. (I am so bad at giving meds time to work and abandon them quickly. I stuck with it, rode it out. I could fell fuzz brain 25 mins. After taking it. I am pleased to say this combination is working for me. For the first time in my life I am starting to feel human again. It gives me energy and just an overall good feeling. I am also sleeping a lil better.
Lately I feel like I have reached another plateau and plan on discussing this with my doctor. I dd a search on " max" dosage of Pristque and ended up here. THANK YOU.
I was under the impression that Pristique is only rx'd at 75mg.
Posted by Lisalisa110 on September 24, 2011, at 16:15:21
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by WAS on May 18, 2011, at 17:04:19
Good day everyone,
I have been on pristique for about 8 months now. I felt better slowly, about 3 weeks until I really started to feel somewhat better. Around. The 5 th month I really felt like I plateaud. My doc then added Seroquel. Ist night 1 tablet, 50 mg. 2nd night, 2, 50mg (100 total ) 3rd night 3, 150 mg. From the 4th night on the 159mg pill, each night around 7:00pm. The addition of Seroquel hit me immediately. I want sure if I could continue. (I am so bad at giving meds time to work and abandon them quickly. I stuck with it, rode it out. I could fell fuzz brain 25 mins. After taking it. I am pleased to say this combination is working for me. For the first time in my life I am starting to feel human again. It gives me energy and just an overall good feeling. I am also sleeping a lil better.
Lately I feel like I have reached another plateau and plan on discussing this with my doctor. I dd a search on " max" dosage of Pristque and ended up here. THANK YOU.
I was under the impression that Pristique is only rx'd at 75mg.
Posted by Lisalisa110 on September 24, 2011, at 16:22:48
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by Lisalisa110 on September 24, 2011, at 16:15:21
Sorry about the double post. I just completed that (grueling) registration and I am trying to learn how to use my iPad. Talk about page back, re-send, ahhhhh! I could scream. But you wouldn't hear me. I might feel better. Anyway, this is he time of day when I feel reallly lousy. I swear I have early Alzheimer's. My Mom had it. From about 3pm to 6pm, every single day. I don't understand it. I wonder if increasing my Pristigue will make a difference. I felt like this before starting the antidepressant highway. Anyone else get confused, blue, trouble concentrating around this time?
Posted by AussieDi on September 24, 2011, at 20:45:38
In reply to Re: Highest dosage of Pristiq (desvenlafaxine) ?, posted by Lisalisa110 on September 24, 2011, at 16:22:48
Yes I did feel horrible in the afternoon which made me dread my kids coming home from school. Doctor had me take another 50mg of Pristiq at 4pm and this helped to fill in the gap.
Posted by anamia on August 26, 2013, at 8:02:39
In reply to Highest dosage of Pristiq (desvenlafaxine) ?, posted by SLS on January 31, 2009, at 7:01:42
Been on pristiq roughly 5 yrs. am on 500mg once a day, also edronax 16mg once a day, stilnox 3 tablets at night, 900mg seroquel at night, 30mg Valium at night, 30mg temazepam at night, 50mg nitrazepam at night, 30mg oxazepam at night. All the night meds I can take that dose of them every three hours if still unable to stay or fall asleep. Introducing saphrys now as well at night. Also on 100mcg of thyroxine. On topamax to counteract the metabolic syndrome seroquel and zyprexa caused. Similarly am on motilium to counteract the nausea from the pristiq. Also tried valdoxin which was waste of time.
Initially started on pristiq to help come off Effexor. Had been on 800mg once a day. Was still hell. Have tried gradual reduction to come off pristiq but was hospitalised as became physically too unwell. Tried cold turkey with same result. Been told that to come off they would need to put me back on Effexor. Can anyone else see the problem here lol. Either way you are screwed. My pristiq withdrawal symptoms both times lasted approx 4 months but my mood deteriorated to the point where I was forced back on them by hospital staff. Literally been on every anti depressant and sedative there is, including the old maoi s which parnate was great but dropped heart rate to less then 10bpm. If I respond well to a drug the dose has to be continuously increased but it gets to a point where they can't go higher without causing serious side effects. Pristiq I went from 25mg to 400mg in 3 months.
Wish had never started meds in the first place, but at 10yrs of age, you don't really get a say.
This is the end of the thread.
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