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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by floatingbridge on July 16, 2009, at 4:39:44
If all goes as I hope on friday with pdoc, I can taper the pristiq.
Please--looking for tips, experiences, and possible palliative means that might help me mitigate the dreaded withdrawal. Effexor was a doozy. I expect nothing less (though always willing to be surprised!).
fb
Posted by SLS on July 16, 2009, at 6:28:50
In reply to getting off pristiq for emsam, posted by floatingbridge on July 16, 2009, at 4:39:44
> If all goes as I hope on friday with pdoc, I can taper the pristiq.
>
> Please--looking for tips, experiences, and possible palliative means that might help me mitigate the dreaded withdrawal. Effexor was a doozy. I expect nothing less (though always willing to be surprised!).Using an anticovulsant might help. Trileptal was mentioned on the Withdrawal board as being effective. It is low on side effects. Someone else mentioned Depakote. Of the two, I can't guess which one would work best. My first reaction was to say Depakote, but the account given of Trileptal was compelling. Both drugs reduce glutamate excitability by inhibiting sodium channels and promoting GABA activity, although I would guess Depakote would be better at accomplishing the latter.
- Scott
Posted by Phillipa on July 16, 2009, at 11:23:07
In reply to Re: getting off pristiq for emsam » floatingbridge, posted by SLS on July 16, 2009, at 6:28:50
fb you did it once you'll do it again!!!! How long have you been on the pristiq? And what dose of EMSAM? Let me know how it's going. Love Phillipa
Posted by floatingbridge on July 16, 2009, at 11:48:04
In reply to Re: getting off pristiq for emsam, posted by Phillipa on July 16, 2009, at 11:23:07
Hi Phillipa,
Well, I have to line this up with my pdoc. --This is what I want, based on what I've read here and medscape, etc. I don't want to tinker with the ssri snri group any longer, and from what I've read, I am a good candidate for an MAO.
It can help in case of chronic fatigue syndrome (I'm not diagnosed--just chronically fatigued!) And also help with ADD (which I do 'have'.) I don't tolerate dexedrine well, though it does make me feel brilliant until it wears off.
I've taken pristiq since January at 50mg.
I imagine the lowest dose (6MG?)
fb
Posted by floatingbridge on July 16, 2009, at 11:53:27
In reply to Re: getting off pristiq for emsam » floatingbridge, posted by SLS on July 16, 2009, at 6:28:50
Hi Scott, thank you for this advice. I have taken depakote before and seemed to tolerate it well. Can I print out this post to take to pdoc tomorrow? ; ) There's no way I can remember what you just wrote!
I'm feeling a wee bit hopeful, which makes me a wee bit anxious.
Thanks for your posts regarding withdrawal, esp. the older ones you posted on Withdrawal board.
I've been following your lithium trial--and hoping for the best,
fb
Posted by floatingbridge on July 16, 2009, at 12:22:24
In reply to Re: getting off pristiq for emsam, posted by floatingbridge on July 16, 2009, at 11:53:27
Posted by SLS on July 16, 2009, at 12:46:41
In reply to Re: getting off pristiq for emsam, posted by floatingbridge on July 16, 2009, at 11:53:27
From what I've just read, there may be evidence that Trileptal is more effective than Depakote for treating different kinds of withdrawal. Depakote does not appear to be as potent to prevent alcohol withdrawal as was once thought. Alcohol, BZD, and SRI withdrawals probably all include glutamate hyperexcitability. Perhaps this commonality indicates that the same AEDs will mitigate the withdrawal symptoms of these three classes of drugs. It would be convenient.
- Scott
Posted by ricker on July 16, 2009, at 14:11:55
In reply to Re: getting off pristiq for emsam » floatingbridge, posted by SLS on July 16, 2009, at 12:46:41
It may be that I'm just lucky, but I've never experienced withdrawal when coming off a med! 22 years of various combo's so I've stopped many a med.
The only reason I can think of is that I've been taking clonazepam throughout those 22 years so maybe it's the key to eliminating potential withdrawal agony, for me anyway.
Like Scott mentioned, A/C's may help with unwanted side-effects and clonazepam is in that category so maybe give it a try.
Hope all goes well with your discontinuation.
Regards, Rick
Posted by Zana on July 16, 2009, at 14:48:01
In reply to Re: getting off pristiq for emsam, posted by ricker on July 16, 2009, at 14:11:55
Glad you've had so many helpful posts. I have taken trileptal and found it a real downer. Really flatten me out. I think I was taking about 1200mgs. But that was a trial using it as an AD. And being downed out might be just what you need if you are having a tough time discontinuing the Pristiq.
Hope it goes well.
Zana
Posted by bleauberry on July 16, 2009, at 19:04:35
In reply to getting off pristiq for emsam, posted by floatingbridge on July 16, 2009, at 4:39:44
I was going to give my routine answer of going slow in tiny steps, but I realize you want to do this as rapidly as possible, so my routine answer is on the shelf for another day. :-)
In the old Dr bobs Tips and in some anecdotal reports over the years, probably one of the most helpful things during effexor withdrawals is a common over-the-counter drug that might surprise you. Benadryl. Why or how it works no one knows. It just seems to help the whole withdrawal syndrome somehow.
Posted by floatingbridge on July 16, 2009, at 21:48:20
In reply to Re: getting off pristiq for emsam, posted by bleauberry on July 16, 2009, at 19:04:35
Thank you for the all responses and information! I haven't gotten the script yet--that's to be decided tomorrow. Not sure I'm up for the withdrawal, but I feel, at least I have enough information now to make some better informed decisions. Today was so cr*ppy, I know that I have to do something....
kindest regards,
fb
Posted by Phillipa on July 17, 2009, at 19:47:11
In reply to Thanks Re: getting off pristiq for emsam, posted by floatingbridge on July 16, 2009, at 21:48:20
fb well how did it go? Love Phillipa
Posted by floatingbridge on July 17, 2009, at 21:29:46
In reply to Re: Thanks Re: getting off pristiq for emsam » floatingbridge, posted by Phillipa on July 17, 2009, at 19:47:11
Hi Phillipa, Thanks for asking!
Well, my pdoc /therapist was willing--he brought the patches out--but cautioned me against making the change at this time. Instead he counseled I get some blood work done to check for agents like mono, lyme, and autoimmune disorders. He thinks I may have post-viral fatigue on top of this. He's still in favor of stimulant therapy for my refractory depression and doesn't think the emsam would be stimulating enough.
Now, if it wasn't pristiq, I might have made the decision to try the patch. However, I really don't know if I can handle the withdrawal right now. Effexor withdrawal nearly killed me, I have a child, yadda, yadda. So I balked, and put off the decision until l I see him next week.
Meanwhile, it's a continuation of dex AND he wants to try 100 of pristiq. I asked if that would make withdrawal more difficult. He said longer. I'm not sure about upping the pristiq tonight. And it's off to the doc for blood-work.
Sigh. Anti-climactic.a crumpled fb
Posted by Phillipa on July 17, 2009, at 21:48:14
In reply to not this week » Phillipa, posted by floatingbridge on July 17, 2009, at 21:29:46
Oh my!!!! What kind of doc do you see alternative? If not you sure have a great pdoc. I wish I also had yours. Love Phillipa actually this is incredible to me.
Posted by ColoradoSnowflake on July 17, 2009, at 22:12:51
In reply to Re: not this week » floatingbridge, posted by Phillipa on July 17, 2009, at 21:48:14
Wow, your doc sounds great to me, also!! Mine never gives me blood tests for anything! I think that's fabulous he wants to look for those other things first!! It sure makes sense!
Good luck!!! Gayle
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