After a long period trying different ADs, I've gone back to Effexor. My Dr. prescribed the latest incarnation, Pristiq, supposed to be more effective but some say it's just a trick to extend the patent.

Along with the Pristiq, my Dr has prescribed a folate supplement that is supposed to make the AD more effective.

I'm starting the second week and feel ok, hoping for better results as more time goes on.

I just started Pristiq today and will keep you posted. This is after being weaned off Paxil CR which I was on for four years, then going to Cymbalta (what a nightmare). I really thought I was going to die. I was then was put on Zoloft which caused severe side effects. I'm hoping Pristiq will work for me.

I've been at the 50mg dose for 2.5 weeks now, so I'm still hoping for improved effects. My Psych dr is more concerned so he prescribed the 100mg for when the 50 mg rx runs out. If Eeffexor goes to a generic, I'll go back to that just for the cost savings. I was also prescribed 0.5 mg Clonapam/klonopin 3x daily for this incessant anxiety I have, maybe due to just starting out on the Pristiq, not sure, but it seems to help.

I was put on Cymbalta when I went off Effexor, I was told that Cymbalta used the same mechanism as effexor but had some additional AD properties, I did ok on it, but it wasn't any better/worse than effexor for me. So once again I switched to try to find the magic bullet.

Hi Infidel,

This is very interesting to me. I take Effexor and have for about 15 years. I have always had success with it and continue to, which I am so thankful about. Recently I heard about this drug, Pristiq, but at the time the person couldn't recall the name of it. She said that it was supposed to be better than Effexor. Now that I know the name, I think I will do some research on this - right now! I'll get back to you with whatever I find out.

Thanks for this info!

Always Trying

HE


Hi Always Trying,

Pristiq is actually produced in the body of anybody who takes Effexor, it's a metabolite of it. One of the advantages is that the theraputic dose is only 50mg which a patient can be started on straight away. I guess the reseason that the dose is so much lower than Effexor is that not a 100% of the Effexor is metabolised into Pristiq. It also avoids the main pathway into the liver which would help anybody with any liver problems - though it does not completely avoid being metabolised by it.

It's expected to have less side effects than effexor but I think it's to early to be sure. As regards it's effectiveness there seeems to be some doubt about it having any advantage in terms of effectiveness over EFFEXOR -the (POSSIBLY) cynical view is that this drug has been produced to switch peope over from Effexor as that goes 'generic' in a couple of years.

Also this quote from a link I find has the following to say -

"" The main Wyeth marketing point for Pristiq is that patients can get better by taking the beginning dose of 50 mg, eliminating the need for a complicated upward dose titration process. Sorry, but this is not different from Effexor. If you look at one of the original fixed-dose studies of Effexor, comparing patients taking 75 mg, 225 mg, or 375 mg, you’ll find that the 75 mg dose separated from placebo as well as Pristiq’s 50 mg. Psychiatrists typically begin Effexor at either 37.5 or 75 mg/day. At least with Effexor XR, when you keep increasing the dose, efficacy improves, meaning it actually has an efficacy advantage over Pristiq, because when you increase the dose of Pristiq, you lose efficacy, according to the U.S. study data. ""

This suggests that it either works for you or not at 50 mg. This could be seen as a disadvantage, but looking at it a different way, you start at the effective dose and don't have to wait for it to be titrated up - that measn you'll find out quicker if itt is going to work for you or not and would reduce the time taken to get noticeable effects as you don't have to wait to get to the theraputic dose - i've been on effexor for 3 weeks and i'm still only on 112.5 though that goes up tomorrow to 150.

I think it's most likely to have benefits for people who respond to Effexor but get bad side effects and who could hopefully change over to pristiq and maybe reduce or mostly illiminate them though there's not enough data yet to be sure of that. Time will tell, but lets hope it will turn out to be a godsend to anyone for whom Effexor works but have severe side effects.

Hope this helps

Prot.

Prot -
You are 10 steps ahead of me! The info I found is from exactly where you found it, so I have nothing to add. Only the info you did add was good to know and of course not written by Wyeth. Another thing that is very interesing to me is that I do have liver problems, which my doctor knows. She hasn't ever made any comments about it, but maybe with this new drug out, she may want to switch me. Hmmm, all good food for thought.
Thank you very much for your knowledge!


Also, RITCHIE! Hey - come back and keep us posted on how this is working for you!

Always Trying

Infidel,

You too please keep me up to date on how this works for you. I may wait til I hear from you guys before I talk to my doc about it.
(Sorry about that!)
A.T.

Thanks for all the information. It helps a lot. Still on the 50 mg Pristiq but haven't noticed any difference. Still have the crying jags and extreme sadness. I know it takes time but I don't want to wait. The only side effect I have noticed is slight nausea. My doctor prescirbed Provigil and Lamictal several months ago, so I'm taking these with Pristiq. I don't have all the symptoms of bipolar according to him, just mood swings. I wonder how long before the dosage of Pristiq is increased if the 50 mg doesn't seem to work. I'll keep you guys informed and let me know anything you find out also.

I'm brand new to forums, but I REALLY hope this forum keeps up and you guys continue to give updates on Pristiq. I've been on Effexor XR 75mg for almost 2 years with awesome results in decreasing my anxiety and depression. I have a new husband and my life is awesome now except for the darn sexual side effects; I would love to get off of the Effexor but the withdrawals are TERRIBLE!! My doctor gave me Pristiq and says I can replace my Effexor with it starting tomorrow. I am very anxious and hopeful. Lets keep everyone updated on this new drug.

My doctor took me off the Pristiq. I had rapid heart beats, increase in anxiety, and severe hostility and crying. I'm now back on Paxil which I went through hell to get off. In addition, he has put me on klonopin three times a day. I'm not sure what's next but I'm feeling a little more in control. But, just because Pristiq didn't work for me doesn't mean it can't work for someone else.

I'm really curious about this new drug. I'm really curious to read some pposts from people who have taken both and tell if there really is that much of a difference or if it is really just another patent extender. I bet the withdrawals will still be just as hellish for alot of folks.

Has anyone every heard of sever itching as a side effct from taking Pristiq? 50mg

Did you also experience sever itching when you were on Pristiq?

Hey just signed up so thanks. A little about me: Been depressed for as long as I can remember. Had an aunt and uncle commit suicide when I was young and father left when I was six. Saw father for the first time in about 25 years (35 now, married, 3 year-old boy and baby girl on the way) and we didn't say a word to each other. Also, started a new job which sucks and this maybe triggered the latest episode of depression, but...
Started taking Cymbalta about a year ago, opted for therapy off and on in the years before but figured I would try drugs for the first time. Cymbalta started out good but then became a nightmare. Went from 30 to 60mg in a weekend and had all the side effects: Nausea, fatigue, insomnia (no kidding!), everything. Things seemed to even out, felt good. I could focus, good mood. Very recently, it seemed to stop working Stuck with it until yesterday when I met with the nurse practitioner and she gave me samples of Pristiq. Took one this morning, so far so good! I really thought I would freak from not taking Cymbalta but I feel okay. I will keep you posted...

Today is my second day on Pristiq and I'm pleasantly surprised to be feeling so good off of Effexor - NO withdrawals. No side effects as of yet and no itching as mentioned by one of the people who posted. I'm anxious to see if all of the Effexor side effects are gone :) Thanks for the response.

****Is there anyone else out there that has switched from Effexor to Pristiq?*******

I can tell you that NOTHING else worked to get off of Effexor and I tried really hard to get off of it. My doctor tells me that the half life of the Pristiq is longer and therefore will be easier to wean off of(unlike withdrawals within hours of missing Effexor!). I don't know whether I'll stay on Pristiq or wean, but if it doesn't have some unwanted side effects that Effexor I may just stay on it.

I'm looking forward to hearing other people's experiences switching from Effexor to Pristiq and/or weaning off of Pristiq.

Looking forward to a "happy" day.

Nearly a month now, no side effects noticed other than lots of fatigue, which may or may not be from the Pristiq. I guess I should say the sexual side effects seem the same, delayed orgasm, otherwise no noticeable difference. I'll be going from 50 to 100 mg this week, so I'll be able to report on that soon.

I have been on the Pristiq one week and LOVE IT!!!!!!!!!!! I didn't have withdrawals from the Effexor and the sexual side effects are GONE!!!!!!!!!!!!!!!! My husband would like to send the doctor flowers - ha ha. I have been extremely tired some days and I'm not sure if it is that I have been sick or the Pristiq, but I may just have to add Red Bull to my med regimen :).

Looking forward to hearing others experiences with Pristiq.

I'm on day 4 of 100 mg Pristiq and I'm feeling worse and worse. No energy during the day, in spite of taking Concerta as a stimulant. I get plenty of sleep but still feel tired regardless, even doing some physical activity doesn't shake it off. It is working for depression but I"m starting to experience anxiety again.

I'm really considering going back to Effexor, I never really had side effect issues with it and it seems like there's more control in varying the dose, whereas with Pristig it's just all or nothing.

Pristiq should be pretty easy to stop taking, since it shouldn't have the sideeffects that effexor has. If they can start you at the 50mg then you should be able to stop just as easy. Maybe try every other day for a bit, then every third day.

Are you in the US? We have a generic of Effexor in South Africa called Venlor - it's been out for about 2 years, I think.
I'm surprised. I thought you guys got all the good stuff first :)

I'm in the US, thought it was going generic sooner than that. Either way, I think Effexor worked better for me, so I'm going to try to get switched back over. I never had too much of an issue with the side effects.

Am i right in thinking you can just stop effexor 1 day and switch to Pristiq then next? Im currently taking 375mg of effexor so i guess
that would be 100mg of Pristiq? Does anyone know if its avalable in the UK yet? We are normaly years behind lol

My pdoc switched me from Effexor to Pristiq. After 4 days on it we had to up my dosage to 100 mg because 12 hours after taking a 50 mg dose there wouldn't be enough left in my body to prevent the "sand shakes" in my head among other things. After being on it for 2 weeks, my pdoc was on vacation and his associate took me off Pristiq due to excessive side effects and put me back on Effexor. I had absolutely no side effects going off Pristiq at all (two weeks isn't long but at least those of you interested in trying it will know that if it doesn't work for you it may not pose a problem to stop it with little or no pain after a couple of weeks). Since I was back on Effexor, my regular pdoc and I decided it would be best to up my dose to see if it would help with the depression symptoms. I had been on 225 mg before trying Pristiq so I went back to 225 for a week and then upped to 225 + 37.5 for a few days and then to 300 mg. It has not really helped my mood or energy but it has upped my blood pressure quite a bit.

Spoke to pdoc yesterday about this and voiced interest in trying Pristiq again hopefully with success this time given that I have had a previous experience with it. I think my side effects could have been a result of going off Effexor...I have been on it about 3 years. So I have an appt Wednesday and he is putting together a cross titration schedule for me. This time when I need to go up to 100 mg (if I need to), I won't take one pill every 12 hours but the whole dose at once just like I take my Effexor. I am also going to ask for some Ambien so I can try to keep my sleep schedule regular. I will say that at the end of my two week trial of Pristiq my mood and energy level were great (normal for most people but I say great because my mood and energy have been lacking for some time). This is what gives me incentive to give it another try. I am also on Klonopin - usually .5 mg per day but changing meds/changing doses tends to increase my anxiety temporarily so I may have some days where I take more. Pdoc doc always writes my Rx for extra so I have some to take PRN.

I really hope the second try works for me. I want to feel good and have energy to live life (and clean house!!). I think Pristiq has a lot of potential and is not simply a patent extender. It is a real alternative.

Fyi, I believe Effexor XR loses it patent protection here in the US in 2010. Different countries have different rules for patent protection and that's why some countries already have a generic version.

Also, lots of times I see people complaining of itching after starting a new AD or other medication. Itching and rash are hallmark signs of allergic reaction. Please call your doctor and bring it to his/her attention. If it's just itching, your doc may say it's acceptable and treat it. You can get a prescription for something that will treat the itching rather than being miserable with it.

I will post again once I am back on Pristiq and let you know how it's going.

Hi,

I was reading some of the clinical data on the internet and it seems like pristiq is MORE effective at 50mg than 100mg. (which is very odd.)

Anyone taking this notice that the efficacy decreases as the dose increases?

I read something along the lines of no increased efficacy with doses over 50 mg as well. I find that very weird too especially since they are making 2 doses of the med - 50 mg and 100 mg. I know I could tell a difference between taking 50 mg and 100 mg.

It will be interesting to see how the clinical trials data compares to real life experiences as more people begin taking this medication.

I have been on Pristiq a couple weeks now and was elated at the decrease in sexual side effects, but I do have to admit that my mood and energy aren't as good as on the Effexor XR. I would like to try to get off all meds and have been told that Pristiq is easier to wean with less withdrawals than Effexor XR. I am happy for this alternative, because before Pristiq I saw no hope of ever getting off of the Effexor due to HORRIBLE withdrawals. I do notice a small swimming brain about 12 hours after I take my Pristiq, but I'm trying to cope. I did have itching the first week or so with no rash and it has resolved without doing anything - I think it is just a mild side effect of the Pristiq - not an allergic reaction. Depression SUCKS!!!

On Monday, I started the cross titration of Effexor with Pristiq. My doctor has me on 150 mg Effexor and 50 mg Pristiq. My side effects are quite minimal...more tired than normal and some headaches. Huge difference between my first try at Pristiq when I went cold turkey off Effexor. Now I am really convinced all those nasty side effects were from going off Effexor and not from Pristiq at all.

I see the doc again tomorrow to report results. I want to stay on this dose for a while...maybe a couple weeks before we change it up. I'll see what he says.

Side effects usually start for me between 24 and 36 hours after a med change/dose change and I'm over that hump by quite a bit now.

So far, so good... Yay!!!!!

I'm on day 11 with a combination of 50mg of Pristiq and 150mg daily dosage of Bupropine. Most of my side effects have gone away. The only ones that really lingers is dilated eyes (only really a problem with wearing contacts) and fatigue.

Actually, kind of a strange one, but I was wondering if anyone notices their jaw being really tense? I've consistently been catching myself gritting my teeth down. I've never really had this kind of problem before so I'm assuming this has something to do with it.

I started taking Pristiq very recently - today is my 3rd day on 50 mg. So far, so good. Granted, nothing of huge note has occurred...but I am hopeful. I'm on other meds that mainly are for bipolar disorder and Klonopin for anxiety and Adderall for ADHD. In addition, I was taking Zoloft and Wellbutrin. However, my OCD was sky-rocketing and I was maxed out on the dosage of Zoloft so my pdoc weaned me off of Zoloft and put me on Luvox. I couldn't tolerate Luvox (stomach-wise) so I had to get off of it. As of Monday, I start Pristiq (no more Zoloft) and my Wellbutrin dosage is going down from 300 mg to 150 mg. (I'm still on the other meds.)

As for Effexor, I took it years ago - I can't remember for how long - a few months? At the time, I was misdiagnosed with Major Depression and while Effexor helped with my depression, it made me manic. I was under the care of a well-meaning family doctor and then he referred me to my pdoc (who pulled me off Effexor, gradually, with no withdrawal problems.)

I will keep you all posted as to how Pristiq goes for me - and I look forward to hearing how you all are doing, too.

I am now on day 6 of Pristiq 50 mg after switching from Cymbalta 60 mg. There were absolutely no withdrawal effects with a direct switch and I can already feel a difference. Cymbalta caused weight gain, less energy and motivation, naps during the day, and just a general 'slowing down' of my system.

Pristiq has already increased my energy, decreased my appetite, and I have no desire for naps during the day. So far so good and I hope it just keeps getting better!

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I Have been taking pristiq for a month and a half now. I did not notice a change with the 50 so I began taking 100. I feel more fatigued and apathetic than ever. I experience nausea and now depression from the lack of motivation and lethargy.Its difficult to say whether I am still experiencing effexor withdrawls or whether it s the Pristiq. Its been 3 weeks without the effexor xr so it seems to me that I shouldn't still be experiencing the side effects.In any case I am going off the Pristiq because in my opinion there is nothing special about its helpwith my depression.

This is usually listed in the side effects data as bruxism (clenching of jaw and grinding of teeth). I noticed this SE when I first started taking Effexor. My dental hygeinist noticed the number it was doing on my gums (damage). I now wear a night guard when I sleep to prevent from grinding at night. It's not as bad when I am on a steady dose of an AD but when I change doses or changes meds it seems to get worse.

You get them at Walgreens...about $25 bucks...there are maybe 3 different sizes. Your dentist can also make you a customized one for a lot more money. I went with the Walgreens model and it works just fine for me.

[quote name='cja' date='Jul 3 2008, 01:23 AM' post='428315']
On Monday, I started the cross titration of Effexor with Pristiq. My doctor has me on 150 mg Effexor and 50 mg Pristiq. My side effects are quite minimal...more tired than normal and some headaches. Huge difference between my first try at Pristiq when I went cold turkey off Effexor. Now I am really convinced all those nasty side effects were from going off Effexor and not from Pristiq at all.

I see the doc again tomorrow to report results. I want to stay on this dose for a while...maybe a couple weeks before we change it up. I'll see what he says.

Side effects usually start for me between 24 and 36 hours after a med change/dose change and I'm over that hump by quite a bit now.

So far, so good... Yay!!!!!
[/quote

[quote]
Hi, I'm very curious to know how you're doing switching from Effexor to Pristiq. I've been on 150mg of Effexor for 5 years and feel like it's starting to not work as well. My Dr wants me to switch to Pristiq, but I'm a little nervous. Are you feeling better? Side effects?

I have been on Pristiq for 3 weeks now and I literally feel like I'm not taking any medication at all. There are no side effects and no benefits. Don't feel "better" at all. Still feeling mopey and withdrawn. Going back in next week to talk about other options. Or maybe I'm not being patient enough and should stick it out a few more weeks to see if the benefits start to show up. Anyone else have this experience with Pristiq - just feeling like it's not doing anything. I feel like I'm taking a placebo or something.

I have been on Pristiq for three weeks now after failing with Lexapro and Addavan. Pristiq has done wonders for me! Of course the first few days it didn't seem to be helping but my Doctor added Abilify (2MG) in addition to Pristiq and what a world of difference it has made. I walked around in a haze having terrible panic attacks and weepiness to feeling "normal" again. I take the meds together as soon as I get up in the morning and I have had NO side effects from either.

On Monday, I started the cross titration of Effexor with Pristiq. My doctor has me on 150 mg Effexor and 50 mg Pristiq. My side effects are quite minimal...more tired than normal and some headaches. Huge difference between my first try at Pristiq when I went cold turkey off Effexor. Now I am really convinced all those nasty side effects were from going off Effexor and not from Pristiq at all.

I see the doc again tomorrow to report results. I want to stay on this dose for a while...maybe a couple weeks before we change it up. I'll see what he says.

Side effects usually start for me between 24 and 36 hours after a med change/dose change and I'm over that hump by quite a bit now.

So far, so good... Yay!!!!!


Hi, I'm very curious to know how you're doing switching from Effexor to Pristiq. I've been on 150mg of Effexor for 5 years and feel like it's starting to not work as well. My Dr wants me to switch to Pristiq, but I'm a little nervous. Are you feeling better? Side effects?


Update: the side effects have gone away, my mood is good and energy level is good. My pdoc agreed to me staying on this dose for another 2 weeks. I had adjustments to other meds from my PCP and pdoc didn't want too much to change for me in such a short period of time. I will be on this dose (150 Effexor 50 Pristiq) until 7/18 - my next appointment. He wants me to then go to 37.5 Effexor and 50 Pristiq for a week and then to 37.5 Effexor and 100 Pristiq. I am a little concerned that going from 150 Effexor to 37.5 will be too much of a jump for me. I will voice this concern at my appointment.

If you are on 150mg Effexor, you may only need 50 mg of Pristiq. My pdoc has a couple patients that were on 150 Effexor and switched to 50 Pristiq with no cross titration, had no problems (might have had some miminal side effects) and are doing good. Being nervous about changing ADs is a very normal response. There is no way to know for sure how it will work for you and what you may experience while adjusting from one to the other. I would bring up the subject of cross titration with your doc. I had a hard time with side effects just starting Effexor years ago...so I fall into what I guess I would call an extra sensitive category. Ask your doctor about other patients that have been switched and how he approached it with them. If you go cold turkey off Effexor like I did, you could have a bad time of it. Pristiq did not prevent Effexor withdrawal for me.

On another note, you mention your doc wants you to change but you didn't indicate why. If Effexor XR is working for you at the dose you are on and you aren't having problems or unresolved symptoms, I see no reason to change. I definitely follow the philosophy of if it ain't broke don't fix it.

Good luck!

Were you taking any medication prior to this?

I have been taking Remeron for about 3 years. I recently added Effexor which I felt pretty good on but had sexual side effects and as an alternative my doc decided to change to Pristiq because it's supposed to have less side effects. Unfortunately, it's not really working for me. With the exception of the fact that I still can't have an orgasm, I feel no other side effects and no benefits. My issue with the orgasm thing is that it's NEVER been an issue for me. Ever. And now I can't at all. So it's not that I'm used to it being difficult and it's just a little harder now or something like that. Going back tomorrow to talk about other options I guess.