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On Pristiq for about 18months. On Paxil. Taking Pristiq and Cymbalta. Concerned?

Dec 2014
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Practicing since : 2007
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I've been on Pristiq for about 18months. Prior to this I was on Paxil for more than 10 years then went off it for several years after I retired. My rheumatologist wants to change to Cymbalta which he says is for depression and pain (my gastroenterologist says I absolutely can't take NSAIDS for pain because of my Crohns which is in remission). The rheumatologist said I could just stop the Pristiq and begin with Cymbalta the next day. True? I no longer go to the psychiatrist who first prescribed Pristiq because I've moved and don't yet have a Pcp to ask either. Even when I've been very depressed I'm not suicidal so that's not my concern. Thanks.
Posted Sat, 12 Oct 2013 in Depression
Answered by Dr. Seikhoo Bishnoi 2 hours later
Brief Answer:

Detailed Answer:
Welcome to Health Care Magic

You are a 66 years old female and have average height and average weight. You have been diagnosed with Fibromyalgia about 30 years back. You have noticed that the pain improvement occurs with Prednisolone. You have been on Venlafexine (Pristiq) for 18 months. Your rhemuatologist want to change your drug to Cymbalta or Duloxetine from very first day. You are advised not to take NSAID because of fear of Chrohns.

Now coming to your question-

-Pristiq is Venlafexine and Cymbalta is Duloxetine. Both are drugs of SNRI group. Both drugs are used in mild to moderate depression and have good results. It has been proved in very research studies that Duloxetine is very useful in depression and anxiety associated with pain conditions. It is very useful in females. As per my opinion there is major risk in changing the venlafexine to Duloxetine. Mild increase in anxiety can occur because of very little serotonis withdrawal symptoms. If you face mild anxiety you can take low dose benzodiazepines for that.

-You are getting relief in pain with Predenisolone. Predenisolone is a steroid drug and it is very good anti-inflammatory drug. Fibromyalgia pain has some origins in inflammation and this is the reason you are getting relief. I would advise you to not to take the drug for long periods of time as on long terms it can cause side effects and can also worsen depression. You can go with Duloxetine, this is a good drug with comparatively more efficacy than Venlafexine in controlling anxiety and pain conditions.

Thanks, hope this helps you, if you have more questions you can ask again.
Above answer was peer-reviewed by
Follow-up: On Pristiq for about 18months. On Paxil. Taking Pristiq and Cymbalta. Concerned? 1 hour later
Hi Dr Bishnoi
You write there is major risk in changing. Did you mean to write NO major risk?
Also what are some benzodiazapines?
And is it safe to begin taking cymbalta the day I stop pristiq?
Answered by Dr. Seikhoo Bishnoi 11 minutes later
Brief Answer:
Hello again

Detailed Answer:
I am sorry this was a typing mistake.

There is no major risk in changing the medicines as both are of same group.

To prevent mild withdrawal anxiety you can go with Benzodiazepines like Etizolam or low dose clonazepam. The medicines will provide symptomatic relief if any anxiety issues occurs.

It is safe to begin taking Cymbalta on the day of stopping Pristiq.

Thanks, you can ask again for any other doubts.
Above answer was peer-reviewed by
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