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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Debilitating Withdrawals After Discontinuing Pristiq

I have been advised to change from Pristiq (DESVENLAFAXINE) to Avanza (Mirtazapine) due to suffering migraines and not being able to treat them whilst on Pristiq. To transition I was advised to discontinue Pristiq for 3 days then start Avanza. I am suffering debilitating withdrawals and wondering if this is a healthy way to transition.
Wed, 3 Jun 2015
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Psychiatrist,  's  Response
Hello thanks for choosing HCM for your health related queries

I can understand your concern. Desvenlafaxine is a SNRI drug which helps in serotonin and noradrenalin neurotransmission. Mirtazapine is a different drug and the drug increases serotonin neurotransmission mainly. Abrupt stoppage of Desvenlafaxine has caused the withdrawal and even if both drugs have same actions to some extent still in my opinion the drug change should be done by cross tapering of drugs. In this method the doses of Pristiq should be reduced gradually over about 4 weeks and in the same time doses of Avenza should increased gradually. Cross tapering prevents any serious withdrawal symptoms. Please discuss with your doctor if symptoms persist.

Thanks, Hope this helps you. Take care

Dr. Seikhoo Bishnoi,
Psychiatrist
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Suggest Treatment For Debilitating Withdrawals After Discontinuing Pristiq

Hello thanks for choosing HCM for your health related queries I can understand your concern. Desvenlafaxine is a SNRI drug which helps in serotonin and noradrenalin neurotransmission. Mirtazapine is a different drug and the drug increases serotonin neurotransmission mainly. Abrupt stoppage of Desvenlafaxine has caused the withdrawal and even if both drugs have same actions to some extent still in my opinion the drug change should be done by cross tapering of drugs. In this method the doses of Pristiq should be reduced gradually over about 4 weeks and in the same time doses of Avenza should increased gradually. Cross tapering prevents any serious withdrawal symptoms. Please discuss with your doctor if symptoms persist. Thanks, Hope this helps you. Take care Dr. Seikhoo Bishnoi, Psychiatrist