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How to get off Pristiq?

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Posted on Mon, 28 Jul 2014
Question: I am currently taking prestique 100 mg er... I am trying to come off the medication after three years of taking it. Began skipping one day at time then went to two the following week. I found that to be very difficult with the side effects. What would the best, and safest way for me to discontinue using this prescription. I am ready to be off and my doctor agrees. Just feel like this is going to take much longer than expected.

Thank you so much! XXXXXXX
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Answered by Dr. Preeti Parakh (29 minutes later)
Brief Answer:
Gradually taper off.

Detailed Answer:
Hi XXXXXXX

Welcome to Healthcare Magic!

Taking Pristiq on alternate days or every two days is not the correct strategy. Pristiq (desvenlafaxine) is related to Effexor (venlafaxine) which is known to have mjor discontinuation symptoms. When you take it on alternate days, the blood levels alternately go very up and very down, which is not much different from stopping abruptly. In fact, even stopping abruptly would be better than this because at least the discontinuation symptoms would gradually reduce and be gone in a week or ten days. But what you are doing makes the discontinuation symptoms go up and down, lingering ever since you started this.

The best thing would have been to gradually taper off the drug. For example, from 100 mg per day, you should have come down to 75 mg per day, then 50 mg per day and then 25 mg per day before stopping. Since you have been on the drug for around 3 years, you should have taken at least three months to get off it. That is, each reduced dose should be continued for at lease a few weeks, till your body got adjusted to it.

Getting off antidepressants should only be done at those times in life when life is relatively stress free. For example, I would never advise an accountant to start the tapering when is time for the annual accounts closing. Or a student should never do it when the exams are due. Choose a suitable time for yourself, discuss with your doctor and then go ahead.

I hope this helps you. Please feel free to ask in case you need any clarifications.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Preeti Parakh

Addiction Medicine Specialist

Practicing since :2002

Answered : 1486 Questions

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How to get off Pristiq?

Brief Answer: Gradually taper off. Detailed Answer: Hi XXXXXXX Welcome to Healthcare Magic! Taking Pristiq on alternate days or every two days is not the correct strategy. Pristiq (desvenlafaxine) is related to Effexor (venlafaxine) which is known to have mjor discontinuation symptoms. When you take it on alternate days, the blood levels alternately go very up and very down, which is not much different from stopping abruptly. In fact, even stopping abruptly would be better than this because at least the discontinuation symptoms would gradually reduce and be gone in a week or ten days. But what you are doing makes the discontinuation symptoms go up and down, lingering ever since you started this. The best thing would have been to gradually taper off the drug. For example, from 100 mg per day, you should have come down to 75 mg per day, then 50 mg per day and then 25 mg per day before stopping. Since you have been on the drug for around 3 years, you should have taken at least three months to get off it. That is, each reduced dose should be continued for at lease a few weeks, till your body got adjusted to it. Getting off antidepressants should only be done at those times in life when life is relatively stress free. For example, I would never advise an accountant to start the tapering when is time for the annual accounts closing. Or a student should never do it when the exams are due. Choose a suitable time for yourself, discuss with your doctor and then go ahead. I hope this helps you. Please feel free to ask in case you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry