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Suggest Ways To Wean Off Pristiq

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Posted on Tue, 23 Jun 2015
Question: I suffer from anxiety and depression, and was on 100mg of pristiq, down to 50mg and then straight off that dose, as per the advice of a psychiatrist. I am now feeling depressed and anxious again. However want to continue a holistic approach to my condition. I have been reading a lot that one should taper off this drug far more slowly, a 10% reduction of the dose weekly, rather than an abrupt cessation from 50mg. What do you recommend?
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
yes anti depressant drugs should be tapered slowly

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

As per protocol and routine approach any antidepressant when used for depression should be stopped gradually and that is at least after 3-6 months(depending upon duration,severity and frequency of problem) of complete improvement.

10 % reduction for every drug is not possible and practically not feasible sometime.
If I were your treating doctor I would recommend following approach:

100 mg to 50 mg can be done directly.

50 mg for 4 weeks.

25 mg 4 weeks.

12.5 mg for 2 weeks and then stop completely.At any stage if person feels discomfort for more than 3 days shift to previous dose for more 2 weeks.

Sometime few symptoms which are called,'Drug discontinuation syndrome' considered(misinterpreted) as symptoms of depression. But this is not the case always. This syndrome gradually stop on its own.If severity is not significant no need of intervention. Otherwise it can be treated with low dose anti anxiety drugs or with same drug in low dose.

Hope I have answered your query, I will be happy to help further.

Regards,m
Dr.Chintan Solanki.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (30 minutes later)
I re-instated 1/8th of the pill. for about 2 weeks, which is roughly 6mg. But have been off completely for about 3 days now. I have been having crying spells, and feeling moments of anger/ agitation. Should i start taking the 6mg again for a while longer? or should i just continue without them. I have university exams coming up in 3 weeks so this is a stressful time and I need to be able to concentrate as best as I can. Are there any supplements that you would recommended? I have been taking samE (400mg) and tyrosine, as well as fish oil to help me transition off antidepressants.
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
restart 6 mg again

Detailed Answer:
Hi,

Thanks for information.

You should take 6 mg(and if needed increase the dose at which you feel stable)until your university exams over. After that you can taper and stop.

No supplement will help specifically.

But timely sleep, regular healthy meals and daily exercise will of course help.You can take samE and tyrosine with prestique low dose.They may replenish serotonin requirement but no specific studies mentioning the effectiveness of the same.

If after exam you feel discomfort while stopping you can take low dose benzodiazepine under your treating doctor's guidance.

All the best and take care.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest Ways To Wean Off Pristiq

Brief Answer: yes anti depressant drugs should be tapered slowly Detailed Answer: Hello XXXXXXX Thanks for writing to us. As per protocol and routine approach any antidepressant when used for depression should be stopped gradually and that is at least after 3-6 months(depending upon duration,severity and frequency of problem) of complete improvement. 10 % reduction for every drug is not possible and practically not feasible sometime. If I were your treating doctor I would recommend following approach: 100 mg to 50 mg can be done directly. 50 mg for 4 weeks. 25 mg 4 weeks. 12.5 mg for 2 weeks and then stop completely.At any stage if person feels discomfort for more than 3 days shift to previous dose for more 2 weeks. Sometime few symptoms which are called,'Drug discontinuation syndrome' considered(misinterpreted) as symptoms of depression. But this is not the case always. This syndrome gradually stop on its own.If severity is not significant no need of intervention. Otherwise it can be treated with low dose anti anxiety drugs or with same drug in low dose. Hope I have answered your query, I will be happy to help further. Regards,m Dr.Chintan Solanki.