Prozac Crossover Method for Pristiq Weaning
The short half-life of Pristiq and the fact that it is an SNRI may warrant considering a crossover to Prozac, and then tapering off the Prozac due to its longer half-life. Pristiq is acting on both serotonin and norepinephrine levels. Prozac only addresses serotonin. So the crossover will involve a dip in norepinephrine support and Prozac will likely provide the serotonin support. In our experience, a sudden norepinephrine drop is much more tolerable than a sudden serotonin drop.
Methods described here including the below need to be talked about with a prescriber sensitive to your situation prior to attempting.
Prozac Crossover Methods Should take into account:
- Medication-sensitive persons may have difficulty switching to a different medication. Stay in close touch with your prescribing physician to avoid complications.
- Before weaning down off Pristiq, your physician may want to induct a small dosage of Prozac to test your tolerance, for example, by cutting the 10mg green elliptical in half to get 5mg.
- Your prescriber may advise you to start 5mg Prozac for one week (one-half tablet) while still taking Pristiq.
- The dosing ranges for Prozac and Pristiq are not equivalent so some guidance from a medical professional is needed to get your situation mapped out. But an example might be if you are taking 50mg Pristiq, drop to 25mg Pristiq, and go up to a total of 10-15mg Prozac.
- You can gauge how long to do this step, by how symptomatic you are after one week or two weeks, etc. If you are still symptomatic, discuss this with your doctor who may advise you to continue for another week at this step.
- Consult with your physician and If the above was tolerated, then discuss if your doctor feels you are ready to convert over to all Prozac (in the example this would be 20-30mg). This would be followed by another rest period of 1-2 weeks before any changes.
- From here, look at the Prozac tapering page with your doctor and ask them to use those instructions for your guide
- Your doctor may advise putting you back on your original Pristiq dose if the above is not tolerated. The physician would generally just do a straight taper off the Pristiq in this case.
- Be aware that by switching over to Prozac, you are going from an SNRI to an SSRI. Your physician may agree that generally, Prozac withdrawal is easier to manage than Pristiq as it does not carry the norepinephrine aspect (stimulatory) of Pristiq. This may result in fatigue. But your doctor may advise that Prozac may mitigate harsh effects such as brain zaps that are more associated with Pristiq.
Is Pristiq Prescribed Only to Women?
Although Pristiq (desvenlafaxine) was originally marketed mostly to target women for menstrual or menopausal issues like “hot flashes,” with its pretty-sounding name and cute commercials featuring wind-up dolls, lots of soft pink and pastel colors, and gentle music, prescribing the drug today is not limited to the female market at all.
There are no limits on who may be prescribed Pristiq (desvenlafaxine) except not to children or the under-25 age range due to the high risk of suicide. Among the elderly population, antidepressants are known to be outrageously overprescribed, and the number of complications due to multiple medications, co-occurring disorders, and medical conditions makes the problem exponentially worse.10 It is unfortunate that though general medical practitioners are highly skilled technicians in their bio-physical healing arena, they are less skilled in nutritional aspects of improving health, and are, tragically, wholly untrained in treating mental health issues, let alone within a holistic or drug-free context.
What is Pristiq Prescribed to Treat?
In 2007, the FDA approved Pristiq to treat MDD or major depressive disorder in adults.12
Pristiq has also been prescribed off-label for the following:
- depression in adolescents 13
- Fibromyalgia
- hot flashes for women in menopause
- women’s menstrual difficulties
- chronic pain
- anxiety
- bipolar
- neuropathy associated with diabetes
A wide range of populations and age ranges have been prescribed Pristiq beyond its FDA approval for the treatment of a wide array of conditions. This may have resulted in a significant number of patients for whom Pristiq did not provide the relief they were seeking, with the additional problem of not knowing how to get off Pristiq safely.
Side Effects That Lead People to Wanting Pristiq Tapering Help
Pristiq tapering would resolve fears about health issues related to the drug. A 2012 adverse reaction report (among several similar) lists 36 suicides and deaths attributed to Pristiq for that year.1 This report often omits the ages but includes both males and females. The physician attending the patient at death listed Pristiq, and sometimes multiple antidepressants as the cause of death from suicide, renal failure, hepatic failure, thrombocytopenia, and other drug-induced conditions. Cardiac arrest and serotonin syndrome accounted for other deaths reported in the study of adverse reactions to Pristiq and other SNRI antidepressants. These deaths raise concerns.
Except in the case of serotonin syndrome or other medical emergency situations as noted above, Pristiq taper protocols should be as gradual as possible. Only in the case of serotonin syndrome, Stevens-Johnson syndrome, dropping sodium levels, or other major life-threatening reactions such as seizures, skin eruptions, cardiac events, etc., would a physician be justified in calling for immediate Pristiq cessation.
Emergency treatment for serotonin syndrome or Steven-Johnson syndrome, or other life-threatening adverse events, is possible only in a hospital setting with an emergency ward, critical or intensive care unit, and trained emergency staff immediately on hand to keep the patient alive if possible.
Those caring for or living with the person should also be apprised of the possibility of these types of worst-case scenarios, and know exactly what to do should they occur. A word of caution: some VOIP phone lines do not have 911 access. It is a good practice to work out an alternative plan so as not to delay access to an ambulance if one is ever needed.
CAUTION: Pristiq Timed-release …
There is an additional complication with exactly how to gradually withdraw from PristiqXR because it is a timed-release medication. Like virtually all other antidepressants, the side effects of Pristiq can be quite uncomfortable and harsh, and extremely hard to tolerate, which may lead to the decision to quit taking it. But trying to quit Pristiq gradually may not be as straightforward as it is for drugs that are not time-release formulations.
The FDA recommends gradual Pristiq cessation whenever possible and acknowledges that abruptly getting off Pristiq or another SNRI medication is associated with potential patient risk. FDA warnings are clear that abrupt Pristiq cessation can have disastrous health impacts.2,7
But no directions are provided as to how exactly to gradually reduce a timed-release pill that only comes in 50mg and 100mg doses, and where the maximum daily dose is 100mg. Clearly, there is an oversight and a huge gap here in giving instruction and guidance to either prescribing physicians or their patients. The task of withdrawal from a timed-release antidepressant is somewhat like figuring out the Rubik’s cube before YouTube.
Alternative to Meds Center’s Physicians Are Trained in How to Quit Pristiq Safely
According to the very apparent absence of available literature, it is clear that there is little direction given to medical practitioners to assist their patients in how to get off Pristiq. Antidepressant tapering and tapering SNRIs or similar medications is not part of the medical training given to doctors in school before they start practicing, nor is it provided by drugmakers or even the FDA, as mentioned above.
Thankfully, Alternative to Meds Center utilizes fully licensed psychiatrists, and other fully licensed and certified doctors, nurses, and practitioners who ARE trained in safe Pristiq tapering protocols. One could say that Alternative to Meds Center has “cracked the code” for how to get off Pristiq with minimum discomfort and maximum comfort and safety. Contact the center for more details on the protocols designed for safe Pristiq tapering.
The Best Solution for Safe Tapering from Pristiq
Alternative to Meds Center provides the finest help with how to get off Pristiq in a nurturing in-patient setting. The center’s Pristiq cessation program (alternatives and withdrawal) has overcome the difficulty of administering gradually reduced dosage and indeed is completely oriented toward patient safety and comfort. For over a decade and a half, Alternative to Meds Center has assisted thousands of clients stopping Pristiq and other medications safely, gently, and comfortably.
Our programs are administered using techniques that allow for a safe and gradual withdrawal from Pristiq despite it being a timed-release medication. Program steps are individually tailored for each client which benefits the client’s overall personal health. Discovering and eliminating root causes for mental distress, depression, fatigue, sleep issues, insomnia, anxiety, or other undesirable conditions is what makes it possible to elevate and improve natural mental health. That is our prime goal which we offer to our clients, and in so doing, likely reduce or eliminate entirely the need for prescription medications.
Programs implement a blend of many protocols such as neurotoxin testing and removal, nutritional deficiency testing and correction using both oral and IV infusions, and holistic adjunct therapies designed for enhanced patient comfort, a better quality of sleep, more energy, and a brightened mood. We use many additional program components such as restoring the microbiome, life coaching, relaxation therapies, mineral baths, craniosacral massage, nebulized glutathione treatments, prescribed dietary changes, and more, under the oversight of our holistic practitioners including our fully licensed holistic psychiatrist. You are invited to view our services overview pages for more details on the services provided at the center for Pristiq tapering and improving mental health holistically.
Pristiq tapering treatment offered at Alternative to Meds Center is an investment in you for your health-focused and sustainable recovery.
SNRI drugs manipulate the distribution of certain natural hormones and transmitters. Rantamaki’s research from 2016 concluded that despite a marked deficiency in understanding of what antidepressants do to the CNS and brain chemistry, their therapeutic effects are only temporary.6 Addressing psychosocial, dietary, and other challenges can play a significant role in the treatment of depression or other symptoms.
Have your doctor help with how to cut the dosage which may involve actually cutting the pills. In the case of Pristiq, the lowest dosage is the 25mg tan-colored squares. The tablets can be cut in half when needed providing a 12.5mg option. When these tablets are cut they become no longer extended-release. Desvenlafaxine (immediate-release) has a short half-life of 11 hours,8 but Pristiq is contained in a time-release format designed to release over a 24-hour period. The longer the half-life, the slower the medication will leave your body, which, generally speaking, makes the tapering easier. Also worth noting, if there is hepatic (liver) impairment, the half-life can be 13 or 14 hours. These factors can complicate the withdrawal. Do get medical advice before attempting this on your own.
