Seeking Insight

[Tia72]

Three weeks ago I was taken off Paxil and put on Pristiq.

Withdraws and adjustment is absolutely awful.

Anyone familiar with Pristiq?

I went from feeling managed to completely raw.

Therapist has not been approved yet.
New doc has not been approved yet.

Feeling completely abandoned and alone and truly terrified.

 

[aka]

I have been on Pristiq for a year now. Worked great for about 8 months on 50mg then my depression started increasing. My doctor tried to up me to 100mg but I had some really bad side effects so I had to go back down to 50mg. My doctor has current added Abilify with the Pristiq to help with my depression. I have never been on Paxil though so have no insights into it.

Therapist has not been approved yet.
New doc has not been approved yet.

Does this mean you are not current in therapy and not seeing a doctor or they want you stick with the med changes?

I defiantly understand being completely miserable from medication side effects the only advice I can give you is to talk with the doctor who prescribed the Pristiq. Perhaps the change in medication was too fast or you are having a bad reaction to the Pristiq this is something you can work out with the doctor. Hope you feel better. :)

 

[anthony]

Was Paxil working for you?

 

[greenleaf]

Also, did they take you off Paxil with no slow taper? If so, no wonder you're having troubles, it's one of the worst for "discontinuation". Can you call back and ask to be tapered slowly if that's maybe a problem right now?

 

[Tia72]

Going to attempt to answer the questions and hopefully not create any confusion.

Ok.
2011 trauma began
2011 lost medical insurance
2011 obtained legal council for trauma
No medical... No resolution at this point with my case so I was all alone in my research for medication, help, therapy.
2012 had psych eval and diagnosed with PTSD. (Psych eval was for my case)
Aug 2012 found Paxil is medication successfully used with PTSD patients. So I went to an urgent care clinic that I knew the MD. and we got me on it.
After adjustments and patience ... My life was changed for the better. Anxiety was absolutely manageable, insomnia was not so bad, nightmares were gone except for rare incidents. I laughed again, didn't want to hurt myself.
Therapy with LMFT was good.
Medicine checks with Doc every six months with positive results.
June 2014 first part of case won. Previous employer took responsibility for injury thus taking all financial responsibility for my psych care. (Great right??)
Aug 2014 finally authorized to see psychiatrist.
I am TERRIFIED of psychiatrists. Absolutely terrified.

This new doc tells me... "Paxil is an old drug. Pristiq is new and better. You need to be on that"

Instructs me "begin Pristiq (50mg) and cut Paxil dose in half for seven days, then stop Paxil completely"

So I did as I was told.

Day 9 of new medication and being off the Paxil. COMPLETE emotional meltdown. Three days later, even worse. To the point I was hurting myself. Day 13 went back to doctor for help.

Told I was "not" withdrawing. Paxil is not a controlled substance. There are no withdrawals. If I want to hurt myself, then I should check mysel into a psych hospital. What do you want me to put you back on the Paxil!!!!???? (This all said to me by a psychiatrist)

Answer to questions about therapist and doc.
I do want a doc and I do want a therapist.
Problem: work comp is the most difficult. I have to wait for authorization to see new doc and therapist. Unless the therapist and doc are "work comp" I am "s.o.l."

I feel I did better on the Paxil. Only side effect was lack of labido which has returned full force since stopping the Paxil. However who care about labido when everything sucks, I don't leave my house, I stay in frumpy clothes all day etc etc

So here I am...
3 weeks completely off the Paxil
4 weeks on Pristiq

No doctor
I cannot/will not go back to the psychiatrist. He compromised my health. No trust.

My husband and my mom keep a close eye on me. Did not let me be alone for two weeks. My wounds have healed. I have scars only. I have been out by myself twice the past three days. I get terrible anxiety.

So where am I?

I'm without a doctor unless I go to the emergency room and how productive is that?

I am scared because I don't know what to do now. I am emotionally raw. My fight or flight is through the roof.

I have read a lot about Pristiq and as it is with any medication there are pros and cons. Everyone is different which stinks right now.

The LMFT I was seeing... She is a good person to talk to however in terms of medication she cannot say anything except what everyone says "have you talked to the doc" which right now triggers me big time.

 

[anthony]

Paxil is an old drug. Pristiq is new and better. You need to be on that

You need to tell your shrink to stop pushing his preferred drug that benefits him... and to put you back on the one that worked for you. Doctors are normally tied to drug companies / drugs specifically, and they get more money to push x, y and z drug over any other drug, which often they get nothing.

You were on a drug that worked... the simple solution is to go back on that drug and drop the Pristiq which obviously isn't working for you. Psychiatrists are biased, and not always working for the best interest of their patients. You tell them what works and what doesn't, and what you will and won't tolerate... not the other way round.

 

[Tia72]

I agree about the meds.
I agree about the psychiatrist being bias to the medications vs. the patient.
I agree I should go back on the Paxil.
We do believe he received a kick back for the Pristiq which is $700 vs. Paxil which is $8.99 (generic and out of pocket)

As for talking to the doc....
Where I am emotionally/mentally... the thought alone of going back to that doctor throws me into a terrible state worse than where I am right now.

I spoke to my pharmacist today about both meds and she suggested I continue the Pristiq for another 30 days. Which would put me at being on it for eight weeks. She said it will take six weeks to know/feel any improvements. The additional two weeks I suppose are for good measure in giving the medication a chance. At which point she gave suggestions on how to stop the Pristiq and how to re-introduce the Paxil.

Logically .... I am willing to do this only because I am not being monitored/treated by any doctor. Until I can get into the new doctor, which I and my attorney are working to get pushed through urgently. By the end of 8 weeks, I can honestly say I have "tried" the medication and give a true self assessment on the medication working or not working as good as the Paxil.

I can say wellbutrin is not a medication for me ( six months of taking it ) Prozac made me a psycho (after "one" dose ) Effexor is not productive medication (9 months of taking it) Paxil seems to be the medication I have found some peace...

Then I ask... is the peace or ability to function on Paxil... as good as I will ever be?? (I cannot work, volunteering is no good, I don't go out, I don't care how I look, I rarely sleep a full night without fear, terror, anxious feelings and sensations...I spend more time playing a FB game than I do being social....) To look back on who I was and how I was... is like telling someone a tragic love story. So is how I feel on Paxil it?? What if the Pristiq is the wonder medication to break through to recovery?

I "fear" attempting to switch without doctor supervision because of what happened the past two weeks. If I stop one and I fall backwards.. I don't know if I can handle it alone. (which right now, I am alone) And what if Pristiq is the right medication for me but I don't give it a chance.

As much as I trust the pharmacist and all she explained and said (which was HUGE compared to the doctor that changed my meds) she is not a doctor and what if something goes wrong?

I know my thoughts are all over the place. I do not mean to read so flip floppish. (welcome to my stressed out mind)

 

[anthony]

Lots of "what ifs" which only you get to decide, being your life, your decisions. Doctors don't have all the magic answers. Doctors are individuals, some work for you, some work against you... they're literally no different than going to two mechanics, one is trying to sell you things that aren't wrong with your car, the other is telling you they're nothing wrong with all else other than the actual minor issue.

I think you're putting a little to much weight into their abilities and credentials versus the reality of their job. They're supposed to only do things in the best judgement of the patient... which if that was the case, we wouldn't have kickbacks, we wouldn't have doctors killing patients in surgery and the list goes on and on. There are good doctors, there are crap doctors... you have to decide based on your face to face interaction with them.

 

[joeylittle]

You sound pretty sure you want to go back to the Paxil. And that pristiq is not working.

As a person who has been through the med switch thing a lot, my advice would be to not bother about the 8 weeks and go back now. You're having what most docs would call intolerable side effects - aka a meltdown.

I had a prescriber getting kickbacks start me on something too. The difference was, it worked. But the co-pay on it was an arm and a leg.
Grr.

Old drugs are generally good in that they've had a longer time to be researched. That same drug that cost me an arm and a leg was found to be consistently clinically ineffective after 2 years of use. Now I'm on something older, and I prefer the level of info they have on my drugs.

Not that all new drugs are "bad". But switching just because a drug is old is not a good enough reason in my opinion.

 

[greenleaf]

Jeez, I am so sorry you are having to deal with this psychiatrist; he sounds really unethical and/or just plain ignorant of a bunch of things to me... discontinuation syndrome with Paxil is really well documented! Not everyone reacts well to each medication, regardless of whether it's "new" or not! Compromising a patient for his own profit is deeply unethical but some of these people do it; do they just avoid admitting to themselves what they are doing, I wonder??

Paxil is what I've been on forever, it keeps me sleeping ok and keeps me out of a sort of cascading anxiety/fear thing that used to happen when I'd get stressed or triggered, without it.

Re. other things that can help in the mean time: can you do aerobic exercise, including can you walk for at least 1/2 hour per day? Longer is better but a little is better than none, for me at least. It seems to neutralize a chunk of the stress hormones. Every day is best for me. I've cut my paxil way down by exercising regularly; I also felt more energetic after adding a bit of wellbutrin to the paxil. Lower paxil equals easier weight maintenance, fewer side effects. I just plain feel better when in better shape too.

But everyone's brain chemistry is different -- except that exercise seems to help a huge percent of folks some; I bet we all have that chemistry in common. All these things take a while to have their best effect; with exercise, you might need to condition your body some before you can physically do enough to burn off some stress hormones. Don't injure yourself with too much too fast either... :)

 

[Tia72]

Thank you all so much for your feedback, insight and advice.
I really do appreciate it.

For the first time in what seems an eternity I feel heard and helped.

Thank you again

 

[Tia72]

PS
I went out today for the first time in almost a month.
It was a big deal for me and my husband.
I have gone out only a few times (a few miles away from my home) since the med change.
I forced myself to go. Had one small emotional breakdown but was able to push through it.
We went two hours away. I did ok. Rested my eyes while he drove and calmed down enough to enjoy the outing so to speak.
I was however glad to be back home once we arrived.
I went back to my comfort clothes immediately. Yet, I am not in a bad place as I have been after being out.