[jshuman]

Hi,

I'll start off by noting that I am a hypochondriac with a fear of medication. I have taken 2 SSRI's in the past and have had some moderate success (with unfortunate side effects that I assume may be permanent now). I guess I fear taking any pill now, really, but especially psychiatric meds.

Anyways, my psychiatrist says that, usually, after trying 2 SSRI's, patients typically transition to an SNRI. Has anyone on these forums taken or tried Pristiq? I really would like a completely honest review on how it went. One thing in particular I would like to know is how it affected sleep. My sleep is currently a HUGE issue in my life now, as I am getting 4-5 hours per night if I'm lucky. It is possible that Pristiq may lower anxiety, which means it could positively affect the sleep issue, but I have a gut feeling that an SSRI is probably more effective at calming someone down, thus decreasing anxiety and improving sleep.

Anyways, let me know guys. I have struggled a lot recently and my relationship to psychiatric medication has been a rough one. I must do whatever it takes to get better at this point. Thanks everyone.

[ThingWithFeathers]

I've only been on pristiq for 3-4 weeks, so have little knowledge to impart. So far I have had no side effects and my depression is no worse than it was on an ssri. I'm yet to feel the full impact of the med as I'm guessing it'll take 6-8 weeks ro notice a difference.

I'll start off by noting that I am a hypochondriac with a fear of medication.

Oh dear. That is an unfortunate place to find yourself if you need to take psych meds.

I'll try to answer your question first. Although I haven't taken Pristiq, I have taken both Effexor and Cymbalta, also SNRIs. As you may know, Pristiq is a metabolite of Effexor. It's supposed to be a "cleaner" version of Effexor (fewer side effects.)

A prescriber that I saw up until last year said that her patients usually had fewer side effects with Pristiq than with either Effexor or Cymbalta.

I have fibromyalgia in addition to depression, which is why I have taken the SNRI meds for so long.

Each SNRI antidepressant has a different "personality", which is sometimes described as its affinity for serotonin vs. norepinephrine receptors in the brain.

I'm not quite sure how to answer your question about anxiety and sleep. I have taken SSRI antidepressants that I thought made my anxiety worse. Zoloft seemed to make it less of a problem.

Maybe my best answer would be that I've never taken a "main" antidepressant that worked to help my sleep, too.

Many people on antidepressants find that they have to take a second medication to help them with sleep. I am more in favor of using low-dose mirtazapine or trazodone or even Ambien than using an antipsychotic medication like Seroquel for sleep.

I have also had good luck with a supplement containing a combination of melatonin, 5-HTP, and L-theanine. The one that I used is made by Webber Naturals and is called Sleep Calm or SuperSleep. I don't know if this supplement would keep working every night, forever and ever.

Some of the ingredients in it are not recommended to mix with an SNRI or SSRI antidepressant, but I decided (yes, on my own!) that there is not a problem because the supplement contains a low dose of them. I also don't notice any type of problem while taking the supplement.

I have been taking Cymbalta for around 7 years now. It was very sedating and seemed to help my sleep for the first 3-4 years. That is not typical from what I've heard, though.

I am currently taking low-dose Remeron/mirtazapine primarily for sleep, although I also find it to be calming. I think this antidepressant is excellent for this purpose.

A "normal" dose for depression is 30-45 mg. When I first started taking it, half of a 7.5 mg tablet would make me sleepy within 15 minutes. Now I usually take 15 mg at bedtime.

My only complaint about mirtazapine is that it causes food cravings for most people. I gained about 8 pounds the first month that I took it, but no more since then.

If you don't have any problems with emotional eating or weight, I would highly recommend considering low-dose mirtazapine to help with sleep. If you are generally pretty good about eating healthy foods, then I don't think mirtazapine would cause too much of a problem for you.

I have found that the food cravings have lessened greatly as my body has gotten accustomed to the medication. I am pretty good at keeping an eye on what I eat and telling myself "no" to unhealthy foods, so I can deal with the mirtazapine.

Lots of people find SNRI antidepressants to be very sedating when they first start taking them (sedating in the daytime). I think it's typically recommended to take them in the morning (I think that this is because, after the first month or so, they tend to be energizing and often cause insomnia.) I take mine at bedtime.

It can take 3-4 weeks to adjust to the initial side effects.

Wellbutrin + low-dose mirtazapine could be another possible combination to try. It works well for some people.

Do you know about the "discontinuation syndrome" that is associated with SNRI medications? It is extremely severe for some people. If you hope to stop taking antidepressants completely at some time in the next few years, then I would not take an SNRI.

If it looks like you're going to always have to take an antidepressant, then it's not as big a problem.

Ok, I'm going to totally change tack here. I wanted to ask how long you've been taking antidepressants and how severe your depression and anxiety are.

I have been taking antidepressants for around 20 out the last 25 years, plus I have fibromyalgia.

If I could afford it, though, I would find a good doctor (preferably psychiatrist) who works to treat depression and anxiety with holistic methods (supplements, psychotherapy, mindfulness/medication, yoga, good nutrition, sleep hygiene, prescription psych meds as absolutely necessary.)

These doctors usually don't accept insurance because the type of medicine they practice is not generally reimbursable by insurance anyway. Some of them are scammers. Some are very good.

I do not believe that prescription psychiatric medications alone are the best treatment for depression and anxiety. I think it needs to be a "whole person" treatment.

Since I can't afford a doctor to help me with this, I try to do what I can to eat an anti-inflammation diet, to practice good sleep hygience, and I also go to psychotherapy. I am not exercising now, aside from a little walking, but I think that walking and yoga are also very helpful for the mood and general health.

Ok, there are two other things that I wanted to mention.

1. Sleep. I would recommend using an app like SleepBot to track your sleep for a few nights to find out if you have something going on like a movement disorder (restless legs, etc.) or sleep apnea that could be affecting your sleep.

2. Genetic testing to see which antidepressants may work best for you. It's not very expensive, and insurance may cover it. The link is to a Psychology Today article about it.

If you're still reading by this point, I hope I answered your question about Pristiq adequately. Good luck.

[doogie]

It worked well for me for about a year, and then it didn't. It was HORRIBLE to taper off Pristiq. My psychiatrist said there are several meds in that class and all of them are difficult to taper off. Just keep that in mind.

[derangedcandy]

I have been on various medications over the past 7 years, and Pristiq has been wonderful! Effexor (which is in close relation to Prisitq) first saved my life, but I eventually got off of it due to feeling numb, so my psychiatrist switched me to Pristiq, it has continually helped me with combating social and general anxiety, as well as major depressive disorder. It has not been a cure, but has made my life a heck of a lot better!

[jshuman]

This is great to know everyone, thanks so much. I took two different SSRI's (Zoloft and Celexa) each for about 3 months each, but just couldn't sustain them for longer than that. My depression is moderate (mostly a numbness/anhedonia, probably because I am not super engaged with the world right now), and my anxiety, especially social, is at a low point. I've been stuck in a god-awful rut for months. Finding ANY source of help for pushing myself more socially is my main goal.

Though there are risks, I feel a little more confident in trying the Pristiq because, as some might say, it's crazy to expect different results when you are doing the same things. Thanks again guys.