Supratherapeutic doses of Pristiq

[mikl_pls]

So I've seen all these people with Pristiq doses of 150 mg, 200 mg, on up to 400 mg.

Pristiq 100 mg did nothing for me. Cymbalta I recently switched to and it's already pooping out. I did well on Effexor but it had a lot of unpardonable side effects, even in low doses, and I had to get to 375 mg before it helped my depression.

I've asked my pdoc about it and she's convinced that anything above 100 mg Pristiq is too much. I'm a little desperate here because I've tried like 27 antidepressants and the last one I'm willing to try is imipramine and she said it was more likely to cause weight gain than loss (big deal breaker for me...)

My questions are:

1. Has anyone taken any dose of Pristiq > 100 mg?
2. How well does it work?
3. How were/are the side effects?
4. Did you experience any weight gain?

[tommy215]

I wish I had answers for the Pristiq questions...however, I can tell you that Tofranil(imipramine) saved my life the last time I went through a bipolar depression. 

The weight gain on it is no more or less than other sedating TCA's.  Don't be scared to try it. 

That being said, good luck with the Pristiq.  I'm hoping your doctor will chance it and give you an opportunity to raise it above 100.

[Blahblah]

@mikl_pls So if something "poops out" you at some point, even after a break, it will never work for you again? Are there any newer SNRI's coming out now? I'm curious what types of intolerable side effects did you have on Effexor?

[mikl_pls]

7 hours ago, tommy215 said:

I wish I had answers for the Pristiq questions...however, I can tell you that Tofranil(imipramine) saved my life the last time I went through a bipolar depression. 

The weight gain on it is no more or less than other sedating TCA's.  Don't be scared to try it. 

That being said, good luck with the Pristiq.  I'm hoping your doctor will chance it and give you an opportunity to raise it above 100.

 

I'm going to ask my GP for the Pristiq and see how it goes, but if it doesn't do any better than the Cymbalta, Tofranil is next on my list to try. I seem to be getting my diet squared away anyway, so if there's any propensity for weight gain, I should be able to control it. (I have about 110 lb to lose... XD) Thanks for the insight!

5 hours ago, Blahblah said:

@mikl_pls So if something "poops out" you at some point, even after a break, it will never work for you again? Are there any newer SNRI's coming out now? I'm curious what types of intolerable side effects did you have on Effexor?

 

I'm not sure... Cymbalta worked for a long time for me and then pooped out. My pdoc didn't want to raise the dose until I raised it myself to 90 mg, to which she agreed reluctantly. By the end of that year, I was super suicidal and ready to make the switch to MAOIs. She tried to bribe me with 120 mg Cymbalta which I had asked for several times, but I made my mind up to switch to Emsam. Fast forward about a year later, and she finally prescribed me 120 mg with 40 mg capsules (which weren't tier 4 then) but told me to take 80 mg. (???) I was also taking desipramine which was also fantastic. It worked great for a few weeks, then I felt like the desipramine was carrying a brunt of the load of my depression. I got some 50 mg desipramine and mixed it with my 75 mg desipramine and it helped a little, but I could tell the Cymbalta wasn't doing anything, and it was pretty much the desipramine, so I quit the Cymbalta and was taking only desipramine and noticed no difference. My pdoc wouldn't go higher on the desipramine (she hates that medicine for some reason) so we switched to something else, I don't remember... But I've tried Cymbalta about three times and each time it has worked fantastically for about 2-4 weeks and then craps out every time no matter what the dose is or what it's augmented with.

The newest SNRI is Fetzima, and it makes me suicidal and poops out halfway through the day... I STRONGLY dislike Fetzima.

Effexor caused extreme constipation to the point of exacerbating my hemorrhoids that were caused before by an extremely high dose of Wellbutrin a few years back, sexual dysfunction that is absolutely unmanageable with anything, crazy appetite increase and subsequent rapid weight gain, and a dose increase will work for about a week before it "poops out," hence why I ended up at the super high dose of 825 mg before calling it quits on that drug. (I'm a rapid metabolizer of CYP2D6, possibly ultra-rapid, so I could tolerate high doses without any super bad side effects).

[DopamineSick]

On 10/21/2017 at 12:15 AM, mikl_pls said:

So I've seen all these people with Pristiq doses of 150 mg, 200 mg, on up to 400 mg.

Pristiq 100 mg did nothing for me. Cymbalta I recently switched to and it's already pooping out. I did well on Effexor but it had a lot of unpardonable side effects, even in low doses, and I had to get to 375 mg before it helped my depression.

I've asked my pdoc about it and she's convinced that anything above 100 mg Pristiq is too much. I'm a little desperate here because I've tried like 27 antidepressants and the last one I'm willing to try is imipramine and she said it was more likely to cause weight gain than loss (big deal breaker for me...)

My questions are:

1. Has anyone taken any dose of Pristiq > 100 mg?
2. How well does it work?
3. How were/are the side effects?
4. Did you experience any weight gain?

Hi, did you ever try the Tofranil? I was on 50 mg for two weeks and just went up to 100 mg yesterday. I'm curious about other people's experiences with it. I'm also highly treatment-resistant. I've tried many things and nothing has worked. This is my first time on a tricyclic.

[mikl_pls]

5 hours ago, DopamineSick said:

Hi, did you ever try the Tofranil? I was on 50 mg for two weeks and just went up to 100 mg yesterday. I'm curious about other people's experiences with it. I'm also highly treatment-resistant. I've tried many things and nothing has worked. This is my first time on a tricyclic.

No, I never did go to try Tofranil. I've tried other tricyclics though. If you wanted, you could probably start a thread about Tofranil. I've heard from another on here that it saved their life.

[DopamineSick]

18 hours ago, mikl_pls said:

No, I never did go to try Tofranil. I've tried other tricyclics though. If you wanted, you could probably start a thread about Tofranil. I've heard from another on here that it saved their life.

Thanks. BTW, my doctor wouldn't go above 100 mg of Pristiq either. I tend to need higher dose levels of everything. Did you ever go above 100 mg?

[mikl_pls]

1 hour ago, DopamineSick said:

Thanks. BTW, my doctor wouldn't go above 100 mg of Pristiq either. I tend to need higher dose levels of everything. Did you ever go above 100 mg?

I wound up going to my GP and he actually prescribed me 150 mg Pristiq. I tried it for a while and it didn't do much of anything. I saw my pdoc about 4 weeks later and told her that I had tried 150 mg Pristiq, which she said "that's too much," but I told her we had plans of going higher than that if that didn't work. I think she switched me back to Cymbalta at that point, and I told her the only way Cymbalta is going to work for me is if I take it at the max dose of 120 mg.