Pristiq. For bipolar or SZA depression?

[Wonderful.Cheese]

What are people’s experiences with pristiq? For depression, or bipolar depression or SZA disorder depression?

I used to take Effexor xr for years. Then I got off seroquel to try latuda, got manic and psychotic and had to be hospitalized. They instantly blamed the Effexor and cold turkey stopped it. That was no fun. Plus it was latuda’s fault and lack of seroquel’s fault.

I don’t know if my current pdoc will let me touch an AD with a 10 foot pole. I tend to get manic. The light box therapy made me hypomanic even!

But I really could use the help of an AD. And it seems like pristiq interacts the least with my current meds of the AD’s that are generic.

(I’ll eventually be on clozapine and seroquel xr it seems with lamictal and klonopin, as the main psych meds)

[CeremonyNewOrder]

Hi Cheese, I just started pristiq about two months ago. I've always done better with SNRIs and both effexor and cymbalta pooped out on me. It has helped with depression and energy but not my anxiety disorders. One downfall of it is in my opinion, you can only go up to 50mg (which seems like a small amount). Studies show that pristiq's efficacy ends at 50mg and increasing the dose will not improve your symptoms. The pills are also extended release so you can't cut the pills. Another problem is it is not a common med so I have to order a refill way in advance. Right now I'm titrating onto Zoloft and keeping pristiq for now. 

[Wonderful.Cheese]

16 minutes ago, CeremonyNewOrder said:

Hi Cheese, I just started pristiq about two months ago. I've always done better with SNRIs and both effexor and cymbalta pooped out on me. It has helped with depression and energy but not my anxiety disorders. One downfall of it is in my opinion, you can only go up to 50mg (which seems like a small amount). Studies show that pristiq's efficacy ends at 50mg and increasing the dose will not improve your symptoms. The pills are also extended release so you can't cut the pills. Another problem is it is not a common med so I have to order a refill way in advance. Right now I'm titrating onto Zoloft and keeping pristiq for now. 

Hey thanks for the reply! 

Hmm. Interesting info. Thanks for sharing. 

Does the zoloft not interact with the Clozapine? I thought it was something to do with a heart rhythm thing? But if your Dr prescribed it it must be safe. Well that opens up a lot more options for me! Thanks for the info!

Good luck with the zoloft. That was the second psych med I actually tried! The first being paxil!

[gb84]

I was on 50mg of pristiq since the end of June.  Just got bumped up to 100mg.  It wasn't helping then and the increase hasn't done anything either.  Next time I see the pdoc I am going to ask to try wellbutrin.  

[mikl_pls]

I didn't have any good luck with Pristiq. I was on 50 mg and it did nothing. Went up to 100 mg and I still felt very weepy and dysphoric. I switched back to Cymbalta at the time, which I was on prior to Pristiq the first time and immediately felt better, but put myself on a higher dose than I was on previously, 90 mg Cymbalta, because my pdoc refused to go above 60 mg (max is 120 mg). My pdoc finally agreed to give me 90 mg Cymbalta then.

Then when Pristiq went generic, I asked my gdoc if he would give me higher than the max dose, since he actually does PAs (my pdoc literally has no time to do PAs), and he agreed to put me on 150 mg. Not surprisingly, it did nothing. I wanted to try even higher, but my pdoc said 150 mg was too much, which I disagreed with. So I had to switch to something else. They actually studied up to 400 mg in the clinical trials. But as @CeremonyNewOrder said, no additional benefit was shown above 50 mg. The 100 mg dose is kinda a "just for the hell of it" dose I think. Some people actually do get benefit out of going above the max dose. I've read of people taking 300-400 mg Pristiq and getting benefit from it, but at the same time, I've heard of some taking that much and it being a nightmare.