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Lessons from ME/CFS: Finding Meaning in the Suffering
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Pristiq versus Zoloft antidepressants

Discussion in 'General ME/CFS Discussion' started by hmnr asg, Oct 14, 2013.

  1. hmnr asg

    hmnr asg

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    Hi there,
    I understand that reactions to these pills are very individual but I would love to hear opinions.
    I have been given two prescriptions for antidepressants by my doc, one Pristiq (or desvenlafaxine an SNRI) and setraline (the generic zoloft, an SSRI). The pills are not for my CFS but for the anxiety disorder which I have been blessed with in addition to CFS and also the depression that has been gripping me since my CFS took a turn for the worse. I have taken zoloft before and it helps the anxiety but not a dang thing for the energy levels or the brain fog from CFS (but havnt taken pristiq). I was wondering, is there any reason why a person with CFS would prefer one pill to another? or more fundamentally, a SSRI to an SNRI? would one be better (or worse) for the energy level and brain fog than the other?
    I would try the pristiq and just experiment but switching ADs can be a bit nightmarish according to what I have read.
    Any comments are appreciated and I apologize ahead of time for the unoriginal question.

    thanks

    J
  2. vamah

    vamah Senior Member

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    Yes, switching can be very difficult. I have done a fast switch (by whitch I mean about 2 week transition) under a doctor's orders which was disasterous and a much more gradual one (months) on my own that turned out much better. My advice is definitelt to step down your current med very slowly -- when I did it, I gave each step 3-4 weeks.

    I also have an anxiety disorder and zoloft never helped me. I am not familiar with pristiq, but I did switch from prozac, an ssri, to cymbalta, an snri. I had tried another snri about a year before and it didn't help and was hell to taper off, but cymbalta has worked well for me.
  3. hmnr asg

    hmnr asg

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    Thank you for the reply. I would try Cymbalta but a quick google reveals some pretty scary stories (and a few success ones) but it is enough to give me pause.
    As for switching, I thought one just stops one and starts another? im surprised you mention that it took you two weeks. Perhaps I was wrong and one has to wean off from one AD to switch to the next?

    J
  4. vamah

    vamah Senior Member

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    Washington , DC area

    Yes, it is a slow taper off one drug and on to the other, with some overlap where you are taking both. It may not be necessary if you are just switching from one ssri to another, but switching from an ssri to an snri I would definitely go with a slow taper. I am thinking that the problem switching to an snri the first time was that my doc had me go to fast -- I think it was over just one week. Switching from prozac to cymbalta, I lowered my prozac dose by 10 mg every 3-4 weeks, so I was taking both for a couple months. This method worked much better for me.

    I had been cautioned about cymbalta also, but decided to give it a try because it can help with pain. It has worked well for me, but everyone is different.
    hmnr asg and SOC like this.
  5. hmnr asg

    hmnr asg

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    Thanks vamah for the info,
    I guess I will go with pristiq and maybe i will do the gradual switch if it doesnt pan out.

    J
  6. August59

    August59 Daughters High School Graduation

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    Cymbalta has been the best one by far for me. It will be generic in December I think.
  7. SOC

    SOC Moderator and Senior Member

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    I haven't heard any patient say that ADs help with ME/CFS energy problems or brain fog, so I suspect that's a non-issue.

    Cymbalta does seem to help some people with ME/CFS pain, so that might be worth considering. It worked for me for that (at lower dose than usually used for depression) for years. I had no side effects and no trouble going off, but I didn't try to stop it suddenly. That's a bad idea with any AD.


    Other than that, I don't think you can expect any AD to help with ME/CFS symptoms. The scientific evidence doesn't exist that shows ADs help with ME/CFS (the kind with PEM) symptoms.

    Major depression itself can cause fatigue, so your AD may help with that. In my experience depression fatigue and ME/CFS fatigue are very different animals.
  8. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Several yrs ago i was put on effexor and then told that i needed to increase the dose to get rid of my cfs symptomso_O which i tried. I tolerated the lower doses ok, made me feel better about feeling like crap but higher doses made my brain do mickey flips so on docs advice started to taper off and the first dosage drop symptoms worsened so was told to go back up again made things worse. As soon as i started going down then up it just messed me right up and my doc was useless as far as coming off it. What i end up doing was stop it straight away and went back onto zoloft and stayed there till things stabilised and then tapered off which i had done before with no issues. I suppose i stole this concept off the internet where they switched directly over to prozac as it has a long half life and then tapered off it which is apparently alot easier to do.

    So i suppose some do swap straight over from one AD to another but i guess one should do this on docs advice and just be aware of possible withdrawal side effects that could happen but may not.
    hmnr asg likes this.
  9. hmnr asg

    hmnr asg

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    Hi Soc,
    The reason why I am considering ADs is mostly to help me to "feel better about feeling like crap" as heapsreal mentioned and to help with some anxiety. When i was on zoloft couple of years ago it helped my CFS indirectly. I have a few functioning hours every day but nowadays I spend them feeling terrible and wondering whats the point of my existence in this super-useless state. When I was on ADs I would try to at least do a few useful things.
    So I dont expect AD to make the fatigue or the mental fog to go away, but I hope it will give me a tiny bit of an edge (emotionally) over this overwhelming sense of despair thats affecting my few "good" hours.
    vamah and heapsreal like this.

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