Lipkin's Monster ME/CFS Study: Microbes, Immunity & Big Data
The Microbe Discovery Project outlines an ambitious new study by top researchers that has collected patient samples, but needs desperately funds to complete the work.
Discuss the article on the Forums.

Pristiq versus Zoloft antidepressants

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

  1. hmnr asg

    hmnr asg

    Messages:
    38
    Likes:
    22
    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

    Messages:
    593
    Likes:
    694
    Washington , DC area
    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

    Messages:
    38
    Likes:
    22
    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

    Messages:
    593
    Likes:
    694
    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

    Messages:
    38
    Likes:
    22
    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

    Messages:
    1,617
    Likes:
    620
    Upstate SC, USA
    Cymbalta has been the best one by far for me. It will be generic in December I think.
     
  7. SOC

    SOC

    Messages:
    7,803
    Likes:
    16,335
    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.
     
    Cyndia likes this.
  8. heapsreal

    heapsreal iherb 10% discount code OPA989,

    Messages:
    8,558
    Likes:
    7,348
    australia (brisbane)
    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

    Messages:
    38
    Likes:
    22
    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.
  10. Cyndia

    Cyndia

    Messages:
    11
    Likes:
    28
    Hi Soc, I know this is an old thread, but if you're still on here, I was wondering if you could describe some of the differences you experience regarding the energy low of ME/CFS and Depression? I'm trying to sort my energy out. My Doc and psychiatrist say fatigue and cognitive issues are due to severe depression and give me the eyeball roll about self diagnosing ME/CSF but I don't have the sadness or negative, hopeless thinking that I believe is so central to that dx. I am grieving my loss of function and have been at about 30% of my usual function for about 6 months now... I tried citalopram first, then escitalopram and all it did was amplify my fatigue and dizziness/discombobulation... it also really got rid of any connection to my feelings which is for me much worse than having the feelings. I've been reading about neuro inflammation and the cognitive and functional sx of ME/CSF and also that antidepressants do promote cell regeneration in the hippocampus which helps restore cognitive function. The bargaining part of me so wishes there was a med that could support my cognitive function and energy. The side effects though are a huge deal for me. My level of function is so low that adding side effects feels like another layer of stress and burdent to my already taxed bodymind. I have been taking Ashwaganda1500 mg/day, Meriva Turmeric1500 mg/day, Vit D (15,000 A my level was 20), Zinc 30 mg/day, a great liquid multi, methylfolate 15 mg and Magnesium. My good days have me at about 34-40% but my crashes are 25-30% of my normal function. While I believe the nutritionals are anti-inflammatories and supportive, I do skip days because they are also not natural and feel like a burden on my system some days. No big aha's or rapid improvements from anything yet. I'm still hopeful. I have an I'm in recovery attitude. Any updates would be so appreciated!
     
  11. dadouv47

    dadouv47 Senior Member

    Messages:
    317
    Likes:
    442
    Belgium
    Zoloft is by far the antidepressant that helped me the most for my anxiety issues. Also gave me some energy back ( maybe because less anxiety). Of course it's not a long terme solution and not everyone reacts well to it, but it helped me a lot (and also have a lot of stomach issues and Zoloft was one of the few that didn't aggravate those problems).
    Regards
    David

    Ps : damn didn't see it was such an old thread :D Probably not gonna help anymore...
     
  12. Cyndia

    Cyndia

    Messages:
    11
    Likes:
    28
    I heard that - thanks dadouv47 :thumbsup:
     
  13. Hip

    Hip Senior Member

    Messages:
    7,302
    Likes:
    9,419
    You might consider looking at the Canadian Consensus Criteria (CCC) for ME/CFS. These criteria are used by doctors and researchers to diagnose ME/CFS. Have a look at the seven criteria listed on page 2 of the document, and see how many you have yourself.

    Some very telling symptoms that indicate you may well have ME/CFS are:

    Post-exertional malaise (PEM), which is where many of your ME/CFS symptoms get worse a few hours, or over the next day or two, after performing physical exertion, and/or mental exertion. PEM is actually a useful way to help distinguish between depression and ME/CFS, because with depression, physical exercise usually helps you feel better, but with ME/CFS, physical exercise often makes you feel considerably worse. (Note that in the less strict CDC definition of ME/CFS, PEM is not an obligatory symptom; but it is obligatory to have PEM to get an ME/CFS diagnosis by the CCC definition.)

    Autonomic Manifestations (orthostatic intolerance). Orthostatic intolerances are conditions whose symptoms get worse when you stand up. Quite a few ME/CFS patients have the orthostatic intolerance conditions of POTS or NMH. If you have either of these, it again provides evidence that you have ME/CFS. POTS and NMH can be diagnosed yourself at using a simple home blood pressure meter. An explanation of how to diagnose POTS or NMH yourself is given in this document (just search for the word "POTS").


    It may be a good idea to print out the CCC document, and show it to your doctor. You would be surprised how so many doctors are clueless about accurate diagnosis of ME/CFS. It's quite common that patients end up diagnosing themselves, simply because doctors do not know enough about the various symptoms of ME/CFS.

    A doctor knowledgable about ME/CFS will also test you for common diseases that can produce very similar symptoms to ME/CFS, such as hypothyroidism, anemia, and celiac disease. These diseases need to be ruled out before you can settle on an ME/CFS diagnosis.
     
    Last edited: Jun 3, 2016

See more popular forum discussions.

Share This Page