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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Roslynn on January 3, 2009, at 17:44:49
Hi all,
I posted above too...I am feeling worse not better, can barely keep my eyes open-- yet I am full of anxiety. Been on Pristiq about 4 weeks, almost unbearable, been medicating myself with extra ativan & seroquel..my doc wants me to go to 8 weeks...yikes this scares me...but then other option is starting from scratch with something else...
anyone been in this situation? (not necess. with Pristiq)
Posted by bleauberry on January 4, 2009, at 15:22:48
In reply to is 4 weeks a long enough trial for Pristiq??, posted by Roslynn on January 3, 2009, at 17:44:49
Hmmm, feeling worse, not baseline and not better. Well, if it were me, I would do a cross taper to your next choice. Granted these meds do take weeks and even months to do their thing, but 4 weeks is plenty of time to see at least a distant glimmer of improvement if there is to be any. That is pretty evident in clinical trials and anecdotal evidence at all the forums. It is possible, but rare, that someone feels worse at 4 weeks than they did at the start and then somehow magically it turns around for the better. Worse in the first week or two is not uncommon. 4 weeks is a bit much I think.
Worse is not cool. Clinical trials that have looked at this topic show that the degree of improvement or deterioration in the first weeks is a fairly reliable predictor of whether the med will work. There is no black-and-white, no guarantee. But, if it were Las Vegas, the hand you have right now has poor odds.
Of course most people including doctors would debate that the med needs 6 to 8 weeks, that 4 isn't enough. True enough. But in that debate they totally miss the point...you have deteriorated and are worse than you started and the only thing that changed is the med. Hello?
I don't know what other meds you have been on, your history, or your symptoms. But from those things you can gather some clues as to what to choose as your next med trial.
Posted by Phillipa on January 4, 2009, at 16:15:24
In reply to Re: is 4 weeks a long enough trial for Pristiq?? » Roslynn, posted by bleauberry on January 4, 2009, at 15:22:48
Blueberry seriously first week should do something? Never has that happened to me. Wow a week. Love Phillipa
Posted by Roslynn on January 4, 2009, at 17:27:12
In reply to Re: is 4 weeks a long enough trial for Pristiq?? » Roslynn, posted by bleauberry on January 4, 2009, at 15:22:48
> Hmmm, feeling worse, not baseline and not better. Well, if it were me, I would do a cross taper to your next choice. Granted these meds do take weeks and even months to do their thing, but 4 weeks is plenty of time to see at least a distant glimmer of improvement if there is to be any. That is pretty evident in clinical trials and anecdotal evidence at all the forums. It is possible, but rare, that someone feels worse at 4 weeks than they did at the start and then somehow magically it turns around for the better. Worse in the first week or two is not uncommon. 4 weeks is a bit much I think.
>
> Worse is not cool. Clinical trials that have looked at this topic show that the degree of improvement or deterioration in the first weeks is a fairly reliable predictor of whether the med will work. There is no black-and-white, no guarantee. But, if it were Las Vegas, the hand you have right now has poor odds.
>
> Of course most people including doctors would debate that the med needs 6 to 8 weeks, that 4 isn't enough. True enough. But in that debate they totally miss the point...you have deteriorated and are worse than you started and the only thing that changed is the med. Hello?
>
> I don't know what other meds you have been on, your history, or your symptoms. But from those things you can gather some clues as to what to choose as your next med trial.Bleauberry,
Thanks for your feedback.
That's kind of what I was thinking. Eight weeks is a long time to be in this much pain.
My doc also increased abilify from 5mg to 10mg which I think is making me nervous.
Posted by SLS on January 4, 2009, at 18:42:23
In reply to Re: is 4 weeks a long enough trial for Pristiq??, posted by Roslynn on January 4, 2009, at 17:27:12
Hi.
Bleauberry's sentiments are backed up by studies and statistics. If one does not begin to respond to a treatment by the end of four weeks at therapeutic dosages, the probability of responding to it at all drops off very quickly. Some people do respond later than this, of course. It is a bit of a gamble to abort a trial before the end of 6 weeks. However, I don't believe there are many people who feel substantially worse over the course of 4 weeks who later go on to find success with that particular treatment.
> My doc also increased abilify from 5mg to 10mg which I think is making me nervous.
Based upon my own experiences with Abilify, I would encourage you to stick with it for a little while longer. The nervousness might disappear, leaving you with an antidepressant effect that should make other drugs work more completely.
- Scott
Posted by Roslynn on January 5, 2009, at 18:27:16
In reply to Re: is 4 weeks a long enough trial for Pristiq??, posted by SLS on January 4, 2009, at 18:42:23
> Hi.
>
> Bleauberry's sentiments are backed up by studies and statistics. If one does not begin to respond to a treatment by the end of four weeks at therapeutic dosages, the probability of responding to it at all drops off very quickly. Some people do respond later than this, of course. It is a bit of a gamble to abort a trial before the end of 6 weeks. However, I don't believe there are many people who feel substantially worse over the course of 4 weeks who later go on to find success with that particular treatment.
>
> > My doc also increased abilify from 5mg to 10mg which I think is making me nervous.
>
> Based upon my own experiences with Abilify, I would encourage you to stick with it for a little while longer. The nervousness might disappear, leaving you with an antidepressant effect that should make other drugs work more completely.
>
>
> - ScottHi Scott,
Thank you for your advice--I really appreciate it. I've got to change my AD from Pristiq to (??? ), but maybe I will stay with the 10mg Abilify as you suggested. Thanks...and I hope you are doing OK.
Roslynn
Posted by B2chica on January 6, 2009, at 12:09:35
In reply to Re: is 4 weeks a long enough trial for Pristiq??, posted by Roslynn on January 5, 2009, at 18:27:16
ok, i think i've posted to all the previous threads too but i want to make sure that you see my response.
it DID take a LONG time for pristiq to really kick in for me. i say 8 weeks but i actually think it was more like 10.
however the only reason i stuck with it is because my options are very limited. and i REALLY wanted it to work.
i personally am glad i hung with it.HOWEVER you need to judge your level of depression with it. it is not worth it if you are in severe pain of depression to wait and wait for a drug that just may not work. also i was able to augment with zyprexa enough to keep me out of the hospital.
so if you feel you can wait, know that it IS reported by most people that it takes around 8 weeks to really level out.
best wishes.
b2c.
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