![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by TriedEveryMedication on July 26, 2022, at 12:08:31
Been on Pristiq since Dec. 2021. Started at 25mg for a couple months, went to 50 for quite awhile and now I've been on 100mg for 2.5 weeks.
I feel like I just want to sit around and do nothing. Household chores are going undone. I barely can drag myself to the grocery store, only under threat of starvation.
This lack of motivation seems to get worse the higher the dose I take.
Just wondering if it goes away or should I start tapering and go off this. My p-doc wants me to try 100mg for 6 weeks just to be certain. Not sure I can make it another week. Not sure what to do.
Posted by linkadge on July 27, 2022, at 17:23:26
In reply to Does lack of motivation from Pristiq ever go away?, posted by TriedEveryMedication on July 26, 2022, at 12:08:31
Hi there,
I don't have an answer for you, but am interested in any responses. Have you taken venlafaxine? Can you compare the motivational side effects between the two?
I am seeing my doctor next week, and am (loosely) contemplating a switch from venlafaxine to desvenlafaxine.
Linkadge
Posted by TriedEveryMedication on July 27, 2022, at 19:47:38
In reply to Re: Does lack of motivation from Pristiq ever go away?, posted by linkadge on July 27, 2022, at 17:23:26
> Hi there,
>
> I don't have an answer for you, but am interested in any responses. Have you taken venlafaxine? Can you compare the motivational side effects between the two?
>
> I am seeing my doctor next week, and am (loosely) contemplating a switch from venlafaxine to desvenlafaxine.
>
> LinkadgeHi Linkadge, I've been on venlafaxine, mostly around 75mg. Similar lack of motivation issue with it. The longest I've been on it was maybe 5 months.
Posted by NKP on July 28, 2022, at 4:34:39
In reply to Does lack of motivation from Pristiq ever go away?, posted by TriedEveryMedication on July 26, 2022, at 12:08:31
When I told my psychiatrist that venlafaxine may actually be contributing to my lack of motivation, his response was "no, that's the depression". It is very frustrating that some doctors don't seem to be aware of this side-effect of SRIs.
Posted by linkadge on July 28, 2022, at 7:48:42
In reply to Re: Does lack of motivation from Pristiq ever go away?, posted by NKP on July 28, 2022, at 4:34:39
Yeah, meds that increase serotonin can indirectly reduce other brain chemicals associated with motivation.
If the lack of motivation was accompanied by other symptoms of depression, then yes the depression could be the culprit.
In the very least, venlafaxine isn't addressing the neurobiology associated with your lack of motivation.
At most, venlafaxine improved my sleep and anxiety (and perhaps sadness). I have had to use other medications to address motivation.
Linkadge
Posted by SLS on July 28, 2022, at 16:08:12
In reply to Re: Does lack of motivation from Pristiq ever go away?, posted by linkadge on July 27, 2022, at 17:23:26
> Hi there,
>
> I don't have an answer for you, but am interested in any responses. Have you taken venlafaxine? Can you compare the motivational side effects between the two?
>
> I am seeing my doctor next week, and am (loosely) contemplating a switch from venlafaxine to desvenlafaxine.
>
> Linkadge
What is the rationale for making the switch?My guess is that Pristiq might be smoother than Effexor. Venlafaxine has been more helpful to me than desvenlafaxine. Coming off of Effexor was the decision made when we moved on to Nardil.
A friend of mine takes a combination of Wellbutrin + Pristiq. She described the Wellbutrin as helping with mental energy, and the Pristiq as giving her the "wannadoos". She had not taken Effexor previously, so I can't report a comparison with her. However, she has been in 100% remission for 13 years. She was somewhere between being dysphoric to moderately depressed. Parnate had been the only drug she responded to, although moderately at best.
It is possible that your intolerance to therapeutic dosages of venlafaxine is produced by the parent compound, and not the metabolite. They do feel different to me. Effexor gave me a kind of uncomfortable mental energy that Pristiq did not. I don't think I took more than 100 mg/day of Pristiq whereas I need 300 mg/day of Effexor to produce an improvement. 225 mg/day is insufficient.
Effexor = venlafaxine + desvenlafaxine (an active metabolite)
Pristiq = desvenlafaxineWhat is your best guess as to what Effexor does that Pristiq does not.
- Scott
Posted by SLS on July 28, 2022, at 16:19:09
In reply to Re: Does lack of motivation from Pristiq ever go away? » linkadge, posted by TriedEveryMedication on July 27, 2022, at 19:47:38
> > Hi there,
> >
> > I don't have an answer for you, but am interested in any responses. Have you taken venlafaxine? Can you compare the motivational side effects between the two?
> >
> > I am seeing my doctor next week, and am (loosely) contemplating a switch from venlafaxine to desvenlafaxine.
> >
> > Linkadge
>
> Hi Linkadge, I've been on venlafaxine, mostly around 75mg. Similar lack of motivation issue with it. The longest I've been on it was maybe 5 months.Had you ever thought that perhaps higher dosages of venlafaxine - up to 300 mg/day - would break through some dosage threshold beyond which the amotivation, brain-fog, and blunted affect disappear? You might then be left with a clean robust improvement. I doubt any such threshold would exist for you at a dosage lower than 150 mg/day.
Just a thought...
- Scott
Posted by linkadge on July 29, 2022, at 8:58:02
In reply to Re: Does lack of motivation from Pristiq ever go away? » TriedEveryMedication, posted by SLS on July 28, 2022, at 16:19:09
I got really bad hypertension and tachycardia on just 75mg of effexor. I can't really tolerate more than 37.5mg.
Desvenlafaxine is purportedly slightly more noradrenergic (yet, purportedly has a lower incidence of hypertension).
I just checked. Both are generic in Canada, but venlafaxine is still way cheaper, so I guess I'm sticking with that.
Linkadge
Posted by TriedEveryMedication on July 29, 2022, at 21:43:04
In reply to Re: Does lack of motivation from Pristiq ever go away? » TriedEveryMedication, posted by SLS on July 28, 2022, at 16:19:09
> Had you ever thought that perhaps higher dosages of venlafaxine - up to 300 mg/day - would break through some dosage threshold beyond which the amotivation, brain-fog, and blunted affect disappear? You might then be left with a clean robust improvement. I doubt any such threshold would exist for you at a dosage lower than 150 mg/day.
>
> Just a thought...
>
>
> - ScottHi Scott, I never got above 150mg on venlafaxine when I tried it in the past. Felt it made me overly nervous plus other side effects. I guess it is something I can try in the future if the desvenla doesn't work out. I think I will give it the full 6 weeks at 100mg. I also been taking 7.5mg adderall PRN to perk up now and then... not sure that's worth it though.
Regards
Posted by beckett2 on August 6, 2022, at 18:12:20
In reply to Does lack of motivation from Pristiq ever go away?, posted by TriedEveryMedication on July 26, 2022, at 12:08:31
> Been on Pristiq since Dec. 2021. Started at 25mg for a couple months, went to 50 for quite awhile and now I've been on 100mg for 2.5 weeks.
>
> I feel like I just want to sit around and do nothing. Household chores are going undone. I barely can drag myself to the grocery store, only under threat of starvation.
>
> This lack of motivation seems to get worse the higher the dose I take.
>
> Just wondering if it goes away or should I start tapering and go off this. My p-doc wants me to try 100mg for 6 weeks just to be certain. Not sure I can make it another week. Not sure what to do.No, in my experience I felt better when I discontinued. Have you tried wellbutrin? That was the only med (and emsam) that didn't create apathy and loss of sensation.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.