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Ralph LMHC
Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience:  20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
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My psychiatrist has switched me from 120 Cymbalto to 50 Pristig

Customer Question

My psychiatrist has switched me from 120 Cymbalto to 50 Pristig and my PCP is also swtiching me from Estratest to Premarin. I am concerned that there may be side effects that could me masked by switching these 2 at the same time.
Submitted: 4 years ago.
Category: Mental Health
Expert:  Ralph LMHC replied 4 years ago.

Hello,

 

It sounds like the anti depressants have been chanded. Can you ask your PCP to wait 2-3 weeks before the hormones are chaned or is it imperative to chane the hormones immediately?

 

Ralph LMHC

Customer: replied 4 years ago.
THAT WAS MY FIRST THOUGHT BUT IT SEEMS FROM WHAT I UNDERSTAND, ESTRATEST IS NO LONGER MANUFACTURED OR MY INSURANCE COMPANY NO LONGER COVERS IT.
Expert:  Ralph LMHC replied 4 years ago.
OK That takes care of the simple answer. I am not sure what you are concerned with when you say masked?
Customer: replied 4 years ago.

I am pretty sure the Estratest effects my "mental state" in some way, so if the Dr is changing my anti-depressant anti anxiety meds, is there any way of knowing exactly what type of side effects might occur and how they will manifest themselves so I will know if it is the Premarin or Pristig or even possibly the dosage. I also take xanax, .25 up to 3 times a day and Ambien to sleep.

Expert:  Ralph LMHC replied 4 years ago.

Are you having any problems with libido now with just the Prestig?

 

Ralph LMHC

Customer: replied 4 years ago.

That is a hard question to answer. I was just divorced.....but had been celebate for 5 years. I am now seeing someone but does not live in my town, so don't see him often. I don't feel like i would just go with anyone just to have sex......so, I guess my libido is somewhat okay.

Expert:  Ralph LMHC replied 4 years ago.

Hello the reason I asked was that the mental side effects listed for Premarin are nervousness, mood swings and libido changes. Link for Premarin side effects : www.drugs.com/sfx/premarin-side-effects.html . The mental side effects of Prestiq that co occur with the Premarin side effects are nervousness, depression and libido.

The link for Prestiq side effects is: www.mentalhealthmanual.blogspot.com/.../fda-approves-new-anti-depressant.html . I apologize for the delay but I had computer technical problems. To sum up the co occuring side effects are few and listed above. Good luck and best wishes.

 

 

Sincerely,

Ralph LMHC

 

Please click green "ACCEPT" button on this page if you are satisfied with my answer so that I get credit for my work. Your positive feedback and bonuses are always welcomed. If this is a mental health, or medical emergency, please call emergency services (911 in the USA), or go to your nearest Emergency Room. The opinion provided does not replace an evaluation by an appropriate professional.

 

Customer: replied 4 years ago.
ok, i've tried to read through this information but I can't determine how the information applies to me. They all have side effects, but I don't know how one effects the other and no one can seem to tell me, including you or my doctors. I guess I am on my own...trial and error. I am on a search to feel better and I would really hate for these meds to conflict and I end up feeling worse. I also take synthroid, exforge, byetta, glyberide, ultram, calcitriol, folic acid, b-6, b-12, prilosec, and as needed esgic, tylenol and ultracette for pain.
Expert:  Ralph LMHC replied 4 years ago.

Hello I guess I did not understand your question. I thought the information you sought was if you could have a side effect from one of the medications like Prestiq that could be masked by the side effects from Premarin or vice versa. Do you wish to know if the medications that you just indicated have negative interactions with each or in other words are contraindicated?

 

Sincerely,

Ralph LMHC

Customer: replied 4 years ago.

Well my main concern is about the 2 new drugs and how I will know if they are helping. I always have concerns with drug interactions because I have to take so many, but for my mental health the premarin and pristig are brand new for me and I have read what I could but I am not getting the information I am seeking, from the information I read or from you. Why is Premarin better or worse or different from Estratest...what effects should I feel. If I know what is suppose to happen and how long it should take my body to adjust to the new meds and that is not how I feel I know to ask the Dr. I have had vertigo on and off for the last 3 days only since I started taking the Pristig. I haven't seen that written as a side effect and I haven't even started the Premarin yet. Do you know if the Pristig 50 mb is equivalent to the 120 mb Cymbalta?

Expert:  Ralph LMHC replied 4 years ago.

Hello

I am sorry but what you are asking are medical questions, not mental health questions, except for the question about the Cymbalta and the Prestiq which as a non physician I do not feel competent to answer. Therefore I will opt out and refer your question to medical where a physician may be able to provide you with the information that you require. I am also going to send you a link which checks on drug interactions:

www.drugs.com/drug_interactions.html-

 

I hope that this will get you the information that you are requesting. Best wishes.

Sincerely,

Ralph LMHC

Customer: replied 4 years ago.

My original request was for a mental health expert and because i am specifically asking for drug affects and interaction I was wondering wjhy a psychologist would answer rather than a psychiatrist.

 

thank you

Expert:  Dr. Kaushik replied 4 years ago.

Hi there ,

 

Welcome to Just answer !

 

Well, since the previous expert has opted out so i will like to help , provided if you are ok with it .

 

I have read your post , and what i can understand from your previous interactions is that you are mainly concerned about the switch over of the two drugs , and whether they will come with any side effects ? is this the question ?

 

Secondly tell me , whether cymbalta 120 mg and estratest have been tapered before stopping or just abruptly stopped and whether you have started on on both pristiq and premarin ?

 

Regards..

Expert:  Ralph LMHC replied 4 years ago.

Please disregard earlier email as it is a glitch and I opted out.

Sincerely,

Ralph LMHC

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