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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4046
Experience:  MD Psychiatry
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Im currently on Lexapro (30 mg). My doctor switched me to

Customer Question

I'm currently on Lexapro (30 mg). My doctor switched me to Pristig (50 mg). He says to just go from one to the other without any weaning. Is this fine? Or should I alternate the Lexapro with the Pristig for a few days like some websites mention? Thanks.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 2 years ago.

Dr. Kaushik :

Hi there,

Dr. Kaushik :

Welcome to Just answer !

Dr. Kaushik :

Well, i will agree with you here that you should not directly switch over from lexapro to pristiq as these are two different class of drugs , so direct switching is not recommendable as this way you may develop ssri withdrawal side effects which are quite distressing..

Dr. Kaushik :

So, i reckon the best safer way to switch over to pristiq is to first taper down the dose of lexapro by reducing the dose by 5 mg every 5 days till you reach 10 mg dose and then from there reduce the dose to 5 mg after 1 week and then stop the drug completely..

Dr. Kaushik :

Only after stopping lexapro completely , shall you start on pristiq at 50 mg dose..

Customer:

I see

Dr. Kaushik :

You see my opinion may be exactly opposite of what your doctor is saying but i say so because i know for a fact that the withdrawal side effects of lexapro when it is abruptly stopped are really distressing for the patient , so it is my honest advise to discuss this strategy with your doctor to carry out the switch over and anyways if 2-3 weeks wait helps you to have a safe switch over .

Dr. Kaushik :

i hope you see reason in this..

Customer:

I heard withdrawal from lexapro is very bad

Customer:

what are the side effect of w/d?'

Customer:

anxiety?

Dr. Kaushik :

anxiety, electric shock sensations in the brain called as brain zaps, insomnia,

Dr. Kaushik :

nausea, dizziness,

Customer:

when you say reduce by 5mg, just take off 1/6 of each pill per day?

Dr. Kaushik :

stomach upset

Dr. Kaushik :

how are you taking 30 mg dose right now? is it a single tab

Customer:

I shouldn't start Pristig at all while I'm weaning off of Lexapro? Yes, one tab

Dr. Kaushik :

yes..

Dr. Kaushik :

you got it right.

Customer:

Lexapro was great the first 3 months

Customer:

and then it stopped working and i got anxiety again

Customer:

is that typical of these meds?

Dr. Kaushik :

together if taken they may increase the risk of causing a life threatening emergency called as serotonin syndrome..

Customer:

i see

Dr. Kaushik :

so avoid taking them together..

Customer:

ok

Dr. Kaushik :

yes ..

Customer:

they are both not SSRIs?

Customer:

the reviews of pristig are pretty good, but i'm guessing it's a new drug

Dr. Kaushik :

it is typical of these meds to develop resistance / increased tolerance which reduces their efficacy..

Customer:

that's not good,

Dr. Kaushik :

lexaprp is ssri

Customer:

this means that we all have to switch all the time

Dr. Kaushik :

while pristiq is snri

Dr. Kaushik :

not necessary ,

Customer:

it's just finding the right match?

Dr. Kaushik :

sometimes a drug remains effective for long enough duration to see you through the symptoms..

Dr. Kaushik :

yes ..

Dr. Kaushik :

exactly ..

Customer:

i'm afraid as i am weaning my anxiety will increase

Dr. Kaushik :

because different body types react differently to different drugs..

Customer:

can i do something about that?

Dr. Kaushik :

yes..

Customer:

weaning from lexapro, that is...i need to stay focused in my job

Customer:

i'm afraid i will be too anxious if i'm in transition

Dr. Kaushik :

ask your doctor to put you on klonopin 0.25 mg in the morning and 0.25 mg in the evening for 2-3 weeks so as to keep your anxiety away while this switch over is complete..

Dr. Kaushik :

this drug will buy you time for the swtch over ..

Customer:

should i be concerned that my internist thinks these are the same class of drugs?

Customer:

i see

Customer:

thanks for the suggestion

Customer:

i would imagine that this is typical of an internist

Dr. Kaushik :

yes tell him that these are different class drugs..

Customer:

they don't specialize

Dr. Kaushik :

as i have mentioned above..

Customer:

this has been helpful. do i get this chat emailed to me?

Customer:

or should i copy and paste?

Dr. Kaushik :

well this chat will be saved in your account here at Just answer which you can also copy and paste or print directly..

Customer:

thank you very much, doctor

Customer:

very helpful indeed.

Dr. Kaushik :

Wish you all the best..

Dr. Kaushik :

Do discuss this with your doctor and have a safe switch over..

Dr. Kaushik :

Take care..

Customer:

take care and thank you

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4046
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
What if I make the sudden shift from Lexapro to Pristig. Will it be dangerous or just uncomfortable?
Expert:  Dr. Kaushik replied 2 years ago.

If the withdrawal side effects develop ( which is likely if the switch over is direct without tapering but not necessary to happen as some people may escape these withdrawal side effects despite such a switch over ) then these will not be dangerous but yes distressing and uncomfortable and they weill be self limiting and will subside within 2-4 weeks , so if you are prepared to endure these side effects then you shall go ahead with it.

 

Regards..

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