How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Elliott, LPCC, NCC Your Own Question

Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
40019946
Type Your Mental Health Question Here...
Elliott, LPCC, NCC is online now
A new question is answered every 9 seconds

My psychiatrist has just prescribed 50 mg of Pristiq for me.

Customer Question

My psychiatrist has just prescribed 50 mg of Pristiq for me. I am also now on 40 mg of escitalopram. he wants me to take both together for a while. I am nervous about this amount of anti-depressant. I mentioned it to him and he said not to worry. I just want a second opinion. I also take 150mg of trazadone for sleep at night. What is your opinion?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

Psychiatrists are free to give you whatever psychotropic medications that they want to.

Elliott, LPCC, NCC :

Sometimes they mix medications that have known contraindications, feeling that they may help the individual client.

Elliott, LPCC, NCC :

He is giving you three medications that are considered to be at high risk when taken together. They may help you, but if I were in your position I would think carefully about taking them.

Elliott, LPCC, NCC :

Here is what the very reputable www.drugs.com says about these three medications combined:

Elliott, LPCC, NCC :

Interactions between your selected drugs



trazodone ↔ escitalopram


Applies to: XXXXX XXXXX



Talk to your doctor before using escitalopram together with traZODone. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision

Full Size Image
, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. In addition, you may have an increased risk of developing an irregular heart rhythm that may be serious. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



trazodone ↔ desvenlafaxine


Applies to: XXXXX XXXXX (desvenlafaxine)



Talk to your doctor before using traZODone together with desvenlafaxine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp

Full Size Image
, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



escitalopram ↔ desvenlafaxine


Applies to: XXXXX XXXXX (desvenlafaxine)



Talk to your doctor before using escitalopram together with desvenlafaxine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea

Full Size Image
. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Elliott, LPCC, NCC :

You can read this from the source that I have prepared at:

Elliott, LPCC, NCC :


http://www.drugs.com/interactions-check.php?drug_list=1013-0,2228-0,2796-12488

Elliott, LPCC, NCC :


I would, at the very least, get a second opinion from another psychiatrist who has seen you face-to-face.

Customer:

But, I did ask him about that and he said he, after 40 years in practice, has never seen a case of serotonin syndrome.

Elliott, LPCC, NCC :

So you are willing to take a chance then?

Customer:

I am not sure. I think I want to talk to him more before I start the Pristiq.

Customer:

I have a long relationship with this Doctor.

Customer:

Do you think it's wise to hold off?

Elliott, LPCC, NCC :

If he monitors you very closely then you will probably be safe. He does have experience but this combination of all THREE flies in the face of conventional wisdom about safety.

Elliott, LPCC, NCC :

Trusting him means a lot, and if he will watch you closely and warn you of all possible symptoms to be aware of then you might want to follow his directions - but with great care.

Customer:

Well, when the Pristiq was filled by the Pharmacy, the computer did not put up any red flags. The Pharmacist said it would if it detected a problem.

Elliott, LPCC, NCC :

If you have treatment resistant depression you might consider the non-invasive and very effective Transcranial Magnetic Stimulation (TMS).

Customer:

What would you think I would look for if there was an issue?

Elliott, LPCC, NCC :

You would look for any of the symptoms listed above.

Elliott, LPCC, NCC :

drugs.com has the following pedigree:

Elliott, LPCC, NCC :

drugs.com Data sources include Micromedex™ (updated June 15th, 2013), Cerner Multum™ (updated June 17th, 2013), Wolters Kluwer™ (updated June 6th, 2013) and others.

Customer:

I was on Effexor for many years, and I was fine, then I went off and I fell into GAD and Depression. He tried lexapro first and it has not worked, so he wants to try Pristiq since it's so much like Effexor

Elliott, LPCC, NCC :

Modern psychiatry is very experimental and the patient is tested for effectiveness. Every patient is different and so no outcomes are ever guaranteed.

Customer:

Yes, that is true.

Customer:

I think I'm going to hold off until I talk to him again - I need more reassurance.

Elliott, LPCC, NCC :

If you take the combination (and the other two without the Pristiq are already risky), then you can look for:

Elliott, LPCC, NCC :

confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp


nausea, vomiting, and diarrhea.


 

Customer:

Okay, thank you!

Elliott, LPCC, NCC :

I think you are making a wise decision

Elliott, LPCC, NCC :

I shall keep you in my prayers.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Customer:

Thank you. I will pray for you as well! God bless you!

Customer:

War Regards,

Customer:

Warm Regards, Dan

Elliott, LPCC, NCC :

Thank you. and God bless you too and keep you safe and lift your depression. Amen.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 
Chat Now With A Mental Health Professional
Elliott, LPCC, NCC
Elliott, LPCC, NCC
5114 Satisfied Customers
35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.