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Ask Dr. Kaushik Your Own Question
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4672
Experience:  MD Psychiatry
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My primary care doctor is switching me from pristiq er 100mg

Customer Question

My primary care doctor is switching me from pristiq er 100mg to fetZima because I have been feeling very irritable, moody, extremely tired with no sex drive and more. They advised me to take 50mg of pristiq for 7 days and then switch to the fetZima which is 20mg x2 days and then up to 40mg. Does this sound right. Or should I stay on the pristiq and add something else?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 1 year ago.


Welcome to the site.

I am a psychiatrist and i believe i can help you with your query.

1) Kindly please tell me the list of medications that you have tried other than pristiq er ?

2) What time of the day do you take pristiq er ?

3) What is your core diagnosis ? Is it depression or mixed anxiety depression ?

I shall get back to you with a final answer once you reply to my queries.


Customer: replied 1 year ago.
I have tried Paxil and Zoloft.
I take pristiq er at night.
I was formally diagnosed with generalized anxiety disorder when I was young and seeing a psychiatrist. Since I've been managed by my primary care who feels it's mixed anxiety and depression.
Expert:  Dr. Kaushik replied 1 year ago.

Thanks for the inputs.

Well, in my opinion using fetZima in place of pristiq would not yield you the desired effect or any sort of improvement in your symptoms since this drug basically belongs to the same class of snri anti depressant to which the pristiq belongs to so it is not offering any thing new plus more importantly it is much weaker a drug in comparison with pristiq, so using it instead would be a complete wastage of your precious time and your doctor's energy, not to forget it may compromise the situation even further by not offering something significant in due course of time.

So i believe instead of coming off pristiq , you ask your doctor to keep you on pristiq 100 mg dose but add an augmenting agent like buspirone at dose of 5 mg three times a day as this drug being both an anti depressant as well as an anxiolytic will boost the efficacy of pristiq and bring the extra edge in it which seems to be lacking at the moment.

So kindly discuss this with your doctor , hopefully he may find this logical.

Wish you all the best. I hope this helps.

Please kindly leave a POSITIVE RATING If you are satisfied with the answer.