Switching from SSRI to SNRI

Posted by sandiegan1972 @sandiegan1972, Oct 3, 2019

On Lexapro (10/15mg) - 2006 to 2010 for Anxiety, took moderate Benzos
Celexa (20/30mg) from 201o to 2018 for Anxiety, took moderate Benzos
Major relationship life event in December 2018.
Continued with Celexa (30mg) and Klonopin (2-3mg) or Xanax (2 mg/day)
Switched to Lexapro in March (upto 12.5mg) and Klonopin (2-3mg) or Xanax (2 mg/day)
Switched to Zoloft in August (it was terrible, I think due to fast increase)
Back on Lexapro and Xanax. Cannot tolerate Lexapro beyong 10mg - not sure why. Taking small 12.5mg dose of Seroquel (Quetiapine ) for sleep
Changed pdoc. Diagnosed with GAD and MDD
Doc wants to try SNRI (either Cymbalta or Pristiq)
Any experiences with those meds? (I have heard SNRI increase anxiety, but pdoc assured wont be the case for me). Should I go very slow?

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Hi, @sandiegan1972 - Welcome to Mayo Clinic Connect. It sounds like you've been through a journey trying to find the right medication for anxiety.

As you look with your doctor at switching from an SSRI to an SNRI, I'd like to tag some Connect members who may have some experiences with these medications who may have some input for you, like @doorman @pankaj @babydoll @sandij @secretwhitepop @jakedduck1.

sandiegan1972 - were you wondering about going slowly with tapering off the SSRI or going on an SNRI instead, or both?

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@sandiegan1972
Do you know what’s causing your stress? What are you worried about?
Have you always had these problems?
Why so many different meds?
6 meds, didn’t they work? Why the Cymbalta & Pristiq. Seroquel is for schizophrenia and bipolar disorder. It’s not an approved drug to be used as a sleeping aid.
Jake

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@jakedduck1

@sandiegan1972
Do you know what’s causing your stress? What are you worried about?
Have you always had these problems?
Why so many different meds?
6 meds, didn’t they work? Why the Cymbalta & Pristiq. Seroquel is for schizophrenia and bipolar disorder. It’s not an approved drug to be used as a sleeping aid.
Jake

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@jakedduck1 Hi Leonard, yes, Seroquel IS used as a sleeping aid. In fact, I was on it years ago through my psychopharmacologist and now I’m on it through my primary care doctor. I’m behind, so I’m just now reading this post. Please don’t tell people that and scare them about what they are taking. It works wonders for me and I’m a chronic insomniac due to fibro & RA.

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@karen00
Seroquel is not recommended for sleep and the evidence so far suggests the risks of prescribing Seroquel off-label outweigh any benefits.
I know a man who takes it and now has Seroquel induced Diabetes although his dose is substantially higher.
I have Insomnia as well but would never consider taking an Antipsychotic or any other medication because one of its side effects cause drowsiness.
Jake

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Hi Karen00, phew! You have been through a lot! Have you asked your Dr. to run the genetic test for psych meds? I know Mayo offers it and other places like Genesite and Gene folio. Perhaps that can help guide the med choices that will work better for you! Worth a shot, especially after trying and switching so much. I wish you health and healing. Let us know if you have tried the test!

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@jakedduck1

@karen00
Seroquel is not recommended for sleep and the evidence so far suggests the risks of prescribing Seroquel off-label outweigh any benefits.
I know a man who takes it and now has Seroquel induced Diabetes although his dose is substantially higher.
I have Insomnia as well but would never consider taking an Antipsychotic or any other medication because one of its side effects cause drowsiness.
Jake

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@jakedduck1 Hey Leonard! Thanks for giving that info. Now, you’re the one who HATES cooking, right?

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@karen00

@jakedduck1 Hey Leonard! Thanks for giving that info. Now, you’re the one who HATES cooking, right?

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@karen00
You bet! I’d rather be hung upside down by my feet and lowered into boiling oil after I’ve been locked in a dungeon and been put on every torture device known. I’ve had two kitchen fires but I put them out back when I didn’t mind cooking. Today I’d let it burn to the ground!!
Jake

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@jakedduck1

@karen00
You bet! I’d rather be hung upside down by my feet and lowered into boiling oil after I’ve been locked in a dungeon and been put on every torture device known. I’ve had two kitchen fires but I put them out back when I didn’t mind cooking. Today I’d let it burn to the ground!!
Jake

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@jakedduck1 Hey!!! But you are trying, right? I think I remember some attempts??? When did you develop this hatred? I hate it, too! But I used to LOVE to cook. My husband at the time kept telling me that I “didn’t need it”. So without encouragement I quit! Now I know better than to let someone else’s opinion influence me. However, I still can’t get that love back. Luckily I live with my brother, who likes it, so I’m set! Anyway, I do enjoy your sense of humor! Keep it coming!........Karen

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Wow ! Honestly I feel for you. I don’t have any advice to give as I have not walked down your path so much. We can send someone to the moon, invent technology to the point that we barely have to move anymore but science cannot come up with something other then pills to calm the mind. Hopefully there is someone in this crazy world who one day soon will come to your (our) rescue . I’m sure you don’t want to hear again and again “be strong” hang in there which proves you are by reaching out.

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