Switching antidepressants

[madcha]

Hi. I am currently titrating down on zoloft. I have been on it for 7 years mostly at 200 mg. I had gone down to 150 mg for a couple of weeks, but my dr. now wants me to titrate down quicker to be able to switch over to effexor for migraines. So I am beginning to feel some of the discontinuation symptoms...upset stomach, headaches, slight more agitation. Mr. Dr wants me to get to 50 mg on zoloft before I introduce the effexor. Does anyone know if it is possible to do it sooner. Is there a risk of serotonin syndrome? I just do not want to have to go through all of this withdrawal stuff and then have to wait to build up on the effexor. Any thoughts? And any thoughts on how to help with the withdrawal symptoms? Thanks,

[sara12345]

The medication, Migraleve, that Maddie took with her anti-depressant is an abortive pain medication, NOT a daily preventative medication.  The abortive pain pills are far stronger and have all kinds of potential problems.  The daily preventative pills take about 4 weeks to work.

The reason for taking anti-depressants and daily preventative migraine medications is because if you take any pain relievers, even the over the counter ones, more than twice a week, you risk rebound migraines which can be horrible and can last forever.  It doesn't sound like you, Maddie, have them so often.

To not take the pain killers more than 2 times a week, was a fact that my last main doctor neglected to tell me.  With no limit on the number of refills on my pain pill prescription and no mention of it, I had severe migraines constantly all summer long before I had a stroke the following September.  I fired him for a something else as well and sent him a nasty letter about it.  It's important to have the true facts about the medications that you are taking.

[4Maddie44]

If I were you I would find out all you can about Effexor as preventative for migraines before I take it.  If you look back at old posts, you mind fin d some help there.  I know one person said they didn't get migraines until they took Effexor.  I don't want to scare you, but you must find out if it really is the drug for you.  I say that, because Effexor is a difficult drug to withdraw from.

I know sara  has bad migraines, and she knows all about them.

I am scared to mix migraine drugs with my anti-depressant as I once had a very bad reaction.  I was in a psychiatric hospital at the time, and asked staff if it was OK to take Migraleve with the anti-depressant I was taking at the time (forget which one it was) and I had a fit.

Now when I get a migraine I take an ordinary over the counter pain killer and lie down.  I always know when I am getting a migraine because I have jagged flashing lights in front of my eyes, and cannot see.

When I was working, and bringing up young children it was difficult to cope with migraines, b ut now I am retired, I can just lie down until it passes.  I also have positional vertigo, so have to be careful how I move my head.  Just putting it down can bring on a migraine.

Do hope other people here can advise on what to do.

[sara12345]

I think that the doctors often don't consider the time needed to taper off a medication and rush it too fast.  I wouldn't go so fast that you are very sick.  

Yes, Effexor can help as a pain killer, but I was under the impression that all anti-depressants were pain relievers.  I could be wrong on that, but hate to have you change your anti-depressant if one has helped you so well.  

So do daily preventative migraine medications help as pain relievers for migraines, e.g. Topamax.  I'm on both a daily preventative migraine med and a newer brand of Effexor called Pristiq, but it's relatively the same.  (The Pristiq costs a lot more because it's not out in generic like the Effexor is.)  So I would slow down with your tapering off and ask your doctor about the daily preventative migraine meds as well.

What kind of doctor is making the changes in your medication?

Good luck.

[madcha]

Thanks for your response....yes, listening to my dr. is the best advice. I just like to be well educated, so I can talk to him about trying certain things, esp if there is any chance of making this transition any easier. thanks again for your help!!!

[madcha]

What dosage were you at on the zoloft when you switched and what did you start at on the effexor? yes, effexor is SUPPOSED to help with migraines. I have migraines associated vertigo(the dizzy part of migraines). Dr. Tim Hain has a flow chart of meds used for it http://www.dizziness-and-balance.com/disorders/central/migraine/mav.html. Clearly, every person responds differently and not every med is going to work..I am hoping that the effexor can take care of both..I may be way too optimistic. Do you take anything for migraines? Thanks for your response.

[4Maddie44]

Hello, I went straight  from Zoloft to Effexor, but had no withdrawal symptoms from the Zoloft.  I have been taking 150mg daily of Effexor for 3 years now.

I have had migraines most of my life, and still get them, even though I am on Effexor.  I didn't know it could be prescribed for migraines.

Your body will still have to get used to the Effexor.  it can take those 2-3 weeks again to build up in your body.

[witheredrose]

Even tapering off of a med can still leave you with slight symptoms of withdrawel just not as bad as it would if you were to suddenly stop. , so i think regardless your going to have them. I would listen to your doctor's suggestion, as hes the doc and were not! If something happened because you listend to someone elses advice here, and not your actual doctor, we would feel terribly horrible:(! I would ask the doctor if you can if you really want to do it that way to be on the safe side! Everybodies body is different!
Good luck and take care!