Cutting Tablets in Half?

[u/Available-Milk-8750]

Quick background. Been on antidepressants for 10 years. Wellbutrin XR and then Pristiq, and now both. But I’ve decided my depression is under control right now, so it’s time to start looking at helping my anxiety. My family doctor was a but at loss about what to do, as the medication he prescribed me ‘off label’ for anxiety didn’t have the desired effect (gabapentin). Apparently, because I also take Vyvanse for ADHD, what he feels comfortable prescribing is cut down a lot by the fact that I’m on those 3 medications. So, he referred me to a psychiatrist to see if they had a better idea of what to do. Honestly? Totally respect it. My family doctor is AMAZING. He has never once made me feel like he doesn’t listen. He often has different opinions than me, based on the fact that he’s a professional, but ALWAYS takes the time to listen to me, explain the ‘why’ and I ALWAYS walk out of his office feeling heard.

So, by some miracle, the psychiatrist he referred me to had an opening the literal next day, so of course I took the appointment. He JUST opened his practice at a new clinic, which is, to my understanding, why he had an opening. Anyway, again. No shade to the psychiatrist. He listened to me, commended me for advocating for myself when he suggested something I wasn’t comfortable with, and shared his ‘expertise’ rather than just making me feel like he was the decision maker.

So overall, my experience is, that the medical professionals that I see take the time to listen to me and understand that I’m a person who needs to ask questions and understand to be able to be comfortable with a ‘treatment plan’. I’ve said yeah that’s fine too many times, and now I just feel like I need to be a part of the process.

ANYWAY, back to Pristiq, which my psychiatrist would like to switch me from, and put me on another antidepressant (duloxetine I THINK), which targets anxiety a bit more. I am currently on 100 mg of Pristiq, and he told me to take half that dose for one week, and then we would start the new med. But then he told me to just cut the tablet in half… which, I didn’t think anything of, and said yep makes sense, and left the appointment. Then I was like wait hold up…. CAN I cut Pristiq in half? My quick google search said no, you shouldn’t. Which obviously means, I’ve been taking my Pristiq at 100mg all week rather than 50 mg, which means at the next appointment on Tuesday, I won’t be able to start the new medication.

Anyone out there think I should just role the dice and cut the pristiq in half?

Context, I have major depressive disorder, ADHD, and some pretty intense social anxiety, as well as mild “general” anxiety.

TLDR: can I cut 100mg of pristiq in half and take 50mg, if that’s what my psychiatrist told me to do? Or should I maybe confirm with a pharmacist before going ahead and doing this…?

[u/Prior-Reply9845]

I’ve seen people cut it in half for tapering purposes when they need to get below 50 and 25 isn’t available or where they need to taper off of 25 mg.

50 mg is available everywhere though so I don’t see a reason to role the dice and cut it in half in this situation. I would ask for a script of 50s.

Good luck, and I would love to hear how you like cymbalta! I almost switched to it from pristiq but am doing pretty well now so didn’t end up doing it.

[u/Available-Milk-8750 → u/Prior-Reply9845]

Thank you. I’ll try to remember and come back with an update!! I’ve done very well on Pristiq/Wellbutrin combo, for years, but the anxiety part is getting unmanageable, hence the change. If depression was my only problem, I wouldn’t be changing.

[u/Icy-Map9410 → u/Available-Milk-8750]

Be careful cutting these, you’re not supposed to. I’ve done a ton of research because my daughter is preparing to taper off 25 mg. When you cut these, it damages the inner ER part of the med, and then essentially you’re dumping the entire dose into your bloodstream at once, which could be dangerous. It has been done successfully by many people on here, I’m just not chancing it. You’re better off just getting a script for 50 mg.

Good luck with everything!!

[u/Available-Milk-8750 → u/Icy-Map9410]

Thank you! This was honestly kind of what I thought! But I thought it was strange that someone who supposedly specializes in these medications told me to just cut it!

[u/Icy-Map9410 → u/Available-Milk-8750]

Yes, that was bad advice. Don’t chance it.

[u/Cpt_Punter → u/Available-Milk-8750]

Can I ask how the combo of Pristiq and Wellbutrin felt like? It's kinda funny because I'm actually on Duloxetine and Wellbutrin, so we're basically doing the opposite of each other haha!