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  • Jan. 27, 2009

    Pristiq: New antidepressant medication approved

    By David Mrazek, M.D.

340 comments posted

Need more help?
  • National Suicide Prevention Lifeline
    1-800-273-TALK (8255)
  • Go to the nearest hospital or emergency room
  • Call your physician, health provider or clergy
  • National Alliance on Mental Illness
    www.nami.org
    1-800-950-NAMI (6264)

As I talked about last week, it takes quite a while for a new medication to be approved by the Food and Drug Administration (FDA). Additionally, medications can be granted additional indications (diseases the medication is approved to treat) over time. For instance, Rogaine was first developed for treating high blood pressure. The side effect of hair growth led to the additional indication of treatment for hair loss.

Pristiq (desvenlafaxine) was approved by the FDA in February of 2008 for the treatment of major depressive disorder in adults. Pristiq is not available in generic at this time and will not be for some time.

Pristiq works by preventing the reuptake of the serotonin and norepinephrine in the brain. We know that certain neurotransmitters such as norepinephrine, serotonin and dopamine are not in proper balance when a person is depressed. We don't routinely check neurotransmitter levels because we don't completely know what the levels mean. Someday checking these levels may be part of a depression screening.

Like many antidepressants, Pristiq can have side effects, which may include:

  • Nausea
  • Dizziness
  • Trouble sleeping
  • Hyperhidrosis (increased sweating)
  • Constipation
  • Fatigue
  • Decreased appetite
  • Anxiety
  • Sexual dysfunction in men

If you've been diagnosed with depression, Pristiq might be a good option if other medications haven't worked well. And, if you've taken Pristiq, please share your experiences.

340 comments posted

blog index
  • February 10, 2012 12:53 a.m.

    hi I had a ssri 10 years ago and started having a convulsions like tremor that started form feet and worked its way up body , stopped them and with in 3 days symptoms stopped , just tired from all the spasms. Went to a psychiatrist to see about decreasing my valproate and he said no you need to go back on antidepressant as well , com nurse and gp were Prendergast I had weaned myself of deptran ,within 3 days had violent convulsions/.muscle tremors stopped pristiq after taking for 7 days but it took two and a half weeks for tremors to stop. Still feeling tired at times. But back on track

    - anna

  • January 23, 2012 7:56 p.m.

    I have been taking Pristiq for almost a year and have gained 20 lbs. Same thing happened while taking Paxil a few years ago. I know it sounds vain, but I can't stand being over weight and am considering getting off meds in order to loose weight and size. In the last year, I've gone from size 10 to size 14. My optimal size is 8. For the longest time, I couldn't see the retention that I saw immediately with Paxil. Suddenly, I am a whale. I know I should be more concerned with my mental health than my physical appearance but I do have to look into the mirror daily. I don't look like myself anymore. I am risking a depressive relapse, over time, if I go off the meds but . . .

    - Rachelle

  • January 16, 2012 12:58 p.m.

    Have been on Pristiq for about 8 weeks and am going to go off it before I kill myself. I've never been so hopeless in my entire life. All I do is cry and sleep and eat. I feel disgusting and worthless. In the first few weeks, I thought I had found my miracle drug, but the last 6 weeks have been hellish. It's back to Prozac for me until I can find a pyschiatrist I trust. The fatigue is terrible. It's so bad I almost give up.

    - Tasue

  • January 3, 2012 1:02 p.m.

    I am so sorry to read the comments indicating problems with Pristiq inasmuch as I have thrived on it and, in fact, after trying other "similar" drugs at the request of my insurance company, found it was the only one I could take that did not produce side effects - I have experienced none. The other drugs caused me to want to sleep all the time. I am 70 years old and normally very energetic. I tell people that I was ADHA before it was diagnosed as a disease ;). A few years ago, however, I lost my energy, motivation, interest in things I have always loved, etc., and pretty much became lethargic and sad for no obvious reason. I thrived after a radical mastectomy and sub-Q in 1971 for BCA, several breast implant surgeries the result of reconstruction, Rhumatoid Arthritis and its treatment, hysterectomy, gallbladder removal and a few other more minor surgeries. I point out these set backs to emphasize that sometimes depression is not always caused by external circumstances. I know that, for me, it was the worst thing that had ever happened to me and there was nothing to blame except possibly the fact that I was aging and my brain chemistry was suffering. My doctor joked that he was going to prescribe his "motivator." And it was. It only took a few days for me to begin to feel relief, and I have felt normal ever since with zero side effects.

    - Sue

  • December 29, 2011 10:18 p.m.

    Presiq put my son in a manic state.

    - Arlene

  • December 13, 2011 12:48 p.m.

    I tried taking Pristiq and had sleeping problems. Had to take sleeping pills and they only worked for about 4 -5 hours. I also got major pain in my body so bad that I had to take Oxycontin in order to function. I also got anxiety, headache, blurry vision and started having bladder problems. My bladder would hurt and I felt like I had to urinate but when I tried nothing would happen. The discomfort in my bladder would wake me up at night. Started having memory problems and anger issues as well. The side effects of trying to get off the drug were just as bad. I had nightmares, cold sweats, heart palpitations. I would never take this drug again.

    - maxine

  • December 11, 2011 2:26 a.m.

    I was switched from Zoloft to Pristiq, which I then took for four months. I began experiencing hypomanic episodes, an increased resting heart rate, had very little concentration, and could only sleep three or so hours a night because my mind was always active. I went to the ER for suicide one night and had to go through the discontinuation which was brutal; I got lithium poisoning on the withdrawal. Anyways, if you take this medication: BE CAREFUL. I thought I was fine and that Pristiq was awesome when I had the hypomania, but the lows and discontinuation were hell. I thumbs down and strongly dislike this med.

    - Sara

  • December 6, 2011 9:43 a.m.

    In response to Chad I can empathize with you but haven't your realised yet?, We ARE ALL NORMAL Just be yourself and ignore the critics, im still getting "professionals" doing that now

    - john

  • December 6, 2011 9:37 a.m.

    my life was perfectly ok, with a number of problems i admit but my GP reccomended i went on anti sepressants beacuse he could see a "breakdown" coming , guess what? he was right, i lost my job, house, wife children having been asked to leave whilst still Ill. I wish i had never been so stupid as to go "under the doctor" it started in my early 30s, and im 62 now still having to take the prescribed rubbish and still get suicidal thoughts. im on a third floor flat in exeter uk and i find it hard not to open the window and kill myself. My advice to one and all if getting depressed, try and solve it yourself before the quack doctors get hold of you )0( like the previous commentator they have given me ECT and it does harm the memory

    - john

  • December 4, 2011 1:06 p.m.

    My doctor has recently switched me onto Prestiq i have to say im in my second week i was taking another pill for three years this seems to be making me happier and to feel again but i am getting severe headaches and buzzing in my ears and upset belly im really hoping that it stops soon besides the few side affects i am getting i really like this compared to my old pills

    - Chrystal

  • November 30, 2011 8:43 a.m.

    37 years since I was diagnosed with deppression.Now 51,I went through the whole spectrum of antis with no change except side effects.I was recently prescribed Prestiq and amazed at the differents in my thoughts.Only side affect is eating less which for some people can be a good thing.Still early days yet.Magic for me after all these years battling with deppression..Christine

    - Christine

  • November 22, 2011 4:01 p.m.

    My blessed Doctor has tried so many anti-depressents for me and none of them have worked. Pristiq is the first one that has worked for me. Side effects, definatley include the extra sweating. This is difficult to measure as I am on other medications that have this too as a side effects. I dont care how much I sweat, Thank you lab guys and Doctors for coming up with this one. Mary

    - mary

  • November 16, 2011 9:33 a.m.

    I have bipolar 2 disorder and along with my mood stabliser,it is the only one that has ever worked, and I've been through more than I can even remember. Thanks Pritiq!

    - Carol

  • November 15, 2011 1:23 p.m.

    I was Paxil for more than 16 years and it stopped working.My doctor gave me starter pack of Pristiq and the 14 day free prescription for it.It did work for me while I was on it for about a month. The only side effects I noticed were that my self control button for my mouth stopped working,I would say what I thought.And my ears natural balance was upset,I started getting flaky pieces of wax coming out and itching.Other than that I was fine on it.I have switched to Effexor XR since my insurance wouldn't pay for the Pristiq is something else works. so far so good and I have lost a few pounds.

    - Carol

  • October 30, 2011 8:16 p.m.

    I was on Pristiq for about 3 years. While it worked well for me, discontinuing was brutal. I asked my doctor how to wean off properly, and his method proved to be horrible. So I asked another doctor who gave me a different method. Then I researched quite a bit about weaning off and read more than a dozen methods of discontinuation. I've also read dozens of reviews much the same as mine here. I'm in my 3rd week off the meds, and I'm still not quite normal. I wish I was on a different medicine that worked as well, but was easier to taper off. I give Pristiq a thumbs down.

    - Chad

  • October 17, 2011 7:47 p.m.

    I was put on Pristiq after having PPD and having troubles boucing back from it. So far I think it a great medication I don't like couple of the side efforts i have been having but for the most part i fell put together and my friends and family notice great changes in myself. I will be on it for another 2 months then will be slowly removed and see how it goes. will post after being removed to see what happens

    - K

  • October 12, 2011 8:50 a.m.

    I have been on and off Celexa since I was about 15. In May, I decided to wean off the Celexa as I thought I was feeling better. By the end of July I was having panic attacks all day long with the obsessive thoughts of when the next panic attack would come along. At this point I could barely eat due to anxiety. In early August I had had enough. I started taking Celexa again along with Ativans. Well by late September I was up to 30 mg of Celexa and found that I still had to take Ativans as I would have panicky feelings if I didn’t take it. When I had stopped Celexa I found that I no longer had urinary incontenance. However, when I started up again, I had to go all the time! On October 1, I decided to see a walk-in doctor who prescribed Pritiq. On October 2nd without weaning from Celexa I started Pristiq. I’m on day 11. I have had a few side effects: dry mouth, decrease appetite (which is a huge change from Celexa), vivid dreams (but not nightmares), and a bit jittery in the morning, oh and mild headaches (but I think this is caused by stopping my Ativans 3 days ago.) I have more energy, I can concentrate and I actually have more emotions on Pristiq than I ever did on Celexa

    - Sunshine

  • October 5, 2011 3:05 p.m.

    I was diagonsed with Major depression November'10. My doctor put me on Prestiq and I had a few side effects including sweating, weird dreams and fatigue. So now I am ready to finish my treatment and the withdrawls are not nice. I've had major dizziness, nausea, and less of an apetite. Stopping cold turkey is not an option for me so now I am gradully decreasing my doasge until I no longer have withdrawls. All in all I'm glad I sought help and Pristiq worked great for me. Thanks Doc!!

    - Vivian

  • October 4, 2011 7:52 a.m.

    At first I was in denial that I even had depression/anxiety as I had been like this for so long but after visiting my Dr for something completely different he asked me how things were going. We talked for a while about how i was feeling and then he recommended I start taking pristiq, he said they were very good. I was a bit shocked that he had put me on antidepressants although I decided to take them but had terrible side effects such as dry mouth, nausea, couldnt sleep, jumpy and blurred vision. Everyday I wanted to stop taking the tablet because of the side affects and i thought i didnt have a problem so why am i taking them anyway. After about a week every couple of days a side affect would disappear and after 3 weeks i started to feel good. Now after being on them for a couple of months i feel fantastic, I now realise that I did have depression as I have lots of energy, I enjoy going out and socialising, and im getting things done, things dont seem as much of an effort, and im not getting annoyed and frustrated over silly things. They are so fantastic that ive got my sister, my best friend and now my husband on them. So my advice is if you feel the side affects are too much and you wont to stop or feel its not working, just keep going for a little longer as its worth the wait.

    - annette

  • September 30, 2011 3:16 p.m.

    After being on Effexor XR for 13 years I began to wonder if it was really working. At 150mgs I was still experiencing bouts of depressive episodes, wasn't sleeping but was able to drag myself out of it, thinking that it was my insomnia that was causing my problems. My PCP and I talked about weening me off - I was determined to stop all the "nonsense" of being on an anti-depressant. During that time of weening off, we were moving to another state. Long story short, and having an anti-depressant completely out of my system, the stress of the move produced a major meltdown complete with severe suicidal thoughts which landed me in a Psyche treatment center for 3 days. With the aid of a good therapist, 50mgs daily of Pristiq, I have never felt more normal. Having major depressive disorder AND being on the wrong drug, I never knew what normal meant. Now I do. Not waking up with terrible anxiety, not fearing social interaction, being able to preform normal daily functions. I have none of the desperate feelings I'd had for 13 years. The only side effect I can report is a little bloating which I remedy with a cup of Ginger tea after each meal. My advice is finding a competent Psychiatrist. 2 months of once a week hourly sessions and my input as to what was or was not working helped put me back with the living. Pristiq saved me. Advice, do NOT rely on your PCP as they aren't equipped with all the knowledge needed to treat a mental illnesses, nor do they have the time to

    - Alice

  • September 29, 2011 4:35 p.m.

    @Jen: I have migraine and Pristiq has had no effect either way. My chiropractor is aligning my neck, which is helping more than anything. Something in the "atlas" part of my head/neck. Check into that if nothing has helped migraine.

    - Chrissy

  • September 29, 2011 4:33 p.m.

    I have certainly not had decreased appetite! Not increased but certainly not decreased. I would say it does help as well as any other have, with the least amount of side effects. I've been on different meds since 1980s; this has been about the best.

    - Chrissy

  • September 20, 2011 7:07 p.m.

    I can't take Effexor cause it gives me migraines, be interested in anyones experience with Pristiq and migraines. I need a different antidepressant and I've tried about everything, the "best" ones give me migraines. I've had ECT got me out of a really bad patch but I'm not keen to have it again if I can avoid it, think it's fried my memory

    - Jen

  • September 15, 2011 12:32 a.m.

    I have been takeing pristiq for two months its doing ok feel a little bette and able to function at work but have problems at home still,isolating sleeping a lot still,not interested in anything I used to like, only side effects is lack of appetite problem sleeping and sweating .I think it will get better in time

    - Bob

  • September 13, 2011 7:31 p.m.

    I have been on Pristiq for over a year having never been on an anti depressant. Naturally I was anxious about the side effects. I had severe abdominal issues for about 3 weeks which then disappeared for the most part. It depends when I take it. It seems to work best for me if taken in the morning. My depression went from post-partum to post divorce and this med may have saved my life. Combining with counseling and strong social support is key!!

    - Elise

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