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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 24, 2011 7:26 a.m.

    Has anyone noticed any sexual side effects (women) on this antidepressant?

    - Lisa

  • February 4, 2011 1:51 a.m.

    My doctor put me on Pristiq recently for management of depression and to see if it would help alleviate some of my chronic pain. I have been on several AD's before, most recently Cymbalta which gave me terrible headaches, fatigue, irritability, and horrible withdrawals that included severe vertigo; like falling down backwards, or that roller coaster feeling, just very discoordinated when I would move, especially side to side in a quick manner. Also would get withdrawal symptoms that included horrid diarrhea that was very persistent, as well as appetite issues. So far Pristiq has given me headaches, which I am hoping go away. I hear that the withdrawals may be very severe with this medication, but I am hoping that this isn't true if I need to cease taking it. So far I have not noted any drastic decrease in pain, but I will say my very persistent and severe anxiety has been alleviated significantly since taking it, which is a major factor in me continuing to take this medication. Like usual, the pharmaceutical companies charge outrages prices for these medications, which is another downfall in taking it, but this pretty much goes with most of these types of medications, which is extremely unfortunate. It seems to be the case that finding the right anti-depressant can come down largely to the specific individual, there seems to be a very wide spectrum of people anti-depressants help tremendously, and others who get dreadful effects off of them.

    - Nate

  • January 26, 2011 6:34 p.m.

    I started taking Pristiq when I became depressed after my marriage broke down, my father was terminally ill and my favourite aunt had a stroke and went into a nursing home (all at the same time!). I was lucky enough for the medication to work quickly, to have virtually no side effects and my depression lifted enough for me to cope with all that life threw me over the next 18 months. I was also in contact with a sleep psychologist who has been wonderful. Medication, coupled with support and a determination not to let depression win, has allowed me to get to a very special and positive point in my life right now. My son has suffered from severe depression and suicidal ideation over his 26 years and was on Zoloft with not great results. He's just started on Pristiq after a severe bout of depression - like me, with few side effects. His depression has lifted to a point where he can seek counselling and begin to see, and feel, that life is a great thing that offers wonderful opportunities and experiences.

    - Barbara from Australia

  • January 18, 2011 8:57 p.m.

    Pristiq unfortunately didn't work for me. I stayed on it for almost a year, in part because i had tried different antidepressives in the past without good results that i thought I should give this med a chance, but also because the tamper down has being so prolongued because the withdraw symptoms have been quite severe. It has included dizziness, vertigo, nausea, vomiting, palpitations, even worst depression than when I started on pristiq

    - Antonio

  • January 18, 2011 7:10 p.m.

    it's very humbling to read all the personal statements here. thanks to everyone who has shared their experiences. my experience with pristiq is a good one. after the losses of my father, sister, brother, experiencing a divorce all in 5 years time, i needed something more than Lexapro. I want to note that my 'journey' back to recovery has included a grief counselor (2 years) a psychologist (5 years) a psychiatrist (1.5 years ...after starting pristiq), and a great relationship with my GYN and my GP. i am 47. all this happened while I had a hysterectomy and started menopause. the drugs were always considered to be my 'safety net'. the WORK was my talk therapy with my counselors AND the proper diet AND the absence of alcohol AND adding simple exercise AND treating myself with a) respect and b) tolerance. a pill will not solve any problem by itself. it needs to be part of a PLAN of action for healing. even the most clinically depressed person needs to eat right, avoid alcohol and do as much as possible to create an environment in which to succeed. HANG IN THERE!! i am here tonight to learn more about pristiq withdrawal symptoms. with the permission of ALL of my supporting MD's, i have gradually stopped taking pristiq, and am feeling mild withdrawal symptoms. i spoke with my pharmacist tonite who assured me that "feeling withdrawl symptoms does NOT mean I can't stop" it just takes the body (in this instance, the brain), a while to adjust. Bless you all &

    - jt

  • January 16, 2011 11:55 p.m.

    @ jamie- when I had those symptoms (hair loss weight gain (without a change in my diet), and worsening of depression my dr ran a thyroid test (TSH level) and found that I was hypothyroid. You should definitely ask your gen phys. or p-doc to take this test, actually insist, if you haven't had one.

    - Lesa

  • January 16, 2011 11:07 p.m.

    To be honest,there have been several ssri's that have worked well for me,but,I believe I have rendered each one of them much less effective after having gotten drunk while on them. Don't know why,but they don't ever work as well after getting drunk while taking them. One Dr. told me that the receptor site is somehow effected by the alcohol and I believe her. Feel like I'm starting from scratch after each time I drink as I get to feeling and functioning fairly well,getting a leg up on the chronic depression and then something,someone triggers the desire to drink and all the positive gains are negated and I start all over again. I don't drink very often but it doesn't seem to matter how long in between,still have that severe exacerbation of my symptoms immediately afterwards. I take 50mg pristiq qd,lithium 300mg qam and 600mg qpm,klonopin .5mg qam and 1mg qhs and 200mg lamictal qpm. At present have Tinnitus that began about two weeks ago and BP hasn't increased,taking an antihistamine but no alleviation as of yet. In concluding,I believe I just answered my own question,but would like to offer this. I believe good old Effexor and/or Cymbalta have both worked better than the Pristiq,but think it does work fairly well although it's hard to say as my other concurrent meds have changed also.Goal is to get me off of ssri and manage with the lithium as there is a risk of med induced mania subsequent to ssri r/t BPD II which I am also alleged to have. Any advice ?

    - Jeff

  • January 12, 2011 2:31 p.m.

    In 2004, I developed restless leg syndrome so, after 13 years on Effexor XR, my doctor recommended that I try Pristiq, a "cleaner version of Effexor," he said. Indeed, shortly after the switch--in 2009--my restless leg syndrome was SIGNIFICANTLY reduced. Unfortunately, I have treatment-resistant depression. Neither the Effexor nor the Pristiq seem adequate to relieve my symptoms the way Effexor once did. I wanted to try something in a different family, like Cymbalta, but my psychiatrist said that the withdrawal period may be too difficult to withstand.

    - Fiona

  • January 12, 2011 8:30 a.m.

    i think pristiq is a wonderful thing! i have tried zolft, welbutrin (?) efflexur (?) something like that anyway :) all either made me sick or kept me up at night - then my dr put me on pristiq and i could tell a marked improvement within days - it has been two months now and i am in shock that i feel like i do - it is almost like "so this is how the rest of the world feels everyday?" i no longer have that overwhelming, drowning feeling, when something goes wrong, it is okay i know it will get better - i don't feel like i am in a fog as with some other meds - i still feel, and cry once in a while if something warrants it- but i am to very thankful for this rx. i have had slight constipation, just upped my dosage of fish oil and that was fixed. granted i still take ambien at night - but i am still seperated from my husband, so i believe once that is corrected and stable, the ambien may not be necessary :)

    - Lisa

  • January 11, 2011 12:01 a.m.

    Been on Pristiq for 7 months. Used by my doc to treat me for PTSD and associated depression. Amazing results. started to work after approx 3 weeks. Sleeping like a baby now for 8 hrs a nite(was averaging 3 hrs per nite for the prior year). Only side affect is small decrease in libido. NONE other. I consider it a miracle drug for my condition. Taking no other meds now (Was on xanax and ambien prior). Had also tried effexor, paxil, lexapro and they were totallu ineffectual

    - Francis

  • January 9, 2011 5:59 p.m.

    Took pristiq once--It Was Enough! Fell asleep ok, awoke three hours later having anxiety attack. Awake rest of night with racing thoughts. Got up in AM shaking like a leaf. Called Dr. told me to stop taking it, Did not have to tell me twice!

    - Scott

  • January 3, 2011 9:31 p.m.

    I'v been on pristiq for about 2 years and i havent heard any one thats been on it as long. I'm consern that i'm crying more now and getting upset easyer.I'm trying to deal with it becouse I don't want more pills.My Dr. dosen't take me off them he just add . Do anyone now what the side affects could be for long turm use ?

    - miriam

  • January 3, 2011 7:59 p.m.

    I was on Zoloft for 7 years with good results until I guess I got used to it, then switched to Wellbutrin -- but found myself in an untenable work situation that I tried my best, unsuccessfully, to cope with. I switched to Pristiq a little over a year ago. I think it works excellently in helping me put one foot in front of the other, though more recent stress is making me crawl back in my hole -- but circumstances aside, Pristiq is great for helping me cope. It does not, however, make me believe in having a future. I have no desire to die, but only small pleasure in living. I don't know if that'll ever change. But to all of you who suffer with clinical depression, you don't have to take a page out of my book! Hang in there and wait things out.

    - MaryAlice

  • January 3, 2011 11:53 a.m.

    I recently switched to Welbutrin for my depression and panic attacks. I've been on Lexapro for 3yrs plus but have recently had an increase in sexual dysfunction. The Wellbutrin caused terrible cramps and pain in both legs and I needed to switch back to the Lexapro. Still looking for a better solution; Lexapro is pretty good except for the ED.

    - Raja

  • January 3, 2011 11:02 a.m.

    I have been taking Wellbutrin 100mg. 1xday for several years... a psychiatrist added 50mg of Pristiq 1xday. I felt better at first... I think I have created a much bigger problem that may be sabbotaging these meds... I drink a bottle of wine everyday and have been totally unmotivated to do anything lately. I need some serious advice... the alcohol is scaring me... I really do LOVE the wines affects on me.

    - Gayle

  • December 31, 2010 3:08 a.m.

    This is TO stormsbrewing, You sound miserable, my heart goes out to you.....really it does, I don't know you and I can just feel your sadness and pain. I want you to know that there is help out there for you, you just have to be patient while finding it. (I know this is not the time for patience when you can barely even stand yourself right now) But I promise you that there is help, you need to seek it out...please , please, I am begging you to speak candidly with your doctor about how you are feeling and your hopelessness....if your doctor doesn't respond well to your concerns, switch doctors or go to a psychiatrist for your depression. I am so worried about you, please reach out to someone,even if it has to be a stranger...I would be willing to exchange emails with you and tell you all about my experiences and battles with Major Depression and maybe help you find the help you need.

    - Julie

  • December 28, 2010 9:42 p.m.

    I have taken Pristiq around a year now. I was glad my dr prescribed it. I felt like a science project. Every drug I tried for my anxiety had a side effect I could not live with: too much sleep, no sleep, nightmares, sexual effects, couldn't sit still, you name it. I would stay it one to two months just to make sure. This seemed to do the trick but now the small amounts of hair I was lossing are now visible. I can't pull my hair back in a pony tail without seeing my scalp and the front of my scalp is visual. Also the anxiety in my chest is back on a daily basis. I'm on 100 mg wondering if anything will help. Constipation is a new term for me and I weight more than I ever have, 155 vs 138 normal high. This is the only med I take. Feeling sad and don't want to have to go through the "testing" again.

    - Jamie

  • December 15, 2010 1:03 p.m.

    I don't remember how long I was on Pristiq, but I can tell you that my side effects damn near took my life literally. I am diagnosed with major chronic depression and chronic anxiety. While I was on Pristiq, not only did I have suicidal ideations, but I actually followed through with an attempt. On Sept. 16, 2008, I shot myself in my chest missing my heart by just millimeters. Obviously, I lived. Thank God! I no longer take it and am now on Lexapro with success. Anyone who is having success on Pristiq, more power to you and good luck.

    - Heather

  • December 15, 2010 10:11 a.m.

    I have been taking Pristiq for a little over a year with very little side effects. I have quit smoking cigarettes for two months now. The only fear I have with taking this particular drug is the withdraw. I have attempted to wing off the drug and was unable. My physican just states that I need to remain on the drug as my brain shouts out for Pristiq when i attempt to stop. My life has defintley changed for the better. I have had wonderful results with Pristiq.

    - Marion

  • December 9, 2010 8:00 p.m.

    I started taking Pristiq 3 months ago. I got an adverse reaction, chest tightness, locked jaw, and tingling in my fingers. I thought I was having a heart attack. Told my doctor but said my heart was fine. I quit on my own and I am paying the price. The brain zaps are horrible, and my sweat smells of ammonia. Pls stay away from meds if you can. It's simply not worth it.

    - Irma

  • December 5, 2010 10:54 p.m.

    My Doctor and I decided to try Pristiq at one time during my treatment. I was on Pristiq for about 2.5 weeks when I noticed some uncommon side effects. I had a dry cough, and I was nauseaus often, and found myself vomiting a few times a week during mealtimes....and I wasn't suffering from a cold or flu at that time. The most dangerous side effect was seeing blood in my stool. The amount of blood increased as each day passed. Then about a week after the syptom started, I woke up to use the restroom. I did not have a bowel movement, (which is when I would monitor the amount of blood) and I was shocked the amount of blood that I saw. I hoped like crazy that my menstrual cycle had just started, but it came from my rectum. I was so scared! I had rectal bleeding without pain, but when I would vomit, I never noticed any signs of blood. So, the bleeding was occuring in my lower GI tract. I told my husband, and I quit taking it -- without consulting with my Doctor. Big mistake!! The withdrawal side effects were horrible. I was so scared and miserable. No more Pristiq for me!

    - June

  • December 3, 2010 1:07 p.m.

    one pill send my sister into the hospital with seizures and raised her blood pressure extremely high when its usually below norman

    - rita

  • December 2, 2010 1:05 p.m.

    I'm on day two & experiencing nausea, dizziness & fatigue. Thank you for posting the list of side effects on your site. For those of you that this doesn't work, keep fighting. Keep talking to your doctors & let them know what works & what doesn't. Keep a journal so you don't forget the small things (ringing in the ears was one of mine in addition to constant body pain). Help is out there!

    - Amanda

  • November 29, 2010 10:34 a.m.

    Is there any help out there really? I have been on different depression meds for years and years. Always something new and better on the horizon. I am at wits end. Of course having SAD disorder and fighting the holiday blues does not help. What really works? Sleep, Sleep and withdrawing into life lived alone and hoping for a cure. Please find a cure as we all suffer, some in silence, some out loud and some just hour by hour and minute by minute.

    - stormsbrewing

  • November 29, 2010 6:51 a.m.

    I have been on Pristiq for close to 1 year. I had tried Cymbalta and Effexor; quit Cymbalta because I felt lethargic, fatigued and that outweighed any relief it was providing me. At first, I thought Effexor was helping me but again, the fatigue, bloating/constipation actually made me depressed. I had withdrawal symptoms when I quit the Effexor: tinnitus which hung on quite awhile, maybe dizziness? Don't really recall. I remember my psychiatrist commented that Effexor was "really hard to get off of." Well, I finally reached the same point with Pristiq and I tapered myself off, and I am so blasted dizzy that last night I got real anxious that maybe something SERIOUS was wrong with me. I also have frequent heart palpitations. I feel really bad. And, after reading many blogs this morning, I realize I am having withdrawal symptoms and I pray to God, literally, this will end soon. I will NEVER take a combo antidepressant drug again. "As God is my witness." I just want to feel healthy again. My bloated abdomen is down and I am pooping normally. Yea! But I want my energy and my clear head back. And by golly, I will fight this until I get it back. - Lou Anne

    - Lou Anne

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