
- With Mayo Clinic psychiatrist
David Mrazek, M.D.
read biographyclose windowBiography of
David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
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Depression blog
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Jan. 27, 2009
Pristiq: New antidepressant medication approved
By David Mrazek, M.D.
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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
November 22, 2010 11:58 p.m.
I have been on Pristiq for approximately 2 years and was on Cipramil for 5years of which during that time I have gaine approximately 70lbs or 35 kgs... prior to requiring the medication, weight was never a problem for 50 years. It seems as though there is no magic pill that can give you back your sanity without there being a dreadful price to pay - which in my particular case happens to be a disastrous weight gain - very sad but true. My Dr. has intimated menopause could be a very large contributor (I will admit a few lbs our kg - but no the amount I have gained with ne'er a problem prior. Thank you for listening.
- Gaia
November 20, 2010 8:04 a.m.
I took only 1 dose of Pristiq and had an adverse reaction to it, had to switch to an SSRI. I have panic disorder/depression and needed something to manage my disorder becasue Xanax was only a temporary fix. I asked to be put on Celexa 20mg. I have only taken it for 1.5 weeks and last night did not need Xanax to fall asleep. I feel so relieved, and can function again. My reaction to Pristiq was pretty scary though. Intense sweating, extreme dizziness and disorientation and loss of muscle coordination. It just was not right for me personally, now my husband takes it and has had much success with it. Don't be afraid to try it, my doc said I was a rare case. Best wishes to all fighting anxiety/depression - there is hope and a lot of great meds out there.
- Adrienne
November 16, 2010 5:05 p.m.
I started taking Pristiq recently and it has been mostly good, except for loss of appetite which isn't major and has stabilized. But I have been consistently losing clumps of hair! I googled Pristiq and hair loss and have found that many others are experiencing this problem. It is not listed as a side effect so I am reporting it to the FDA and asking my Dr. to put me on something else.
- Selina
November 8, 2010 7:39 p.m.
If you read all the side effects people are experiencing, you will see, these drugs are DANGEROUS. I was on a similar drug, Effexor XR, for 7 years. I gained 40 lbs, developed crazy hormonal side effects, had suicidal ideation, problems with aggression. I pretty much stopped caring about everything and became a different person. Be extremely cautious if you take an antidepressant. Do your research first, see what people are saying about it. If you start to react strangely or feel worse, tell your doctor you want off. And DON'T stay on it for longer than six months. Just because they prescribe it for you doesn't mean you are broken and need to be on it forevery. There are other ways to cope that will make you healthier, not sicker. If I could go back to how I was before the meds, I would, without hesitation. I've lost years of my life.
- jmo
November 5, 2010 5:17 p.m.
I really love people telling you to eat better, exercise, etc. for depression and get off the medications...depression is a chemical imbalance, just like taking medication for thyroid, etc. Eating better and exercise is good advice for everyone, and it is important for depressed individuals to do just that, but you have to treat the mind like the rest of your body if there is an imbalance. It can take time to find the right medication for each individual. Don't give up, fight!
- Anna
November 3, 2010 1:46 p.m.
My wife took Pristiq and almost died from liver failure. Her condition improved immediately after stopping this medication.
- Ed
November 3, 2010 11:51 a.m.
Pristiq is working well for me. The only side effect is exessive sweating. Also cost is an issue.
- Delores
November 2, 2010 5:36 p.m.
Pristiq, along with my mood stabilizers, has changed my life. I have been depressed for decades and for the first time am finally finding out how good reality can be. While obviously I don't know how it might help others, it has been a godsend for me.
- Becca
October 24, 2010 9:08 p.m.
Pristiq is the first antidepresant I have tried and it has been about 7 months on it. I dont have any bad side effects and I do have my days where I am depressed still and just want to stay in bed and sleep all day. But overall I feel quite good and know it is because of pristiq. I have pretty heavy depression so the days that are bad are still better than a typical day without pristiq, plus no anitdrepressant is magic, so I dont think any kind is going to make it so you never have a single bad day.
- Alyssa
October 17, 2010 3:28 p.m.
I have been on Lexapro for about 8 or 9 years. Worked fine, but the past couple of years started having sexual side effects, I didn't want to change in a way, as I have been on 9 other Anti-Depressants, and this is the only one I could take. Had horrible side effects with the other 9. I have Chronic Depression, and PTSD, however the sexual side effects was hurting my side of our Marriage, so a Psychiatrist put me on Pristiq. The 1st. couple of days I thought it was going to be my Miracle drug, then I started getting very Irritated for small reasons, by day 5 I was ANGRY at the world, and probably would have hurt someone badly if they disrespected me in any way. My 28 year old Daughter, and my Husband were REALLY scared. I became MANIC BY DAY 6, During the 6 days I slept maybe 16 hours. They took me to the hospital, I ended up staying 3 nights. I STRONGLY believe you will see this drug on the T.V. in a class action Lawsuit by an Attorney within 2 years. NO JOKE.
- Netta
October 14, 2010 12:26 a.m.
I've been taking 100mg for about 6 months. It helps a lot. and i'm also on remron 15mg to help me sleep. You can't forget though, exercise and a eating clean helps a lot too in itself.
- John
October 11, 2010 8:45 a.m.
I tried Pristiq for about 3 months last summer, tapering off of Zoloft at the same time. I lost weight, had much more energy, and didn't seem to suffer from chronic pain as much. However, others informed me I was much more irritable and had a slight manic episode. I went back on the Zoloft and have been mildly depressed since, but functional. When I don't take an SSRI, or similar medication, I become agoraphopic, with panic attacks, and I have bulimia. This medication controls those symptoms. I have been bulimic since I was 24, and now I am 55. Sometimes I think about going off of all meds but I am afraid I will become psychotic. I am thinking about switching to a different medication, in the same family of meds, to see if I can get some energy back. It will probably be Pristiq, if my insurance covers it, or then Lexapro.
- dyngbld
October 9, 2010 4:55 p.m.
55 yrs. female, college educated, Dysthymic, some episodes of depression. Over 15 years have tried Paxil, Zoloft, Cymbalta, Effexor, Wellbutrim. Zoloft had manageable side effects for me. Its effectiveness wore out so I am now on Pristiq. Pristiq feels very natural, no major side effects. Its effectiveness was sometimes one day on, one day off, but recently it has been more consistent. I feel fine and have had some very good days.
- Ruth
October 6, 2010 11:19 a.m.
I came down with deppression after having my baby in November 2009. I was put on Zylof 5mg and for about 10 days I felt better each day. On the 12th day, my heart would not stop pounding, I had sweats/shivers, and I just didn't know what to do with myself. I litterally wanted to jump out of my skin. I went to the emergency room do to a panic attack. The Psych. told me to take 150mg. b/c he felt that it was too low. I went through the whole month of January out in the street in the cold just walking so I could tire myself. I finally called my insurance and asked for a Psych. She immediately took me off Zoloft, I felt the difference from one day to the next. Then I tried Celexa & Welbutrin worked for a little bit but I was always too tired. Tried Prozac on the 3rd day I wanted to kill myself. Then I went to an"snri" Effexor and at the beginning I took a leave of absence from work to see how it would effect me. I would want to sleep alot but I would force myself to go for a walk and kept taking my baby to the sitter so I wouldn't impact her schedule. It took about 6-8 weeks for me to actually feel better. I would definitely tell anyone out there to ask your doctors about trying an SNRI instead of SSRI's. I'm feeling better but I still have my day here and there, but believe me it's not that heaviness on your shoulders where you on't want to do anything. Just think about it as a sad boring day and don't think your meds aren't working. Keep your heads up towards t
- Sofia
September 28, 2010 10:41 p.m.
I've been on Pristiq for probably 8 months or more. It's been pretty good, comparatively, but as time has worn on, it seems to have lost its effectiveness. Granted, this has been a rotten year in general, but I'm having real bouts with depression - almost like "break-through depression" off and on. I don't know if others have had this ... maybe its my life.
- Lauren
September 27, 2010 1:51 p.m.
I was on Pristiq for quite some time and it helped, then I went off it on my own and had no problems AT ALL. I went back on it a few months later and had to go back to the doctor because I wanted to quit smoking and she scolded me and put me on Prozac to ween me off, NEVER AGAIN. she put me on a low dose for 5 days, I had a the worst migraine for the following 5 days that I couldn't even function!! Went back on the Pristiq but now it doesn't seem to be helping, or maybe my depression has just worsened.......
- Tami
September 25, 2010 9:11 a.m.
Seems to me the biggest problem of most everyone posting here is being "Over Medicated". I bet 90% would be better off getting off of ALL these medications and just relaxing and exercising. maybe eating better.
- Nunyabiz
September 24, 2010 7:27 a.m.
Have been on several AD's. Currently on Pristiq, which was well tolerated, with dubious results. Currently weaning off and back to Zoloft as a trial. Zoloft had worse side effects for me than Pristiq but worked for a long time. "Tinkering" is common in the admin. of AD''s. I had a serious depression episode so this is an attempt to stabilize me again. Wish me luck.
- Joe
September 19, 2010 6:35 p.m.
Pristiq worked great! I seemed very happy and wasn't easily distracted. The sexual side effect is major!! stopped taking due to sexual side effect.
- Dani
September 3, 2010 10:59 a.m.
I have been on Pristiq for 15 months now. It has been a lifesaver for me, literally! I suffered from severe depression for 4 years, tried at least 9 other antidepressants, with NO luck! I'm so relieved to finally be able to enjoy life again, as hectic as it is with 4 kids, working full-time and having a husband who is in the military. I hope others are able to benefit from this medication as I have!
- Tara
August 29, 2010 2:29 p.m.
Good luck detoxing from this drug. You doc won't tell you, but it's the hardest med to get off of. Don't take it if you can find another solution.
- sick
August 24, 2010 2:18 a.m.
I took this med. for awhile, it was alot of work to get through the side effects which were mainly sweating alot,WIERD feeling in chest/neck/head/hands/feet..I did adjust to it eventually,it seemed to help mostly with my eating disorder.Then I moved,didn't know where my pristiq was,missed a week,and then went through the same side effects..i kept forgetting to take it,been off afew months..if I have the peace and support and time off from driving i would try it again.But I'm busy taking care of sick parents,I forget about myself and what i need. It helped my eating disorder some and I need help with that now.
- Tami
August 23, 2010 5:02 p.m.
I feel like I have been on every AD out there, at age 21 after having my 1st baby, I became very depressed. It has never ceased. I don't remember all of the AD's I have been on. It just feels like after awhile, maybe years, maybe months, maybe weeks they stop working. I was placed on, oh I don't even know when. I too have gained 30lbs, the sweating is so uncomfortable, (I hate it) and I just can't get the idea that everyone would be better off with out me. I haven't had much self estem for most of my life. I think it is the effect of my depression, and the AD's I have had to be on. I am now 55 years old and so tired of this. I feel just like Diego stated, I hate waking up each morning. Death is about the only thing I can say I think of. My mind is going, I just hate the way I feel and would really like to know who I really am without the AD's. My husband has been the most understanding man there is on this earth. I have lost both my mom and dad my two best friends. I have 2 wonderful children with 2 grandboys and a granddaughter on the way. I SHOULD BE THE HAPPYEST PERSON IN THE WORLD.
- Vicki
August 22, 2010 8:38 a.m.
Manic depression appears as a frequent disorder among us. Yet there is all reference as to how to treat depression and nothing about treatment offer for mania. What is a good drug that can cure mania in a light form to incorporate with an antidepressant drug?
- Majy
August 15, 2010 7:12 p.m.
I am on Lamictal and have been for may years and that has been my constant. I've been on Pristiq for about a year and a half (have suffered depression for more than 20 years and have tried EVERYTHING). Initially had some great results with Pritiq, but slowly have gone downhill. Sleeping too much, a HUGE problem with sweating (which I initially thought was a symptom of my menopause), irritability and los of memory/concentration. Staying on-track at work has been a major problem, alomost causing me my job. Will see my pshy this week and am asking for some other way. This is all so hard!
- Ruth

340 comments posted