
- With Mayo Clinic psychiatrist
David Mrazek, M.D.
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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
August 9, 2010 6:30 a.m.
I have just began to take Prestiq, (5th day). I can't say the experience has been all that wonderful. Emotional ups and downs, dizziness, body weakness and fatique have been the norm. I have been on a low dose of Effexor for the past 3 years, none of the aforementioned problems were present. I am supposed to give this med a 30 day trial; however, if the symptoms do not improve I am going to ask to be taken off the med.
- Lee
July 21, 2010 12:03 p.m.
I took 20 mg of celexa for 6 months to tame anxiety. i felt too sedated and slept too much..gained some weight. My doctor had me try Pristiq to give me more get up and go. It is an SNRI which has an added component. I feel much more alert and more like myself...I do have alot of trouble sleeping though..I wake up frequently. So that is the down side. But I feel much better..its just been 2 weeks.
- sherry
July 17, 2010 8:20 p.m.
I went on anti-depressants last March after struggling for months to try to 'fix' myself (exercise, taking a trip, writing a journal, meditation) but ended up very sick and withdrawn. Realizing I needed help in the form of medicine, I ultimately went on Cipralex (escilatopram). I was on it for 5 months and it helped my mood but the sexual side effects resulted in a relationship I was in ending in January, which triggered another episode, and I recognized it was happening again so asked for Wellbutrin (bupropion) (took for 4 months). It was like taking candy, it did nothing - no increase in libido, no help with mood, still cry unprovoked. I'm now starting Pristiq - does anyone have a similar situation trying an SSRI then buproprion with neither working too great, and is now on Pristiq? Will it fill the gaps of the other 2 I've tried (I know everyone reacts differently, but I'm hoping this is the 'in-between' meds I need).
- Sophie
July 17, 2010 5:20 a.m.
I have just started Pristiq today after a month of being on 10mg Lexapro, my Dr told me that as I was on such a low dose of Lexapro I did not need to take any time to change medication and that I can immediately begin taking the Pristiq. So far I feel pretty good, a slight lingering headache which is not anything like the headaches I got when on Lexapro. All in all though I feel much better and brighter and I am hoping things continue to improve. I am concerned about some of the side effects reported such as the feelings of doom, anxiety, nightmares and aggression. The only thing I have noticed is that I have been yawning a lot and my feet felt tingly when I had a shower although that could have just been the fact that I was so cold before standing under the hot water. I was horrified to read about the lady on page nine who participated in the research study for Prisqit and lost the sight in one eye. Would that have been caused by the medication or was it a prior health issue? I am also wondering the effects of alcohol while taking this medication, I know it is not advisable to drink while taking any form of medication but I am struggling with alcohol abuse as a way to get some relief from the sadness in my life and I am hoping the medication will give me the strength to become sober but I am not sure that I can do it overnight. Finally I would like to send hope and positive thoughts to those suffering the deepest despair - please hang in there to live another day. Please.
- Aussie girl
July 12, 2010 9:35 p.m.
I have had depression since I was in my second year of high school when I was diagnosed with Epilepsy. My parents didn't believe in anti-depressants and so the Epilepsy was treated but not my depression. The only treatment during high school consisted of a lot of useless counsellors and psychologists more interested in their skills than my problems. Finally I hit the lowest year I have had thanks to a jerk of a boyfriend, and I realised I needed something to help the negative thinking. My parents were encouraging me to just think positively and would threaten to throw me out if I didn't start being happy. I went to my GP and was put on Lexapro for a while. It helped for a bit then immediately I lost motivation to achieve - which is a huge part of my personality. So I went back and he put me on Pristiq. That was back in April this year and I have to say that for the first time in my life I feel happy. I'm scared to jinx it sometimes but the negative thinking has dropped to a 'normal manageable' amount. I got up and started my own business and I love achieving again. I'm on 50mg of Pristiq, I also take Epilim (for Epilepsy) but nothing else. Persist and don't give in. Even if that means just keeping on breathing. I also found that my faith gave me something to combat those negative thoughts, if that helps. And Pristiq has helped me to keep the depression at bay while I build my life up again.
- Kate
July 12, 2010 8:55 p.m.
Hi, I've been on Pristiq for about four weeks now with no results. I'm tired, depressed, constipated and dizzy. I also take lamictal, abilify and lexapro. I don't think my doctor has any idea what I should be taking or what will work. That has been the case most of my life. Sigh......
- Cheryl
July 6, 2010 6:45 a.m.
Hi, Just wanted to comment that Prozac also caused me to impulsively want to drive into a concrete overpass on the freeway on the way to work. And no, the thought had never occurred to me before. Just that impulse out of the blue. Living on Prozac was like passing through a dense fog. I promptly ceased taking it. Have tried tricyclics and most SSRI's without success as most make me impossibly sleepy, except Paroxetine. Recently, paroxetine failed with me sleeping up to 20 hours a day and not caring about anything or able to make any decisions, let alone work. Just started Pristiq 50mg last week. Initial response is a little improvement. Sedative effect is abating and have felt happier at times. Most importantly, my concentration is improved and cognitive ability is much less impaired than on the SSRI's. I am so hopeful that Pristiq will be the medication to finally help me as PTSD has robbed me of any quality of life. To others, no matter how hopeless you feel, don't drink or take drugs with antidepressants. Please recognise how dangerous this is, and only complicates your recovery. We all have to take individual responsibility for our illness and our lives ultimately. Taking notes on medication effects can help you keep track of how effective the medication is or if you should try something else. Wishing you all the very best and chin up
- Viv
June 30, 2010 12:43 a.m.
I am currently on 200 mg of trazodone and 10 of Ambien for sleep/depression. Had an alcohol abuse issue, nothing that would seem to cause the sleep deprevation. I am on a cpap, but am not convinced. I have an elevated copper serum level. Has anyone had similar symptoms with high copper?
- Brian
June 29, 2010 1:08 p.m.
I started taking Pristiq about a month ago and I'm going to see my Dr. next week to get off. I did notice that it doesn't cause lack of sexual desire, as the other meds I've tried do, but it causes extreme sweating, I get confused or lose my train of thought a lot easier now and it just made me mean/irritable. My anxiety is back full time also, so I can't wait to get off this. Not sure what she'll give me next....
- Ashley
June 27, 2010 7:20 p.m.
I had to quit taking prestique after a few days. made me feel so weird.....suicidal too. I take a mood stablizer, Lamictal, along with Wellbutrin and Manerix (a canadian ad) but was going down the drain again so the pdoc tried me on this but I just can't do it. I see here some others have had a bad time with it also. Too bad......Effexor used to work for me til it sent me into a frenzied mania. It was sooo very hard to get off. Again, i wish i could take prestique but in my current state, it will do more harm tahn good. Keep up the fight. Dave
- No name given
June 24, 2010 7:21 a.m.
My doctor prescribed Pristiq for me back in March 2010 and I feel wonderful. It took a few weeks to a month for me to begin to feel the full effects. I was diagnosed as major depressive and was out of work for 10 weeks. Not all medicines work for everyone since our chemistry is different; I was just lucky the first one they tried me on worked. I encourage anyone who is suffering from depression to please seek the help you need. There is no shame in depression, it is a disease and is treatable. I also encourage you to seek out support groups because there isn't anything better than having others around you that are going through or have gone through what you are experiencing. Strength is in numbers!
- Mary
June 19, 2010 3:01 p.m.
Diego: your beer drinking had the effect of giving brief relief from depression, which is common among many drinkers. Go back to your doctor immediately, you got Pristiq for depression, you are still depressed, but your thoughts indicate it is time for you to move fast to your doctor or clinic. Been there, done that, amigo.
- Erl
June 18, 2010 2:45 p.m.
I have been taking "Pristiq", for about a month now.....I will admit I felt great the first week,but after that week everything started to go down hill.When I started the dose I also started to go "cold turkey" on beer.I am 28 and after drinking for 18 years believe it or not,things have been geting worse by the day it is so bad that I have completely lost intrest in everything I use to do.I think of death every day and life is hurting me too much!!! I hate opening my eyes every morning, I see the world through blue and grey colors.I do have my mother for wich I keep my self alive.Yet the paine does not stop!!!!!!!!!!Are there any clinics that I may go to?That anybody could recomend?I live in alabaster, Alabama.35007.
- Diego
May 30, 2010 8:42 p.m.
My doctor started me on pristiq. I did not read the warnijngs on the back of the prescription bottle. It said "do not eat yogurt or drink milk while taking this medicine!" Well, those are two of my favorite things. On the second day I was shaking, cold, nausea set in, and I was so sick my daughter had to call an ambulance and take me to the emergency room. I am 82 years old, and depressed, but afraid to try thiis medicine again. (without the yogurt and milk)!!!!! READ THE LABELS
- Pat
May 26, 2010 3:33 a.m.
I have been on almost every AD medication since the late 80's,,Paxil,through the latest,Prestiq. Between the mixes and eliminations of the different meds,I am still wondering about this one.The combination of Prestiq and Zoloft,,along with Depakote ,Ativan,Sonata and Trazadone(for sleep),,Lovaza for the increased cholesterol,(and Crestor),,wow,too many meds for this guy.I am in the time of this round of recovery,,where I question the meds overall effectiveness.Much less their necessity.I will continue with the doctors and therapy I have today,,they are top notch,,I just want to see how others have been on this medication.
- Ken
May 17, 2010 11:24 a.m.
Same for me, I have been on numerous anti-depressants. Each one has a "life", meaning that they always fail. I have also been treated for Manic Depression (bi-poliar disorder), those treatments failed also. I am at my wits end, desperate to live a somewhat normal life. Currently I am taking Cymbalta which has kept my head above water for the last 5 years. This last two weeks I have the feeling Cymbalta has served it's term. I've been EXTREMELY depressed. If Pristiq is anything like Effexor, I have no interest in it or the brain shocks that come along with it. This week I will attempt (in my depressive state) to check out one of the local support groups and I see a new Psych. next week. I am going to push to have my hormone levels checked... as a last resort.
- Cindy
May 13, 2010 9:25 a.m.
I WAS TAKING EXFFEXOR TO HELP TO CONTROL HOT FLASHES .TODAY IS THE FIRST DAY TAKING PRISTQ I HOPE I DONT GAIN WEIGHT.
- eloise
May 6, 2010 3:28 p.m.
I have tried so many different AD's much the same as so many people have commented on. Each one had side effects but zoloft worked the best even though i gained 30 pounds... now that's depressing! Two years ago i was diagnosed with Fibro and most specialists want to treat it with AD's as it is a chronic pain condition. BUT WHAT I CAN HONESTLY SAY TO ALL OF YOU IS.... SEE A NATUROPATH. SO OFTEN THERE ARE UNDERLYING CAUSES THAT CAN BE ADDRESSED WITHOUT TAKING ALL THESE AWFUL DRUGS. Two things that have made a world of difference for me are 5HTP ( a natural seretonin booster and aids in weight loss) and Theanine ( a natural calming agent) neither of these have any side effects and taken together have worked really well for me! Good luck to all of you, but do yourself a favour and see a naturopath and research these two products!!! Lee.
- Lee
May 5, 2010 5:57 p.m.
Thanks for everyone's input. In the last 12 or so years I have tried so many things I can't remember them all. But for recent years I have been on Celexa. I just started Pristiq about 12 days ago because Celexa wasn't doing the job anymore. I felt soooo much better right away. I wasn't waking up nauseaus or anxious and felt really good. But about a week into it I had 2 days of feeling really dark. I was mad at everyone and everything and it felt terrible. Then that feeling was gone. This morning I woke up feeling like my old crappy self and am just trying to wait another week to get everything out of my system and see what the reality is. My sex drive was fine before, but not really great lately. Again, will this correct itself when I have a few weeks of Pristiq behind me? Anyone with similar experience?
- Liz
May 5, 2010 12:05 a.m.
I had been on Zoloft fo several years. I started saying and doing silly things all the time then I started getting confused and even lost when I went places. My Dr. told me the Zoloft had stopped working. He put me on Pristiq and it has helped but I am exausted all the time, I can't sleep, and I have gained 20 lbs in 8 months. Next time I go in he is going to change my meds.
- Vicky
April 26, 2010 9:58 p.m.
Can a person go to a tanning bed while taking Pristiq?
- Linda
April 24, 2010 3:31 p.m.
I must say, things seem a lot better since I am being weaned off of Pristiq 50 mg. I, like a lot of these commentators, have tried about every AD out there. My doctor suggest this as "the last", followed by ..."if this doesn't work, you may be bipolar". At first I was offended. After extensive research on my part (books, psychiatrist, comments like these) I was diagnosed with bipolar depression (I). I am on Citalopram as the AD and Lamictal for the bipolar disorder. Of course the shrink has given instructions on how to wean and I have to say, having barley any Pristiq in my system feels a lot better. At first I loved the "new" feeling of pristiq and it did help with crying and obsession over death. Other than that is petered out pretty quickly. Just like everyone else, I didn't realize just how bad I felt until I started to feel better on this combo. I never knew (I'm 43) that if you've tried all ADs and they work at first and then peter out that you should be tested for bipolar Depression. Good luck everyone. Of course this pill could be perfect for the rightly diagnosed person.....
- Carla
April 21, 2010 8:32 p.m.
While it's true that Pristiq is a metabolite of Effexor, it is MORE than that. I have tried EVERY single antidepressant out there over many years and NONE have worked, Effexor did not work for me! But , as a last resort, while I was in a severe depression, distraught, lifeless, hopeless and suicidal and at death's door with depression was put on Pristiq. Not expecting much, Pristiq worked almost immediately! For whatever reason, this medicine works for me. I am in the lowest dose. I hear it is helping many others too.
- Neli
April 17, 2010 5:08 p.m.
Pristiq is wonderful! It has helped reduce my depression significantly and also had handled my anxiety, PTSD, and panic attacks. I work very closely with a psychiatrist and a professional counselor and have had great success with Pristiq. After getting through the side effects for the first 4 weeks (the worst being insomnia) I am now side-effect free.
- Jennifer
April 14, 2010 7:17 p.m.
I want to say God Bless You all. This is a horrid disease and people don't seem to understand. They just think you should "snap out of it"?? I was on Prozac for years and got the "poop out" as my Dr called it. I was on Wellbutrin, then Cymbalta and some others that I don't even remember. I have seen this Pristiq advertised and wondered about it? I don't think my insurance would cover it though??? It seems that there are varying opinions here of how it affects people. I was put back on prozac in December, but i didn't feel that it was working and thougth I was just going thru menopuase, so i quit taking everything.... Now, I am horribly depressed and irritable. Nothing seems to matter and I don't find pleasure in anything in life. I seem to exist just to make it thru the day and I can go to bed and sleep to escape this awful feeling. I have so much to live for, but don't really feel like I care right now. I am going to the Doctor tomorrow to see if she will try me on something else? I am so tired of trying all of these different meds. i'm not really a pill person, so it's hard to keep trying new things. I've read on this site about taking B-12? Does anyone have an opionion as to whether you think that helps at all??? thanx to all of you, It sure has helped to read these comments and know that I'm not the only one in the world who feel like this??
- Kathy

340 comments posted