
- 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
April 11, 2010 12:56 p.m.
Pristique is just a metabolite of effexor. It was marketed because the patent on effexor was lapsing. It is a cynical attempt to to make more money by marketing a drug that has no benefit over effexor except exclusive marketing rights. If you want to take pristique, take generic effexor and your liver will convert it to pristuque in a few hour for free. Nonsensical drug like this make healthcare needlessly expensive.
- Robert
April 10, 2010 11:48 a.m.
I'VE READ ALL THE COMMENTS ABOUT PRISTIQUE. IT IS BECAUSE MY DOCTOR SWITCH ME FROM EFFEXOR TO PRISTIQUE 50 MG. BUT I PREFERRED TO DO A RESEARCH FIRST. AND NOW I DONT KNOW WHAT TO DO. I HAVE READ GOOD THINGS AND HORRIBLE THINGS ABOUT PRISTIQUE, SO ..WHAT I SHOULD DO? I HAVE LOST 7 LONG YEARS OF MY LIFE WITH THIS ILLNESS AND HAVE TRIED LIKE LOT OF YOU ALMOST ANITHING IN THE MARKET. BY KNOW I AM SUFFERING OF HYPERPLASYA (EXCESIVE SWETTING) PROBABLY BECAUSE I AM IN EFFEXOR. I HATE THIS BECAUSE IT RESTRAIN MY LIFE TO AN AIR CONDITIONED ROOM. I UNDERSTAND VERY WELL ALL OF YOUR WORRIES BECAUSE I HAVE EXPERIMENTED ALL THE POSSIBLE SYMPTOMS OF DEPRESSION. AND I ASK MYSELF, LIKE SOME OF YOU DO, IS THIS WILL BE FOREVER? I HAD TO QUIT MY JOB, NOTHING INTEREST ME ANYMORE, MY FAMILY TRY TO UNDERSTAND , BUT I THINK THEY ARE GETTING TIRED. I AM TAKING : LEXAPRO, EFFEXOR AND SEROQUEL. ALSO I USE CLONAZEPAM TO SLEEP AND FOR ANXIETY. BUT BELIVE ME, EVERY PILL THAT END IN "EPAM" WORSEN MY DEPRESSION, SO I TRIED TO AVOID TAKING THEM, ONLY AT KNIGHTS TO SLEEP. I READ SOMEONE , CAROLE, I THINK THAT WAS ASKING ABOUT ECT. LADY I HAVE BEEN ON ECT TWICE. IT IS SOMTHING THAT I CANT EXPLAIN. I LOST A LOT OF EPISODES IN MY LIFE. THEY WERE GONE. AS SIMPLE AS THAT. IT WAS NOT HELPFUL, AND SOMETIMES I CRIED BECAUSE OF THE GODD AND NICE EPISODES OF MY LIFE I FORGOT. I SPEND MY LIFE PRETENDING THAT I REMEMBER THOSE EVENTS. RIGHT KNOW I KNOW I NEED TO SWITCH, BUT IF PRISTIQUE IS LIKE THAT , WHAT I D
- haida
April 8, 2010 7:45 p.m.
Pristiq, 50 mg, made me extremely tired just like all the other anti-depressants. I quit taking it after 6 weeks.
- m.b.
April 5, 2010 2:19 p.m.
I was prescribed pristiq today 4-5-10, 50mg daily, I also take welbutrin,150sr, daily,and 300mg of seroquel daily. I have been doing well with the welbutrin and seroquel. I am getting ready to start treatment for chronic hep-c this month.Knowing the side affects of the treatment myself and my doctor thought it best that I add pristiq to my already existing regimen. I took the first dose at 9am this morning and around 1pm I started to feel dizzy and a bit naseaus, kind of loopy. I suffer from severe depression, bi-polar and intense anxiety,accompanied with panic attacks. I know that I will be facing a rough period of time with the upcoming treatment and I just want to be prepared for it. I feel very warm and flushed right now,and elevated mentally. I want to know if there is anyone who has a similiar experience to share, or anyone who can give me a little advice on the pristiq ,welbutron, seroquel, combo. THANX
- Robert
April 1, 2010 1:14 a.m.
The most depressing thing about depression is being depressed. LOL! I was reading this blog to see what others experienced on Pristiq. Was on prosac for 17 years... except two years during pregnancy and breastfeeding. Now on cymbalta and deplin but not feeling the relief. Waited to change drugs because I had a pacemaker put in and was told some of symptoms were normal for heart patients/surgery/ etc but would pass. I am on the verge of being fired at work. Since I am on medication, my supervisor thinks I am just insubordinate and lazy. If I am too "sick" to do my job it is cause for termination because I can't fulfill my job obligations. Seems I can't win. Living with depression sucks! For me, for my family, my few friends.. just seems ridiculously unfair.
- bon
March 31, 2010 6:59 p.m.
Each of you should be very proud of yourself. Letting others know of your trials and efforts with various medicines and problems surely benefits others with depression who have the chance to read these posts. I have tried many a-ds over 12 years and as soon as something appears to begin to straighten my path, something happens to me personally. Although I have been on Pristiq since it's unveiling, I cannot give it a real critique as I have been battling serious depression (personal issues) since. I spent almost 2 years in the bed from depression which began with neuropathy. So, as soon as I get a handle on my neuropathy, maybe I can get back with all of you and shed some good news of my life. Take care,all of you and God Bless.
- Guy
March 25, 2010 3:54 p.m.
I have been on Pristiq for about 6 months. Also get the night sweats and wake up soaking wet. I recently went to 100 mg. and have insomnia, fatigue and anxiety. I am going to try a new pshyciatrist and see about changing meds.
- Linda
March 23, 2010 3:55 p.m.
I have fought taking antidepressants for years with a belief that I can handle what ever God gives me but a few months ago I realized that I could not do it any more. I am a professional successful lady with a life, a home and grown children. I had an upset with a past friend that hurt me inside and out. I went to a counselor who referred me immediately to my doctor and she put me on Pristiq. I feel more human and alive than I have in years. I hate to admit that the medicine has given me some stability but it has. The only instability that I have is that I do not want to miss a single dose because I am afraid of every feeling like a did before. I do have some nausea and a little dizziness but it is worth it for the over all results. I just cant believe the difference that it has made in my life.
- Kim
March 22, 2010 7:16 a.m.
I started Pristiq March 2009 50 mg. Recently increased to 100 mg. I have been happy with the medication and its ability to help me with depression and anxiety. The only side effect that still lingers is the fatigue so I take my dose late afternoon. I have tried other antidepressants in the past and for me, this one, is the best.
- Christina
March 17, 2010 8:55 p.m.
I took Zoloft for 4 years...I went off of it, thinking I was fine now. A year later I realized I was losing it...always agitated, impatient and stressed..so I went to the doctor and the doctor said...try Pristiq. well I have been the happiest, most carefree me...the me I used to be...EXCEPT I have gained 15 pounds. The doctor said that would not be a side effect. But I have not changed anything else in my lifestyle at all except taking Pristiq. I am so happy and don't want to quit taking it. I am very active and eat very healthy, so I know that it has to be the Pristiq. Or because I just turned 50?????
- Tracy
March 16, 2010 1:57 p.m.
I've been taking Pristiq for 4 months and my cholesterol has sky-rocketed.
- Abby
March 14, 2010 9:58 p.m.
After taking SSRI's at their maximum strenght, little or no results were experienced; however, just a few days of swithing to SNRI such as Pristiq, changes were quite noticeables, in particular with the level of energy in the body.
- Carlos
March 8, 2010 2:00 p.m.
I've been taking Pristiq since early November, along with Zoloft. The Pristiq has given me hand tremors, high cholesterol, and high blood pressure.
- Abby
March 6, 2010 8:02 p.m.
i have suffered from depression most of my life. Began meds after the birth of my child: Prosac. one day i was driving along beneath a bridge and had the thought "ahh. it would be so easy to turn my steering wheel just a bit to the left and i would be gone. so simple." i had never had a thought like that in my life! so i got off prosac and began zoloft. eventually that wasn't enough and we combined it with wellbutrin. i ended up on the max dosage of both and this worked for me for several years. and then it did not. i began taking Pristiq as soon as it was available and love it. i notice some people talk about their dreams on Pristiq. My dream life is much richer and more fulfilling than my waking life. I love to sleep and i now consider sleeping my "super power." i want to do it all the time. :o) but the black hole has begun to creep around me again now and it is time to either increase dosage or find something else. I did not realize that pristiq was used to help with menopause symptoms, but mine are finally under control after 11 years (i am 51)....could just be i am aging out of it! but i like pristiq and am very grateful for it. there is still no generic form, my ins. does not cover it, but i finally got the 50% discount card and that helps with the cost, of course. Please see you doctors (preferably a psychiatrist) before stopping any meds. do not wait for you next appt. MAKE A NEW ONE! NOT OPTIONAL!
- nelda
March 3, 2010 12:21 p.m.
To people who are trying to find the right treatment, have courage! I have totally been there and eventually found the right one. When you read other people's experiences, they can be very helpful for awareness, but everyone responds differently to each drug. You might do well and have different side effects or be able to tolerate a particular drug better. Also, getting some talk therapy while trying new drugs helped me learn ways to handle the ups and downs. Cognitive Behavioral Therapy also helped me learn how to stop the negative spiral thinking even without drugs. I found one that works for me, but it took most of a year to get there. 1) I had problems people have mentioned here, but with totally different drugs: Prozac gave me the sense of being "shielded" or "removed" from my feelings and didn't help that much, two had little effect, the next one worked but made me kind of high in a bad ADD way, Wellbutrin (not the slow-release kind) made me anxious and disoriented and I would lose my way around buildings! But then I found that Lexapro and then Cymbalta worked well. The side-effects for me are decreased sex drive and tiredness. However, I can overcome those effects enough to put up with them. 2) I can't say enough good about getting enough sleep, sunlight, and especially exercise of any kind - even 10 minutes walking to the Starbucks helps. And the side effects did get less intense after several months. Good luck, and give it time!
- Renee
February 28, 2010 12:13 a.m.
I have major depressive disorder. I started out on Paxil which caused me to be very angry, agitated, mean, and have suicidal-like feelings. Then, I was put on Zoloft, and still, I was agitated all the time. Then I was put on Celexa and Risperadol. Well, the same symptoms occurred, so I gave up and stopped taking everything. I took nothing for years and dealt with major depression. Then, I started on Pristiq and after 2 weeks, I have never felt better. I have been taking Pristiq now for 4 months. I'm calm, happy, and enjoying my life again. I have diabetes and Pristiq has not affected my sugars. I have been losing weight as well, which all the other antidressants caused me to gain weight. I'm sleeping better at night. The only thing I suffered from with Pristiq was the first week of chemical nausea. At the end of the first week, I was feeling better. Another side effect I still have is loss of appetite. I'm just not hungry anymore, but, I make sure I eat. All I have to say is, thank god Pristiq was made cause I'm feeling so much better. My husband is happy too and makes sure I never miss a dose, cause he can live with me happily!
- Kim
February 27, 2010 9:20 p.m.
Curious to know if any of you have experienced dramatic almost real to life nightmares. Since going to a higher dose of Pristiq (100) I have had evil, rage driven, horror filled murderous dreams that would shock even the most evil sickest people out there. This drug creates an evil in dreams that when you wake up your in fear. You literally began to wonder if you are becoming the person in your dreams. I have gone off this head-playing drug cold-turkey; I am experiencing side effects such as short term memory lost, inability to focus but I know this is temporary and am already sleeping better with more pleasant dreams. A few more days then I can coherently decide where to go from here. Effexor was by far the best med I have ever taken for depression. The side effect that made my dr pull me off of it was for the unexplainable bruising on my body that was occurring periodically.
- debra
February 23, 2010 7:23 p.m.
To Denise, Nov. 3/09: Poor Denise, I hear your pain. My dear, please try to find a more caring, knowledgeable doctor, one that will show you more respect. I am 57 and I've had my share of uncaring doctors and yours sounds like one of those. Good luck to you and don't let your doctor make you think that he/she knows better just because he/she's the doctor. It doesn't work that way these days. Do some research and I hope that you can find a more compassionate doctor. Blessings to you!
- Carole
February 23, 2010 7:03 p.m.
I have suffered from major depression for over 20 years and in all that time I have been on too many anti-depressants to remember them all. My life is an emotional roller coaster. I have been on Effexor for about 5 years and in those years I have tried changing dosages many times, have even tried going off anti-depressants completely without the knowledge of my psychiatrist, (big, big mistake); started on them again, but it gets more difficult each time to climb back up again. My first a/d was Prozac, which I took for 4 years. Year one was great; year two was good; year three was okay; year four was hell; I became suicidal and went off them cold turkey, which resulted in 7 weeks of euphoria, which actually means for me anyways, that I was actually happy and normal and was able to motivate myself to do things that other people take for granted. Well after that wore off, it was onto something else, which I don't recall. But right now, on Effexor, I am not doing nearly as well as I would like to be doing. I am afraid to change meds because I have done it so often, with mostly bad results. After reading about Pristiq, I do NOT want to take that. Does anyone know of an SNRI that does not cause weight gain and actually works. And also, I would love some feedback about ECT. Does it work? Is it worth it? I sure admire all of you out there who are struggling with this damnable curse of a disease. You are all so brave and inspiring. God bless you all dear friends. Hugs to all of you.
- Carole
February 16, 2010 2:34 p.m.
I have been on pristiq for about 7 months now. I have tried almost all other anti-depressants and this one seems to work pretty well, but the side effects are becoming too much. I night sweats and wake up with my clothes soaking wet, the fatigue is starting to affect my life (i skip class to sleep and i leave early from anything to go home and go to bed). I want to go off of it but the doctor said i shouldn't right now. If you take this and have no side effects than just wait... you probably will. But some people can handle it i guess.
- kim
January 28, 2010 9:48 p.m.
This is the first day with this med and my Anxiety is gone. I usually wake up and think I am going to die. This feeling is gone. So far this is a wonder drug.
- Fred
January 26, 2010 8:38 p.m.
I tried Pristiq for two months. It seemed to help to some degree with the depression, but I was exhausted and slept too much. It was also very rough on my stomach. I agree with DP's comment and also felt shielded from emotion rather than experiencing increased ability/stability to improve my reactions to situations. After trying so many different drugs and therapy over a very long time, I am now investigating ETC.
- Kathryn
January 26, 2010 11:14 a.m.
Made the decision today to stop Pristiq after 6 months. It did help with the depression, but the fatigue was too much. My joints ache as well. I'm going to exercise and continue with acupuncture and B-12 injections. Dr. said to go cold turkey. We shall see and I will post the symptons if any.
- Melissa
January 25, 2010 3:54 p.m.
I have been on Pristiq for approx 6 months. It has helped with the depression and my emotions are good. I am happy. I work out regularly and eat well. I do get severe fatigue twice a month that is crippling. I am now trying acupuncture to assist with this side effect.
- Melissa
January 24, 2010 3:35 p.m.
I did not respond to Pristiq well at all. I felt "shielded from emotion" rather than an increase in my ability/stability to improve my reaction to situations. I back to Cymbalta whic seems to be just so-so this time around. Has worked in the past, not sure what to do at this point im just not there again...still.
- DP

340 comments posted