Pristiq: Side Effects, Proper Usage, Discontinuation, Price, and Additional Information

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What's Pristiq all about?

Pristiq: Side Effects, Proper Usage, Discontinuation, Price, and Additional Information

Pristiq is a widely prescribed branded medication used to tackle major depressive disorder (MDD) in adults. MDD, often referred to as clinical depression or simply depression, is a severe mental health issue.

Pristiq falls under the category of antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs function by increasing the amount of two essential brain chemicals: serotonin and norepinephrine.

The drug comes as extended-release tablets, required to be taken once a day. Pristiq is available in three potencies: 25 mg, 50 mg, and 100 mg.

Efficiency

Various clinical studies have confirmed Pristiq's effectiveness in managing depression. These studies, based on the Hambling Rating Scale for Depression (HAM-D), gauge the severity of symptoms prior to and after treatment. The scale ranges from a minimum score of 0 points to a maximum of 52 points; higher scores indicate more severe depression symptoms.

In four of these studies, Pristiq emerged successful in reducing depression scores compared to a placebo (placebo-controlled treatment). The average depression scores prior to the treatment were between 23.0 and 25.3 in all four studies. After an 8-week treatment period, individuals taking Pristiq (doses ranging from 50 mg to 400 mg daily) experienced a decrease in their depression scores, up to a 3.3-point reduction.

Two additional studies that lasted up to 26 weeks were conducted. These studies identified that people taking Pristiq were less likely to experience a relapse (depression recurrence) compared to those on a placebo.

Generic Pristiq

The active compound in Pristiq is desvenlafaxine. Generic forms of Pristiq are also in the market, available in the same strengths as Pristiq.

Generally, generic medications tend to be more affordable than their brand-name counterparts.

Pristiq Adverse Effects

Pristiq can trigger mild or severe side effects. Below are some of the key side effects that could develop while using Pristiq. Keep in mind, this list doesn't encompass all possible side effects.

For further information on the potential side effects of Pristiq, consult your doctor or pharmacist. They can provide you with pointers on how to manage bothersome side effects. Alternatively, you can access this detailed article about Pristiq's side effects.

Common Side Effects

The common side effects linked to Pristiq include:

  • nausea
  • dry mouth
  • exhaustion
  • dizziness
  • sweating
  • constipation
  • decreased appetite
  • sleepiness (avoid driving until you know how Pristiq affects you)
  • sleeplessness
  • anxiety
  • sexual dysfunctions, such as diminished sex drive or erectile dysfunction/orgasmic dysfunction

Most of these side effects may subside within a few days or a couple of weeks. If they continue or worsen, consult your doctor or pharmacist.

Severe Side Effects

Severe side effects from Pristiq are rare but can happen. If you experience severe side effects, contact your doctor immediately. Dial 911 if you think you are having a medical emergency.

Serious side effects and their associated symptoms may include:

  • Struggles with suicidal thoughts or actions* can manifest in young people as:
    • a worsening of feelings of sadness
    • contemplation of death or self-harm
    • attempts at suicide
    • escalating anxiety or panic attacks
    • a heightened sense of agitation, restlessness, or incapacity to remain still
    • new or worsening sleeping disorders
    • an increase in irritability, anger, or aggression
    • signs of mania, like extreme levels of excitement and activity, or rapid, non-stop talking
    • acting on impulses without considering the consequences
  • Serotonin syndrome (a risky condition caused by an excess of serotonin in the body). Symptoms can include:
    • rapid heartbeat
    • dizziness
    • sweating
    • flushing
    • tremors or twitching
    • stiff muscles
    • loss of coordination
    • nausea or vomiting
    • diarrhea
    • agitation
    • hallucinations (seeing or hearing things that aren't real)
    • seizures
    • coma
  • New or worsened high blood pressure. Symptoms can include:
    • headache
    • chest pain
  • Bleeding more easily than usual. Symptoms can include:
    • nosebleeds
    • simple bruising
    • vomiting up blood, which can appear red or pink
    • blood in the stool
    • black-colored stools, resembling tar
  • Closed-angle glaucoma (a sudden increase in eye pressure). Symptoms can include:
    • rings around lights
    • blurred vision
    • eye pain or redness
    • sudden severe headache
    • nausea
  • Low sodium level in the blood, more common in adults over 65 years old. Symptoms can include:
    • headache
    • difficulty concentrating
    • memory problems
    • confusion
    • weakness, leading to falls
    • hallucinations
    • fainting
    • seizures
  • Lung-related issues, such as a specific type of pneumonia and interstitial lung disease (a lung condition leading to scarring). Symptoms can include:
    • breathing difficulties
    • cough
    • chest discomfort
  • Seizures. Symptoms can include:
    • involuntary muscle spasms
    • loss of consciousness
    • drooling
    • rapid eye movements
    • loss of bladder or bowel control
  • Severe allergic reactions. Symptoms include (more information below):
    • mild allergic symptoms: skin rash, itching, flushing
    • severe allergic symptoms: swelling, usually around the eyes, lips, hands, or feet, swelling of the tongue, throat, or mouth, trouble breathing

Additional information on side effects

You might be curious about the frequency of certain side effects associated with this drug, or if the drug is implicated in these side effects. Here are some details on several potential side effects related to this drug:

Allergic reaction

As with most medications, some individuals can have an allergic reaction after taking Pristiq. The frequency of this is not fully known. Mild allergic reactions can present as:

  • rash
  • itching
  • flushing

More severe allergic reactions are rare but possible. Symptoms of a severe allergic reaction include:

  • swelling under the skin, typically around the eyes, lips, hands, or feet
  • swelling of the tongue, mouth, or throat
  • difficulty breathing

If you encounter a severe allergic reaction to Pristiq, contact your doctor promptly. Seek emergency medical attention if your symptoms appear life-threatening or if you believe you are experiencing a medical emergency.

Weight loss or weight gain

Weight changes may occur while taking Pristiq, but it's uncertain if the drug is a direct cause. Depression, for which Pristiq is prescribed, can affect appetite, leading to either weight gain or loss. When treating depression, it can be difficult to determine whether weight changes are due to improved mental health or a side effect of medication.

One analysis examined Pristiq's impact on body weight in studies. The review covered people who took Pristiq for 2 months (short-term) and 9 months (long-term).

Individuals taking Pristiq in short-term studies averaged a weight loss of 1.8 pounds. Those taking a placebo (a treatment with no active drug) lost 0.11 pounds over the same time frame.

In long-term studies, those taking Pristiq gained an average of less than 2.2 pounds. Similar weight gains were observed in people taking placebos.

In summary, fewer than 1% of people in clinical studies taking Pristiq experienced significant weight changes. The duration of Pristiq use (either short-term or long-term) does not substantially influence weight changes.

If you have concerns about weight loss or weight gain while taking Pristiq, discuss your concerns with your doctor. They can offer guidance on healthy diet and exercise habits tailored to your treatment.

Decreased libido, which was observed in: + 4% of males using 50 mg of Pristiq + 5% of males using 100 mg of Pristiq + 6% of males using 200 mg of Pristiq + 3% of males using 400 mg of Pristiq + 1% of males using a placebo (inactive treatment)Difficulties achieving an erection, which was observed in: + 3% of males using 50 mg of Pristiq + 6% of males using 100 mg of Pristiq + 8% of males using 200 mg of Pristiq + 11% of males using 400 mg of Pristiq + 1% of males using a placeboDelayed ejaculation, which was observed in: + 1% of males using 50 mg of Pristiq + 5% of males using 100 mg of Pristiq + 7% of males using 200 mg of Pristiq + 6% of males using 400 mg of Pristiq + Less than 1% of males using a placebo

Sexual problems were also reported by some females using Pristiq daily for 8 weeks during studies*. Among those using 50 mg or 100 mg of Pristiq, 1% reported being unable to reach orgasm. The same issue was reported by 3% of females using 400 mg of Pristiq. There were no reports of this side effect in females using 200 mg of Pristiq or a placebo daily.

Some females may also experience decreased libido. However, the number of females experiencing this side effect during Pristiq studies is not known.

If you experience sexual problems while using Pristiq, don't hesitate to discuss them with your doctor. Sexual side effects are common with many antidepressants. These side effects can improve over time. However, switching to a different antidepressant may sometimes be helpful. Your doctor will determine if switching medications is appropriate for you.

Insomnia

Insomnia is a symptom of depression. However, sleep disturbances were also reported in short-term studies of Pristiq. During 8 weeks of daily use, insomnia was reported by:

  • 9% of individuals using 50 mg of Pristiq
  • 12% of individuals using 100 mg of Pristiq
  • 14% of individuals using 200 mg of Pristiq
  • 15% of individuals using 400 mg of Pristiq
  • 6% of individuals using a placebo (inactive treatment)

If you experience insomnia during Pristiq treatment, taking your daily dose in the morning instead of later in the day may help. If this does not help, talk to your doctor about your sleep problems.

Sleep issues often begin to improve within the first few weeks of starting Pristiq as the antidepressant begins to work in your body. If you continue to have sleep problems after a few weeks of treatment, talk to your doctor about ways to improve your sleep quality.

Headache

In short-term studies lasting 8 weeks, 2% of individuals stopped using Pristiq due to headaches.

A headache can be a symptom of more serious side effects of Pristiq, including closed-angle glaucoma, high blood pressure, and low sodium levels.

If you experience a sudden severe headache while using Pristiq, you should contact your doctor immediately. If you experience a milder, typical headache, talk to your pharmacist about a medication to help relieve your pain.

Sweating

Increased sweating can occur while using Pristiq. This side effect was observed in studies of the drug. During daily use, increased sweating was reported by:

  • 10% of individuals using 50 mg of Pristiq
  • 11% of individuals using 100 mg of Pristiq
  • 18% of individuals using 200 mg of Pristiq
  • 21% of individuals using 400 mg of Pristiq
  • 4% of individuals using a placebo (inactive treatment)

Night sweats specifically were not reported in these studies. However, night sweats have been reported in individuals using a very similar drug called venlafaxine.

If you experience increased sweating while using Pristiq, talk to your doctor. They can recommend ways to help manage this side effect.

Diarrhea

Diarrhea was not reported as a side effect of Pristiq in studies. However, diarrhea can be a symptom of serotonin syndrome, a side effect that can occur with Pristiq.

Serotonin syndrome occurs when levels of a chemical called serotonin become too high in your body. This condition is more likely to occur if you are also using other drugs that increase serotonin levels along with Pristiq.

Other symptoms of serotonin syndrome include:

  • fast heartbeat
  • dizziness
  • sweating
  • flushing
  • tremor or twitching
  • stiff muscles
  • loss of coordination
  • nausea or vomiting
  • agitation
  • hallucinations (seeing or hearing things that are not real)
  • seizures
  • coma

If you experience diarrhea along with any of these symptoms, contact your doctor immediately. They can recommend whether medical attention is necessary.

You might experience constipation while using Pristiq, a medication often prescribed for depression. This side effect was observed in various short-term clinical trials of the drug. The percentage of individuals experiencing constipation while taking daily doses of Pristiq for 8 weeks were:

  • 9% for individuals taking 50 mg or 100 mg of Pristiq
  • 10% for those taking 200 mg of Pristiq
  • 14% for individuals taking 400 mg of Pristiq
  • 4% for individuals on a placebo (treatment without an active drug)

To alleviate constipation when on Pristiq, maintain proper hydration by drinking plenty of water and include foods high in fiber in your diet. Regular exercise, such as taking a walk, can also aid in relaxation and relief of constipation. Plus, physical activity has been found to improve mood and reduce symptoms of depression.

If your constipation persists, consult your doctor for potential remedies.

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Another potential side effect of Pristiq is hair loss. According to clinical trials, less than 2% of individuals using Pristiq reported hair loss.

If hair loss becomes a concern, reach out to your doctor. They may conduct tests to determine the cause of your hair loss and recommend appropriate measures to cope with this side effect.

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There is a higher risk of suicidal thoughts and behaviors in children and young adults (below 25 years old) while they're taking antidepressants, including Pristiq.

Pristiq includes a boxed warning, the FDA's most serious warning, for this side effect. This warning alerts doctors and patients to potential harmful drug effects.

Clinical studies revealed that the risk of suicidal thoughts is higher in children, adolescents, and young adults. This risk is highest during the initial stages of treatment and following any changes in dosage. Pristiq is not approved for use in children (below 18 years old).

While taking Pristiq, contact your doctor immediately if you:

  • experience worsening depression symptoms
  • have suicidal thoughts or feelings of self-harm
  • make an attempt to harm yourself or commit suicide
  • have sudden changes in mood, feelings, thoughts, or behavior, such as:
    • new or worsening anxiety or panic attacks
    • extreme irritability, aggression, or agitation
    • difficulty sleeping or changes in appetite
    • symptoms of mania, including excessive energy and rapid speech

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Suicide prevention

If you or someone you know is in immediate danger of self-harm, suicide, or harming others:

  • Ask the vital question: Are you considering suicide?
  • Give support and listen without judgment.
  • Contact 911 or the local emergency number or text "TALK" to 741741 to talk with a trained crisis counselor.
  • Stay with the individual until professional help arrives.
  • Safely remove any harmful objects, such as weapons or medications if it's safe.

If you or someone you know is experiencing thoughts of suicide, contact a prevention hotline for help. The 988 Suicide and Crisis Lifeline is available 24/7 at 988. During a crisis, deaf or hard-of-hearing individuals can use their preferred relay service or call 711 then 988.

Pristiq uses

Prescription drugs like Pristiq are approved by the Food and Drug Administration (FDA) to treat specific conditions. Pristiq might also be utilized off-label for various other conditions. Off-label use refers to administering a drug with FDA approval for one condition to treat another condition.

Pristiq for major depressive disorder

Pristiq is FDA-approved to treat major depressive disorder (MDD) in adults. MDD is another term for clinical depression, often simply called "depression."

MDD is a serious mental health disorder characterized by persistent feelings of sadness and hopelessness over an extended period. Symptoms include anxiety, irritability, fatigue, and loss of energy. Affecting both emotions and physical well-being, these symptoms can significantly impact daily life.

Efficacy for major depressive disorder

Pristiq has been proven effective in treating depression in various clinical trials. Measuring the severity of symptoms using the Hamilton Rating Scale for Depression (HAM-D) scale, research found improved scores in four studies comparing Pristiq to a placebo (a treatment without an active drug).

Before treatment, average depression scores ranged from 22.9 to 25.2 for all four studies. After 8 weeks of Pristiq treatment (from 50 mg to 400 mg per day), subjects saw an improvement in their depression scores, which were lowered on average by up to 3.3 points.

Longer-term studies lasting up to 26 weeks also revealed that Pristiq users were less likely to experience a depression relapse compared to those on a placebo.

Pristiq for Off-Label Uses

Beyond its approved use, Pristiq might be utilized in an unconventional manner. This practice, known as off-label drug use, involves administering a medication that's been authorized for one purpose for another that hasn't been endorsed. You might ponder if Pristiq is utilized for specific other conditions.

Pristiq for Menopausal Symptoms (Off-Label Use)

Pristiq isn't authorized to manage menopausal symptoms, but it's occasionally employed off-label to lessen severe hot flashes during menopause.

Research has shown that Pristiq can decrease the frequency and severity of hot flashes. One investigation assessed individuals taking desvenlafaxine (the active ingredient in Pristiq). These participants experienced a reduction of 55% to 69% in hot flashes during treatment compared to preceding treatment.

If you're intrigued by using Pristiq to alleviate menopausal symptoms, consult your healthcare provider. They can discuss all available options and recommend the safest choices for you.

Pristiq for Anxiety and Social Anxiety Disorder (Possible Off-Label Use)

Pristiq isn't approved to address anxiety or social anxiety disorder.

One review analyzed the impact of desvenlafaxine (the active substance in Pristiq) on anxiety symptoms in people with major depressive disorder. The review discovered that desvenlafaxine significantly improved anxiety symptoms in people with depression compared to a placebo (treatment with no active drug). However, this doesn't guarantee that Pristiq will be effective for treating anxiety unrelated to depression.

One small 12-week study specifically examined the use of Pristiq to manage social anxiety disorder. The study concluded that Pristiq was more effective than a placebo in reducing anxiety. However, the study was limited, involving only 63 participants. Larger studies are required to determine if Pristiq would be effective in treating social anxiety disorder.

Several other antidepressants, such as venlafaxine (Effexor XR), are approved to manage anxiety. Venlafaxine is similar to desvenlafaxine (the active ingredient in Pristiq). It's approved to treat generalized anxiety disorder, social anxiety disorder, and panic disorder.

Pristiq isn't usually utilized to treat anxiety disorders. This is because more evidence is needed to establish its effectiveness for these conditions.

If you're interested in using Pristiq to treat anxiety, consult your healthcare provider. They can recommend safe and effective treatment options for your anxiety.

Pristiq for OCD (Possible Off-Label Use)

Pristiq isn't approved to manage obsessive-compulsive disorder (OCD). There's no data to prove its efficacy for this condition.

Some other antidepressants are authorized to treat OCD. With this disorder, you may have repetitive thoughts causing anxiety, as well as compulsive actions to alleviate these thoughts and anxieties.

If you're interested in using Pristiq to manage OCD, consult your healthcare provider. They can recommend safe and effective treatment options for your condition.

Pristiq for Bipolar Disorder (Possible Off-Label Use)

Pristiq isn't approved to manage depression related to bipolar disorder.

Bipolar disorder is a mental health disorder characterized by episodes of severe depression and episodes of mania or hypomania, resulting in unstable moods over extended periods.

Antidepressants may be used to manage depression related to bipolar disorder, but they're usually prescribed in conjunction with a mood stabilizer. Otherwise, the use of antidepressants alone may trigger a manic episode.

Before receiving Pristiq for depression, your healthcare provider will examine to ensure that you don't have bipolar disorder. If you have bipolar disorder, they may recommend alternative medications for you to take with Pristiq.

Pristiq for Pain (Possible Off-Label Use)

Pristiq isn't approved to manage any type of pain. However, certain other antidepressants are authorized to treat specific pain conditions, such as nerve pain and fibromyalgia. Individuals with fibromyalgia often experience prolonged muscle and bone pain.

One study examined people with diabetic neuropathy, a painful condition resulting from nerve damage in people with diabetes. The study discovered that Pristiq (at dosages of 200 mg or 400 mg daily) was more effective than a placebo in relieving pain.

The results of two other studies on people with fibromyalgia showed that Pristiq was not effective in alleviating their pain.

If you're interested in using Pristiq to manage pain, consult your healthcare provider. They can recommend safe and effective treatment options for your condition.

Pristiq Dosage

The dose of Pristiq prescribed by your healthcare provider might vary depending on numerous factors, such as kidney and liver function.

The following information provides common doses and recommendations. Remember to take the dose your healthcare provider prescribes for you. They will determine the optimal dose for your specific needs.

Drug Forms and Strengths

Pristiq is available in extended-release tablet form. It's available in three strengths: 25 mg, 50 mg, and 100 mg.

The suggested initial intake of DES venlafaxine is 50 mg, consumed orally once per day.

It's advisable to take your medication at a consistent time each day. Continue this 50 mg dosage as instructed by your healthcare provider.

The maximum daily intake of DES venlafaxine is 400 mg. However, higher than 50 mg daily doses haven't proven to be more effective and are more likely to induce side effects.

What if I skip a dose?

If you unintentionally miss a DES venlafaxine dose, administer it as soon as you recall. However, if your next dose is imminent, just disregard the missed dose. Then, take your next dose as scheduled.

Never consume more than one dose of DES venlafaxine to compensate for a missed dose. This practice can enhance your risk of certain side effects.

To prevent forgetting doses, try setting reminders on your phone or using a medication timer.

Is long-term usage necessary?

DES venlafaxine is intended for long-term use. According to clinical guidelines for depression treatment, it's important to continue taking your antidepressant for 4 to 9 months after your depression symptoms improve. Long-term use helps decrease the likelihood of depression relapsing.

Individuals with a history of multiple depression episodes or a family history of mental health concerns may be more prone to depression returning after stopping antidepressants. In such cases, it's recommended to continue antidepressant treatment for a longer period.

If your doctor and you agree that DES venlafaxine is safe and effective for your depression, long-term use may be considered.

Withdrawing from DES venlafaxine

Abruptly stopping DES venlafaxine can lead to withdrawal symptoms. To avoid this, don't discontinue the medication suddenly. Instead, your healthcare provider may recommend a gradual reduction in dosage over several months.

Symptoms that might occur if you suddenly stop taking DES venlafaxine include:

  • nausea
  • sweating
  • dizziness
  • headache
  • feeling irritable or agitated
  • anxiety
  • confusion
  • diarrhea
  • pins and needles or electric shock sensations
  • tinnitus (ringing or other noises in your ears)
  • insomnia
  • abnormal dreams
  • tremor
  • seizures
  • changes in your mood
  • low energy

In some instances, DES venlafaxine withdrawal symptoms can be severe. Certain severe symptoms, like suicidal thoughts and behaviors, have been reported in individuals stopping DES venlafaxine. These reports emerged after the drug was authorized for use.

If you and your doctor decide to discontinue DES venlafaxine, a gradual reduction in dose is recommended. This will help you avoid withdrawal symptoms.

Your healthcare provider will guide you through the process of gradually reducing your dose if they recommend discontinuing treatment.

DES venlafaxine and alcohol

Avoid consuming alcohol while taking DES venlafaxine. Alcohol can increase your risk for experiencing side effects from the medication, such as drowsiness and dizziness. It can also worsen your depression symptoms. If you drink alcohol, discuss your consumption with your doctor to determine whether it's safe for you while taking DES venlafaxine.

Alternatives to DES venlafaxine

Other medications are available for treating major depressive disorder. Your healthcare provider can help you determine if an alternative may be more suitable for you.

DES venlafaxine belongs to a class of antidepressants called serotonin-norepinephrine reuptake inhibitors (SNRIs). Other SNRIs and medications from other classes are also used to treat depression.

If you're interested in exploring alternative treatments, consult with your healthcare provider about other medication options.

Examples of other antidepressant drugs used to treat major depressive disorder include:

Different serotonin-norepinephrine reuptake inhibitors (SNRIs) include: + duloxetine (Cymbalta) - a class this medication falls under + venlafaxine* (Effexor XR) - another SNRI in the mix + levomilnacipran (Fetzima)

Alternatively, selective serotonin reuptake inhibitors (SSRIs) consist of: + citalopram (Celexa) + escitalopram (Lexapro) + fluoxetine (Prozac, Sarafem, Selfemra) + paroxetine (Paxil, Brisdelle, Pexeva) + sertraline (Zoloft) - previously mentioned SNRI is also an SSRI

Tricyclic antidepressants (TCAs) encompass: + amitriptyline + clomipramine (Anafranil) + desipramine (Norpramin) + doxepin (Sinequan) + imipramine (Tofranil) + nortriptyline (Pamelor) + protriptyline (Vivactil) + trimipramine (Surmontil)

Monamine oxidase inhibitors (MAOIs) include: + phenelzine (Nardil) + isocarboxazid (Marplan) + tranylcypromine (Parnate) + selegiline (Emsam)

Additional antidepressants comprise: + bupropion (Wellbutrin, Forfivo, Aplenzin) + mirtazapine (Remeron) + vilazodone (Viibryd) + vortioxetine (Trintellix) + maprotiline + nefazodone + trazodone (Oleptro)

Pristiq vs. Venlafaxine (Effexor XR)

Users may be curious about how Pristiq stacks up against Venlafaxine, which is commonly prescribed for similar purposes. Below, you'll find an analysis of their similarities and differences.

Overview

Pristiq is comprised of desvenlafaxine, whereas Venlafaxine belongs to the category of drugs referred to as serotonin-norepinephrine reuptake inhibitors (SNRIs), as does Pristiq.

Usage

Both Pristiq and Venlafaxine are utilized in the treatment of major depressive disorder (MDD) for adults. MDD is often referred to simply as depression.

Furthermore, Venlafaxine is approved for minor conditions in adults such as:

  • social anxiety disorder
  • post-traumatic stress disorder
  • panic disorder
  • premenstrual dysphoric disorder

On top of that, Venlafaxine may be prescribed for obsessive-compulsive disorder in adults and children aged 7 years and over.

Forms and administration

Pristiq comes in the form of extended-release tablets, available in three strengths: 25 milligrams (mg), 50 mg, and 100 mg. Pristiq should be swallowed whole, either with or without food, once daily.

In contrast, Venlafaxine is provided as tablets with three different strengths: 25 mg, 50 mg, and 100 mg. Additionally, Venlafaxine is available as an oral solution, which must be diluted with 4 ounces (oz) of liquid before consumption. Options for mixing the solution include water, ginger ale, lemonade, orange juice, or lemon-lime soda. For more detailed instructions on consuming the oral solution form of Venlafaxine, consult your doctor or pharmacist.

Venlafaxine should be taken once daily, regardless of whether it's consumed with or without food.

Side effects and risks

While Pristiq and Venlafaxine share certain side effects, there are also distinct differences.

Both drugs carry the potential risk of suicidal thoughts. This is considered a serious warning from the Food and Drug Administration (FDA), as it highlights harmful drug impacts.

It's important to note that individuals with a higher risk of suicidal thoughts may be affected while taking antidepressants. Children, adolescents, and young adults (under 25 years of age) are at a higher risk. Keep in mind that Pristiq is only intended for use in adults, whereas Venlafaxine is authorized for certain applications in children.

To learn more about the potential side effects of Pristiq, consult the "Pristiq side effects" section earlier in the text. For information regarding Venlafaxine's side effects, refer to the drug's prescribing information.

Effectiveness

Although Pristiq and Venlafaxine are authorized for different purposes, they are both employed to treat MDD.

Both medications are recommended as MDD treatment options in guidelines by the American Psychiatric Association.

Costs

Pristiq and Venlafaxine are both brand-name medications. Generics of both drugs are also available. Brand-name medications generally cost more than generics.

The actual price you'll pay for either drug depends on your insurance plan, location, and the chosen pharmacy.

Pristiq is a medication that incorporates desvenlafaxine, while Effexor XR contains the equivalent substance, venlafaxine. Both drugs are classified under the antidepressant category known as serotonin-norepinephrine reuptake inhibitors (SNRIs). The SNRI classification indicates that these medications function in a similar manner within the body.

Desvenlafaxine and venlafaxine share a close relationship. Venlafaxine (featured in Effexor XR) undergoes metabolization through the liver, resulting in a byproduct called desvenlafaxine (the main ingredient in Pristiq). In most instances, the antidepressant impact induced by venlafaxine is primarily attributed to desvenlafaxine.

Therapeutic Applications

Both Pristiq and Effexor XR are authorized for the treatment of major depressive disorder (MDD) in adults. MDD is often referred to simply as depression.

Effexor XR is additionally approved for the management of:

  • generalized anxiety disorder
  • social anxiety disorder
  • panic disorder

Medication Forms and Administration

Pristiq is available in the form of extended-release tablets, available in strengths of 25 mg, 50 mg, and 100 mg. The recommended intake frequency for Pristiq is once daily, and it can be consumed with or without meals.

Effexor XR is dispensed as extended-release capsules, and is available in strengths of 37.5 mg, 75 mg, and 150 mg. Effexor XR should be ingested once daily, either as a whole capsule taken orally, or by opening the capsule and sprinkling its contents onto a spoonful of applesauce. The mixture should then be consumed without chewing, followed by a glass of water to facilitate complete ingestion.

Adverse Effects and Risks

Both Pristiq and Effexor XR have the potential to induce similar side effects due to their shared properties. Below are examples of potential side effects associated with these medications.

Common Adverse Effects

This list encompasses examples of the more prevalent side effects that can occur with either Pristiq or Effexor XR, when isolated for treatment:

  • nausea
  • vomiting
  • drowsiness
  • insomnia
  • strange dreams
  • sexual dysfunction
  • decreased appetite
  • constipation
  • dizziness
  • perspiration
  • anxiety
  • dry mouth
  • yawning
  • tremors
  • tachycardia (rapid heart rate)

Severe Adverse Effects

This list includes examples of serious side effects that can manifest with either Pristiq or Effexor XR, when administered independently:

  • suicidal thoughts and behaviors in young adults or children
  • serotonin syndrome (a potentially dangerous condition resulting from the accumulation of serotonin in the body)
  • increased risk of high blood pressure
  • excess bleeding
  • angle-closure glaucoma
  • low sodium levels within the bloodstream
  • lung issues
  • seizures
  • severe allergic responses

Effectiveness

Both Pristiq and Effexor XR are authorized for the treatment of major depressive disorder, although they may have variations in their prescribed applications.

One study found that, on the whole, both medicines exhibited comparable effectiveness in the treatment of depression. Both medications are exalted as MDD treatment alternatives in guidelines produced by the American Psychiatric Association.

Financial Considerations

Both Pristiq and Effexor XR are brand-named drugs with associated high costs. Generics of both drugs are also available, which usually carry lower prices. The actual cost you will pay for either medication will vary depending upon your insurance policy, location, and the pharmacy you choose to use.

Comparison of Pristiq and Cymbalta

You may be curious as to how Pristiq compares to other medications that are utilized in similar therapeutic applications. In this section, we will examine both Pristiq and Cymbalta, scrutinizing their similarities and differences.

Background

Pristiq contains desvenlafaxine, while Cymbalta incorporates duloxetine. Both medications are classified as serotonin-norepinephrine reuptake inhibitors (SNRIs).

Therapeutic Applications

Both Pristiq and Cymbalta are authorized for the treatment of major depressive disorder (MDD) in adults. MDD is frequently termed simply as depression.

Cymbalta is also authorized for the management of:

  • generalized anxiety disorder
  • diabetic peripheral neuropathy (painful nerve damage associated with diabetes)
  • fibromyalgia (a chronic condition involving pain in muscles and bones, alongside fatigue)
  • chronic musculoskeletal pain (persistent pain in muscles and bones)

This list outlines some of the more common side effects that may occur when taking Pristiq or Cymbalta individually:

  • upset stomach
  • nervousness
  • dry mouth
  • tiredness
  • drowsiness
  • difficulty sleeping
  • constipation
  • decreased appetite
  • lightheadedness
  • sweating
  • sexual dysfunction

Severe side effects

The lists below detail some of the more serious side effects that can occur with Pristiq, Cymbalta, or both medications when taken individually:

  • Pristiq-related side effects include:
    • lung complications
  • Cymbalta-related side effects include:
    • liver issues, such as liver failure
    • low blood pressure when standing up (known as orthostatic hypotension)
    • severe skin reactions
    • urinary retention (difficulty urinating or being unable to urinate)
  • Both Pristiq and Cymbalta can cause:
    • suicidal thoughts and behaviors in children and young adults
    • serotonin syndrome (a harmful condition triggered by an excessive buildup of serotonin in the body)
    • increased blood pressure
    • increased bleeding risks
    • angle-closure glaucoma
    • low sodium levels
    • seizures
    • severe allergic reactions

Efficacy

Both Pristiq and Cymbalta are FDA-approved for the treatment of major depressive disorder (MDD).

While there haven't been any direct comparisons of Pristiq and Cymbalta in clinical studies, separate studies have found both medications to be effective for managing depression. The American Psychiatric Association recommends both Pristiq and Cymbalta as potential treatment options for MDD.

Cost

Both Pristiq and Cymbalta are brand-name medications, and generic alternatives are available for both. Brand-name drugs usually cost more than their generic equivalents.

The actual cost of either medication will depend on your insurance plan, location, and the pharmacy you utilize.

Pristiq overdose

Overdosing on Pristiq can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose may include:

  • rapid heartbeat
  • large pupils
  • vomiting
  • excessive drowsiness
  • seizures
  • irregular heartbeat
  • low blood pressure
  • dizziness
  • muscle pain and stiffness
  • unconsciousness

What to do in case of overdose

If you believe you have consumed an excessive amount of Pristiq, contact your doctor immediately. Additionally, you can contact the American Association of Poison Control Centers at 800-222-1222 or utilize their online tool. However, if your symptoms are severe, contact 911 or visit the nearest emergency room immediately.

Pristiq interactions

Pristiq can interact with several other medications and specific supplements. Interactions can lead to various effects, such as reducing the drug's effectiveness or intensifying side effects.

Pristiq and other medications

Below are lists of medications that can interact with Pristiq. These lists do not include all the drugs that can interact with Pristiq.

Before starting Pristiq, discuss your medication and supplement use with your doctor and pharmacist. Informing them of your drug and supplement regimen can help reduce the risk of potential interactions.

If you have questions about potential drug interactions, consult your doctor or pharmacist. More information on Pristiq's possible interactions can be found in this article.

Pristiq and linezolid or methylene blue

Avoid taking Pristiq while undergoing treatment with linezolid (Zyvox) or methylene blue (Provayblue). Co-administering Pristiq with these medications increases the risk of serotonin syndrome, a harmful condition resulting from excessive serotonin levels in the body.

Pristiq, linezolid, and methylene blue can all raise serotonin levels. When these drugs are taken together, serotonin levels may be raised even further.

If you require linezolid or methylene blue treatment, you must first discontinue taking Pristiq. Your doctor will closely monitor you for signs of serotonin syndrome. You can resume Pristiq use 24 hours after stopping linezolid or methylene blue.

Pristiq and MAOI antidepressants

Taking Pristiq with an MAOI antidepressant increases the risk of serotonin syndrome. This is a dangerous condition caused by high serotonin levels in the body.

MAOIs are a classification of antidepressants. MAOIs and Pristiq both boost serotonin levels in the body.

Avoid taking Pristiq if you have recently used an MAOI. Wait at least 7 days after stopping Pristiq before beginning MAOI treatment.

Examples of MAOI antidepressants that should not be taken with Pristiq include:

  • phenelzine (Nardil)
  • isocarboxazid (Marplan)
  • tranylcypromine (Parnate)
  • selegiline (Emsam)

Using Pristiq with certain other depression medications can boost your chances of experiencing serotonin syndrome. This is a harmful situation caused by an excess of a brain chemical called serotonin in your body. Pristiq and these other medications all work by amplifying your serotonin levels.

Some examples of other depression medications that could increase your risk of serotonin syndrome when taken with Pristiq are:

  • Selective Serotonin Reuptake Inhibitors (SSRIs), such as:
    • Fluoxetine (Prozac)
    • Paroxetine (Paxil, Pexeva, Brisdelle)
    • Sertraline (Zoloft)
  • Other Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) apart from Pristiq, such as:
    • Duloxetine (Cymbalta)
    • Venlafaxine (Effexor XR)
  • Tricyclic Antidepressants, such as:
    • Amitriptyline
    • Desipramine (Norpramin)
    • Imipramine (Tofranil)

Taking SSRIs or other SNRIs with Pristiq also increases your risk of bleeding problems.

It's crucial to discuss the medications you're taking with your doctor in relation to Pristiq. Your doctor can help ensure the drugs you're taking are safe to use together.

Pristiq and lithium

Taking Pristiq with lithium (Lithobid) can boost your risk of serotonin syndrome. This is a dangerous condition that results when levels of a brain chemical called serotonin get too high in your body. Pristiq and lithium both ramp up your serotonin levels.

If you're taking lithium, talk with your doctor before starting Pristiq. They may recommend different treatment options for you.

Pristiq and buspirone

Taking Pristiq with buspirone can boost your risk of serotonin syndrome. This is a dangerous condition caused by high levels of a brain chemical called serotonin in your body. Both Pristiq and buspirone can elevate your serotonin levels.

If you're taking buspirone for anxiety, talk with your doctor before starting Pristiq. They may recommend a different drug to treat your anxiety.

Pristiq and certain drugs for migraine

Taking triptan medications with Pristiq could boost your risk of a serious side effect called serotonin syndrome. This is a dangerous condition that occurs when levels of a brain chemical called serotonin get too high in your body. Triptan medications and Pristiq both elevate your serotonin levels.

Triptan medications are used to treat migraine and cluster headaches. Examples of triptan medications that increase your risk for serotonin syndrome if taken with Pristiq include:

  • Almotriptan (Axert)
  • Eletriptan (Relpax)
  • Frovatriptan (Frova)
  • Naratriptan (Amerge)
  • Rizatriptan (Maxalt)
  • Sumatriptan (Imitrex)
  • Zolmitriptan (Zomig)

If you’re taking a triptan medication, talk with your doctor before starting Pristiq. They may recommend a different drug to treat your headaches.

Pristiq and certain pain medications

Taking tramadol (ConZip, Ultram) or fentanyl (Duragesic, Subsys, Actiq, others) with Pristiq increases your risk of a serious side effect called serotonin syndrome. This is a dangerous condition that results when levels of a brain chemical called serotonin get too high in your body. Pristiq, fentanyl, and tramadol can all boost your serotonin levels.

Tramadol and fentanyl are used to treat pain. If you’re taking tramadol or fentanyl, talk with your doctor before starting Pristiq. They may switch you to a different medication to treat your pain.

Pristiq and Adderall or other amphetamines

Taking amphetamine drugs, including Adderall, with Pristiq increases your risk of a serious side effect called serotonin syndrome. This is a dangerous condition that occurs when levels of a brain chemical called serotonin get too high in your body. Both amphetamines and Pristiq can boost your serotonin levels.

Examples of amphetamine drugs that increase your risk of serotonin syndrome if taken with Pristiq include:

  • Amphetamine (Evekeo, Adzenys, Dynavel)
  • Amphetamine and dextroamphetamine (Adderall, Mydayis)
  • Dextroamphetamine (Dexedrine)
  • Methamphetamine (Desoxyn)

If you’re taking an amphetamine drug, talk with your doctor before starting Pristiq. They may recommend a different medication while you’re taking Pristiq.

Pristiq and anti-inflammatory drugs

Taking a nonsteroidal anti-inflammatory drug (NSAID) with Pristiq can increase your risk of bleeding problems. Taking these drugs together particularly increases your risk of bleeding in your stomach and intestines.

Examples of NSAIDs that increase your risk of bleeding if taken with Pristiq include:

  • Aspirin
  • Ibuprofen (Advil, Ibu-tab, Motrin)
  • Ketoprofen
  • Diclofenac (Zorvolex, Zipsor)
  • Naproxen (Aleve, Naprosyn)

If you’re taking an NSAID, talk with your doctor before starting Pristiq. They may recommend different treatment options for you.

If you do happen to take an NSAID with Pristiq, make sure to inform your healthcare provider promptly if you observe any unusual bleeding or bruising. It is advisable to contact your healthcare provider with immediacy if you notice any blood in your vomit or stool.

Interactions between Pristiq and blood-thinning drugs

Blood-thinning medications are used to treat or prevent blood clots. Concurrent usage of Pristiq with such drugs can increase the likelihood of bleeding complications.

Some examples of blood-thinning drugs that may increase the risk of bleeding when used together with Pristiq include:

  • Apixaban (Eliquis)
  • Dabigatran (Pradaxa)
  • Edoxaban (Savaysa)
  • Rivaroxaban (Xarelto)
  • Warfarin (Coumadin)

If you are utilizing a blood-thinning drug, it is prudent to consult with your healthcare provider prior to initiating Pristiq usage. Additional monitoring for abnormal bleeding may be required when both medications are taken simultaneously. Promptly notify your healthcare provider of any unusual bleeding or bruising encountered during the course of therapy.

Interactions between Pristiq and diuretics

Concurrent use of a diuretic medication with Pristiq may increase the risk of hyponatremia (low sodium levels in your blood).

Diuretic medications aid in the excretion of excess fluid from the body. These drugs may occasionally result in a decrease in sodium levels. Pristiq may have a similar effect on sodium levels in your body.

Examples of diuretic medications that may increase the risk of hyponatremia include:

  • Bendroflumethiazide (Naturetin)
  • Furosemide (Lasix)
  • Hydrochlorothiazide

If you are taking a diuretic medication, it is advisable to consult with your healthcare provider before commencing Pristiq therapy. Regular blood tests may be necessary to monitor your sodium levels. Furthermore, it is essential to inform your healthcare provider of any symptoms associated with low blood sodium levels.

Symptoms of hyponatremia may include:

  • Headache
  • Difficulty concentrating
  • Memory problems
  • Confusion
  • Feeling weak or unsteady on your feet

Interactions between Pristiq and herbs and supplements

Certain herbs and supplements may interact with Pristiq. It is crucial to discuss any herbs or supplements you are currently taking with your healthcare provider or pharmacist before using Pristiq.

Interactions between Pristiq and St. John’s wort

You should avoid the use of St. John’s wort (Hypericum perforatum) in conjunction with Pristiq. Co-administration of this herb with Pristiq raises the risk of a serious adverse reaction called serotonin syndrome.

Serotonin syndrome is a potentially dangerous condition that can develop if serotonin levels in the brain become excessively high. Both St. John's wort and Pristiq can increase serotonin levels in the body.

Interactions between Pristiq and tryptophan

Avoid taking tryptophan supplements concurrently with Pristiq as this combination increases the risk of serotonin syndrome. Serotonin syndrome is a potentially dangerous situation that can arise if serotonin levels in the brain become excessively elevated. Both tryptophan and Pristiq can boost serotonin levels in the body.

Frequently Asked Questions (FAQs) about Pristiq

Here are responses to some frequently asked questions about Pristiq.

Will I feel ‘high’ if I take Pristiq?

No, taking Pristiq will not make you instantly feel euphoric or experience a "high." This medication works gradually to rectify the chemical imbalances in your brain that are responsible for your depression. With continued usage, Pristiq helps alleviate your depression symptoms over time, allowing you to regain your normal state of mind.

Is Pristiq a controlled substance?

No, Pristiq is not a controlled substance. Controlled substances are medications that are both prescribed and dispensed under federal regulations. These guidelines help ensure that specific medications are administered safely to individuals, as they have the potential for misuse.

Pristiq belongs to a class of antidepressants called serotonin-norepinephrine reuptake inhibitors (SNRIs). Antidepressants are unlikely to be misused, so they are not classified as controlled substances.

Can I take Xanax for anxiety if I’m taking Pristiq?

Yes, you can take Xanax (alprazolam) to manage anxiety while concurrently using Pristiq, provided your doctor recommends it. However, if you find that Pristiq makes you drowsy, taking Xanax may exacerbate this effect. It is unsafe to operate vehicles or machinery until you are familiar with the effects of the combined medications.

I’ve noticed what seems like a pill in my stool. Does this mean I didn’t get my full dose of Pristiq?

Observing what appears to be a pill in your stool does not necessarily indicate that you did not receive your full dose of Pristiq. The shell (outer covering) of Pristiq tablets can pass through your digestive system without being absorbed (digested). This is a typical occurrence, and you can rest assured that your body has obtained the complete Pristiq dose.

Research indicates that women taking venlafaxine during pregnancy might have an enhanced risk of developing preeclampsia, a condition characterized by the onset of high blood pressure during or shortly after pregnancy. Women using venlafaxine around delivery may also experience an increased risk of bleeding during childbirth or postpartum.

Furthermore, studies have revealed that babies born to individuals consuming venlafaxine or Pristiq may face certain complications at birth, including issues with breathing, feeding, maintaining body temperature, and regulating blood sugar.

Nonetheless, it's essential to remember that unaddressed depression during pregnancy can bring about serious consequences for both the pregnant individual and the infant.

If you're expecting or planning to become pregnant, engaging in a conversation with your doctor about the potential risks and benefits of taking Pristiq during pregnancy is recommended.

Actions to take

In the event that you become pregnant while using Pristiq, notifying your doctor as soon as possible is crucial. Abruptly stopping the use of Pristiq can trigger withdrawal symptoms (refer to the section "Pristiq withdrawal" above).

If you decide to utilize Pristiq during pregnancy, it's vital to discuss participating in the pregnancy exposure registry with your physician. This registry monitors pregnant individuals taking antidepressants and their offspring, aiding in the identification of potential effects associated with antidepressant use during pregnancy.

For more information about this registry, contact your doctor or call 844-405-6185.

Pristiq and birth control

At this time, it's unknown whether Pristiq is safe to use during pregnancy. In the event that you're sexually active and your partner or you have the potential to conceive, consulting with your doctor regarding your birth control needs while utilizing Pristiq is advisable.

Pristiq and breastfeeding

Studies have suggested that trace amounts of Pristiq may pass into breast milk. A small study did not uncover any adverse effects in babies breastfed by individuals consuming Pristiq. However, more substantial studies are required to establish whether it's safe to utilize Pristiq during breastfeeding.

Little is known about how Pristiq may impact babies breastfed by their mothers. Consult with your doctor to discern the most suitable method of nourishing your infant while you're utilizing Pristiq.

Pristiq cost

The expense of Pristiq may vary, depending on factors such as insurance coverage, the location, and the pharmacy you select.

Financing and insurance assistance

If you require financial aid to pay for Pristiq or require assistance in comprehending your insurance coverage, assistance is available.

Pfizer Inc., the manufacturer of Pristiq, provides a savings card that might help decrease the cost of Pristiq. For more information and to determine if you're eligible for support, contact 855-440-6852 or visit the program website.

Pfizer also offers a program called Pfizer RxPathways, which can help you grasp your insurance coverage of the drug and provide additional information on financial assistance. You can learn more by visiting the program website or calling 844-989-PATH (844-989-7284).

Pristiq dosage

Take Pristiq according to your doctor's or another healthcare professional's instructions.

Timing

You should take Pristiq once each day. You can consume it at any time of the day, yet try to adhere to the same time each day.

To assist in ensuring that you don't propagate a missed dose, try setting a reminder on your phone. A medication timer may be beneficial, as well.

Consuming Pristiq with food

You can take Pristiq with or without food.

Can Pristiq be crushed, split, or chewed?

No. You should swallow Pristiq tablets whole with some liquid. Don't crush, break, chew, or dissolve the tablets.

Pristiq is an extended-release tablet. It's engineered to release the medication gradually as the tablet travels through your system. If you damage the tablet by crushing, splitting, dissolving, or chewing it, you'll prevent the extended-release mechanism from functioning correctly.

Pristiq mechanism

Pristiq is approved for treating major depressive disorder (MDD) in adults. This condition is also known as depression.

What depression accomplishes

When you have depression, the levels of specific chemicals within your brain have become imbalanced. These chemicals are termed neurotransmitters. They encompass serotonin and norepinephrine.

Neurotransmitters aid in passing messages between the nerve cells in your brain. Serotonin and norepinephrine are involved in passing messages that help regulate your mood and behavior. With depression, the nerve cells in your brain release less serotonin and norepinephrine than typical.

What Pristiq accomplishes

Pristiq belongs to a class of antidepressants called serotonin-norepinephrine reuptake inhibitors (SNRIs). A class of medications is a group of drugs that work in a similar manner. SNRIs function by increasing the levels of serotonin and norepinephrine in your brain. Over time, this can enhance your symptoms of depression.

Pristiq is not intended to change your personality or induce instant happiness. Instead, it's meant to work gradually to correct the chemical imbalances that contribute to your depression symptoms.

It typically takes between 2 to 4 weeks for Pristiq to show its effects and improve your well-being, focusing on issues related to appetite, sleep patterns, and concentration before you notice a shift in your mood.

It's crucial to keep adhering to your Pristiq regimen, even if you feel it's not showing significant improvements initially. Generally, it takes several months for the treatment to demonstrably improve your depression symptoms.

Regular doctor visits are essential, particularly when you've just started using Pristiq. Should you feel your depression worsens while on Pristiq, communicate this with your physician immediately. Inform them promptly if you detect any disruptive alterations in your mental state, feelings, or behavior after ingesting the drug.

Important precautions when using Pristiq

Considering various precautions before commencing Pristiq usage is essential.

FDA caution: Suicidal thoughts and behaviors

A significant caution from the Food and Drug Administration (FDA) is associated with this drug. This is the strongest warning issued by the FDA, called a "boxed warning," which highlights potential drug consequences posing harm to users.

Antidepressants such as Pristiq enhance the possibility of suicidal thoughts and actions in certain young adults under 25 years old. This risk is heightened during the initial stages of antidepressant use and after dose modifications. Pristiq is not recommended for use in individuals under 18 years of age.

While on Pristiq, contact your doctor immediately if:

  • Your depression symptoms worsen
  • There are sudden changes in your mood, feelings, thoughts, or behaviors
  • You experience suicidal thoughts
  • You attempt harming yourself or contemplate suicide

Additional precautions

Before beginning Pristiq treatment, discuss any health concerns with your doctor. Pristiq may not be suitable for you if you have specific medical conditions or other factors affecting your health condition. These include:

  • A sensitivity to venlafaxine (Effexor) or desvenlafaxine. Steer clear of Pristiq if you're sensitive to desvenlafaxine (the main component in Pristiq) or venlafaxine (a drug similar to Pristiq). Discuss any medication sensitivities with your doctor before starting Pristiq.
  • High blood pressure. Pristiq may boost your blood pressure. If you have elevated blood pressure, you might need medication to manage it prior to taking Pristiq. Your doctor will constantly monitor your blood pressure while you're on Pristiq. If your blood pressure increases, you may require treatment. If your blood pressure remains high despite treatment, your doctor may lower your Pristiq dose or suggest a different antidepressant.
  • Heart disease. Pristiq might raise your blood pressure, potentially worsening any existing heart condition. Your doctor will keep a close eye on your blood pressure during your Pristiq treatment. Discuss any heart or blood pressure issues with your doctor before beginning Pristiq.
  • Stroke or mini-stroke. Pristiq might increase your blood pressure, potentially boosting your risk of having a stroke if you've had one before. Inform your doctor if you have a history of stroke or blood pressure issues. Your doctor will monitor your blood pressure regularly while you're on Pristiq.
  • Bipolar disorder (manic depression), mania, or hypomania. If you or someone close to you has had these mental health issues, Pristiq might not be suitable for you. If antidepressants are used alone in people with bipolar disorder, the drugs can increase the risk of a manic episode. Pristiq is not approved for bipolar depression treatment. Before starting Pristiq, discuss any mental health issues with your doctor.
  • Epilepsy or other seizure disorders. Seizures were reported in some people taking Pristiq in clinical trials. Pristiq hasn't been studied in people with epilepsy or a history of seizures. If you have these conditions, your doctor will advise whether Pristiq is safe for you to take. Inform your doctor if you have a history of seizures, or if you have more seizures than usual after starting Pristiq.
  • Bleeding disorders. Pristiq may increase your risk of bleeding. If you have any bleeding issues, your doctor will recommend whether Pristiq is safe for you to use. Discuss any bleeding disorders with your doctor.
  • High cholesterol or triglyceride levels. Pristiq may increase cholesterol or triglyceride levels in some people. If your levels are already high, you may need blood tests during Pristiq treatment to monitor the condition. Discuss any history of high cholesterol or triglycerides with your doctor before you start taking Pristiq.
  • Low sodium levels. Pristiq may reduce sodium levels in some people, particularly older individuals (65 years and older) and people taking diuretics. If your sodium level is already low, taking Pristiq could lower it even further. If this happens, you may need to stop treatment. Discuss your diuretic use or history of low sodium levels with your doctor before starting Pristiq.
  • Kidney problems. If you have kidney issues, your body may not clear Pristiq as effectively as normal. If you have moderate kidney issues, you shouldn't take more than 50 mg of Pristiq per day. If you have severe kidney problems, you shouldn't take more than 25 mg of Pristiq per day, or 50 mg every other day. Discuss any kidney issues with your doctor before starting this medication.
  • Liver problems. If you have liver issues, your body may not clear Pristiq as effectively as normal. If you have moderate to severe liver problems, you shouldn't take more than 100 mg of Pristiq each day. Discuss any liver issues with your doctor before starting this medication.
  • Pregnancy. Discuss the risks and benefits of taking Pristiq during pregnancy with your doctor. For more information, see the "Pristiq and pregnancy" section above.
  • Breastfeeding. Pristiq may pass into breast milk. For more information, see the "Pristiq and breastfeeding" section above.

Note: For more information about the potential side effects of Pristiq, see the "Pristiq side effects" section above.

Pristiq Expiration, Storage, and Disposal

When you obtain Pristiq from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date ensures the medication's effectiveness during this time. The FDA recommends avoiding using expired medications. If you have unused medication that has expired, talk with your pharmacist about whether you might still be able to use it.

The longevity of a medication can be influenced by various factors, among them being how and where you store it.

Pristiq tablets ought to be kept at room temperature, in a secure, airtight container, shielded from light. Pristiq should avoid being stored in places exceeding 86°F (30°C). It's best to steer clear of storing this medication in spaces that might become damp or wet, such as bathrooms.

Disposal

If you no longer need to utilize Pristiq and have remaining medication, it's crucial to dispose of it safely. This aids in preventing accidents, such as children or pets ingesting the drug unintentionally, and protecting the environment from harm.

The FDA offers valuable guidance on drug disposal. Additionally, consult your pharmacist for information on disposing of your unused medication.

Expert Information for Pristiq

The following information is intended for healthcare professionals.

Indications

Pristiq is authorized to treat major depressive disorder in adults.

Mechanism of action

Pristiq comprises desvenlafaxine, the primary metabolite of the antidepressant venlafaxine. Desvenlafaxine functions as a serotonin-norepinephrine reuptake inhibitor (SNRI). The exact mechanism by which the drug operates remains unclear.

Pharmacokinetics and metabolism

Desvenlafaxine's bioavailability is approximately 80% following oral intake of Pristiq. Steady state is achieved within 4 to 5 days if dosed once daily. Desvenlafaxine is 30% bound to plasma proteins.

Desvenlafaxine is primarily excreted from the body unchanged by the kidneys. A small portion of the drug is metabolized by hepatic conjugation and subsequently eliminated through the urine.

Maximum concentration (Cmax) and area under the curve (AUC) of desvenlafaxine increase in individuals with moderate to severe liver and kidney impairment.

Drugs affecting CYP450 enzymes do not significantly impact desvenlafaxine's metabolism. Desvenlafaxine does not inhibit or induce CYP450 enzymes. This drug is neither a substrate nor an inhibitor of P-glycoprotein.

Contraindications

Pristiq is contraindicated in individuals:

  • with an allergy to venlafaxine, desvenlafaxine, or any of Pristiq’s excipients
  • who have taken MAOIs for psychiatric indications within the past 14 days
  • undergoing treatment with linezolid or methylene blue

Storage

Pristiq tablets must be stored at room temperature. Avoid storing them at a temperature higher than 86°F (30°C).

Disclaimer:Medical News Today has taken every precaution to ensure that all information is accurate, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. Always consult your doctor or another healthcare professional before taking any medication. The drug information provided herein is subject to change and is not meant to cover all potential uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The omission of warnings or other details for a specific drug does not imply that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

In some cases, individuals dealing with depression may turn to pharmacy drugs as a form of self-medication. This can sometimes lead to serious mental health consequences, such as an escalation of depression symptoms or the emergence of suicidal thoughts.

It's important to remember that while Pristiq has shown effectiveness in managing depression, it should only be used under the supervision of a healthcare professional. Misusing or overusing Pristiq, or mixing it with other medications, can exacerbate side effects and potentially cause severe mental health issues.

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