Pristiq (Desvenlafaxine) for Major Depressive Disorder

What Members SayTop TipsSide EffectsCopay HelpFAQs

Pristiq (desvenlafaxine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with major depressive disorder (MDD).

What Members Say

MHT logo These insights are based on 365 comments about Pristiq from MyDepressionTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.

Benefits:

Crying spells, sadness, and dark thoughts can feel less intense.
Energy, motivation, and daily functioning can improve.
Benefits can last long term for some, though periodic reassessment matters.

Considerations:

Stopping suddenly or missing doses can cause difficult withdrawal symptoms.
Blood pressure monitoring is important during treatment.
Higher doses can bring more side effects without added benefit.

How Pristiq Works and How It’s Taken

Pristiq is a type of medication called a serotonin and norepinephrine reuptake inhibitor that works by blocking the reuptake, or recycling, of serotonin and norepinephrine in the brain. In major depressive disorder, this may help reduce chemical signaling problems linked to low mood. The exact way it treats depression is not fully known.

Doctors prescribe Pristiq when an adult needs treatment for major depressive disorder.

Pristiq is given as an extended-release tablet by mouth, typically once daily at about the same time each day. It can be taken with or without food.

The recommended dose of Pristiq for major depressive disorder is 50 milligrams once daily.

A doctor may adjust dosing for people with kidney problems, and a 25-milligram dose may be used to gradually lower the dose when stopping treatment. People should not stop taking Pristiq suddenly without medical guidance.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Pristiq

These insights are based on 365 comments about Pristiq from MyDepressionTeam members.

Members who use Pristiq often say it helps to stay in close contact with a doctor, especially during dose changes, side effects, or when the medication seems to stop working. They also frequently mention keeping a steady routine, giving the medication some time, and speaking up quickly about symptoms like nausea, insomnia, anxiety, dizziness, or blood pressure changes.

1

Talk to your doctor before stopping or switching Pristiq.
“I do take them religiously because of the fear of how bad I was without them. Also Pristiq has withdrawal effects if you stop suddenly. I have been there, done that, and no thanks! That was awful.”
2

Keep your dosing routine consistent.
“Yes, I have forgotten a dose here and there, but halfway through the day I’m lightheaded and feeling sick. First thing hubby asks me is, ‘Did you take your meds?’ So I check, and sure enough that morning’s dose is still in the AM pack.”
3

Give it some time, but keep track of how you feel.
“I started a new antidepressant, Pristiq, six weeks ago. I feel like it’s working.”
4

Ask about monitoring if physical changes show up.
“She had previously asked me to take my blood pressure daily and record that, as well.”

Connect with others who understand life with major depressive disorder. Join MyDepressionTeam for free.

Pristiq Side Effects

In clinical studies of Pristiq for major depressive disorder in adults, the most common side effects occurring more often than placebo (an inactive treatment) were seen in 3 percent to 22 percent of people taking the recommended 50-milligram dose. They include:

Nausea
Dizziness
Insomnia (trouble sleeping)
Hyperhidrosis (sweating more than usual)
Constipation
Somnolence (feeling sleepy)
Decreased appetite
Anxiety
Male sexual function problems, such as delayed ejaculation, erectile dysfunction, or trouble reaching orgasm

Serious Side Effects and Warnings

Pristiq can cause serious side effects that may require immediate medical attention. These include:

Suicidal thoughts and behaviors — The risk may be higher in people ages 18 to 24, especially early in treatment or when the dose changes.
Serotonin syndrome — This is a potentially life-threatening reaction from too much serotonin in the body.
Increased blood pressure — Blood pressure may rise during treatment.
Abnormal bleeding — The risk may be higher if Pristiq is taken with medicines like aspirin, nonsteroidal anti-inflammatory drugs, or blood thinners.
Angle-closure glaucoma — This is a sudden increase in eye pressure that can cause eye pain and vision changes.
Mania or hypomania — Symptoms can include an unusually elevated or irritable mood, increased energy, or risky behavior.
Discontinuation syndrome — Withdrawal-like symptoms can happen if Pristiq is stopped suddenly.
Seizures — Seizures may occur with Pristiq.
Hyponatremia (low sodium levels in the blood) — This can be serious.
Interstitial lung disease or eosinophilic pneumonia — Serious lung inflammation can cause worsening shortness of breath, cough, or chest discomfort.
Severe skin reactions, including Stevens-Johnson syndrome — A rare, serious rash with blistering or skin peeling can occur.
Acute pancreatitis — Sudden inflammation of the pancreas can cause severe belly pain.
Takotsubo cardiomyopathy — This is a sudden heart condition that can cause chest pain or shortness of breath.
Severe allergic reactions, including angioedema — Swelling can occur, including swelling of the face, lips, tongue, or throat.

Get medical help right away if you think you are having a serious reaction.

How To Save on Pristiq

Information about savings or copay help for Pristiq was not provided in the source manuscript.

What To Know Before Taking Pristiq

Tell your doctor if you have any allergies to desvenlafaxine, venlafaxine, or any ingredients in Pristiq.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements. Especially tell your doctor if you take migraine medicines called triptans, opioids, lithium, buspirone, amphetamines, tryptophan, St. John’s wort, or other antidepressants. These can raise the risk of serotonin syndrome.

Avoid alcohol while taking Pristiq.

Do not take Pristiq if you:

Are allergic to desvenlafaxine, venlafaxine, or any of the ingredients in Pristiq
Take a monoamine oxidase inhibitor (MAOI), linezolid, or intravenous methylene blue, or if you have stopped taking any of these in the last 14 days

You may see something in your stool that looks like a tablet. This can be the empty tablet shell after the medicine has been absorbed.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Pristiq, talk with your doctor about the risks and benefits. There is a pregnancy exposure registry that monitors pregnancy outcomes in people exposed to antidepressants during pregnancy: the National Pregnancy Registry for Antidepressants, 866-961-2388.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Pristiq?

In four eight-week studies in adults with major depressive disorder, Pristiq improved depression symptoms more than placebo. In longer-term studies, people who stayed on desvenlafaxine were less likely to relapse than those switched to placebo: 14 percent versus 30 percent at 26 weeks in one study, and 29 percent versus 49 percent at 26 weeks in another.

In studies that directly compared 50 milligrams and 100 milligrams per day, there was no sign that 100 milligrams worked better.

How long does Pristiq take to work for major depressive disorder?

The clinical studies measured improvement over eight weeks. The study information does not give an exact day or week when people first start to feel better.

Can Pristiq cause anxiety or trouble sleeping in people with major depressive disorder?

Yes. Anxiety and insomnia were among the most common side effects reported with Pristiq, and nervousness, feeling jittery, and abnormal dreams were also reported. People starting antidepressants should also be monitored closely for worsening depression, suicidal thoughts and behaviors, and unusual changes in behavior, especially early in treatment and when the dose is changed.

What tests or monitoring are needed with Pristiq for major depressive disorder?

Blood pressure should be checked regularly while taking Pristiq because increases in blood pressure were seen in clinical studies. If you already have high blood pressure, it should be controlled before starting treatment. In some people, dose reduction or stopping treatment may be considered if blood pressure stays elevated.