Desvenlafaxine (Pristiq): Uses, Dosage Side Effects, Withdrawal, Reviews

What Is Desvenlafaxine And What Does It Treat?

Desvenlafaxine (Pristiq) is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved for the treatment of adult patients with major depressive disorder (MDD). Desvenlafaxine (Pristiq) is also currently under review as a treatment for moderate-to-severe vasomotor symptoms associated with menopause.

MDD is a serious mental health condition. With MDD, you may feel sad and hopeless over a long period of time. You may also feel irritable, anxious, tired, and lacking energy. As well as having these feelings, you may also have physical symptoms, such as trouble sleeping or changes in your appetite. These feelings and physical problems can have a significant impact on your daily life.

How Desvenlafaxine (Pristiq) works

Desvenlafaxine (Pristiq) is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance.

What Is The Most Important Information I Should Know About Desvenlafaxine (Pristiq)?

Do not stop taking desvenlafaxine, even when you feel better. With input from you, your health care provider will assess how long you will need to take the medicine.

Missing doses of desvenlafaxine may increase your risk for relapse in your symptoms.

Stopping desvenlafaxine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).

Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for “switching” from depression into mania. Symptoms of mania include “high” or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).

Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.

What Should I Discuss With My Health Care Provider Before Taking Desvenlafaxine (Pristiq)?

•          Symptoms of your condition that bother you the most

•          If you have thoughts of suicide or harming yourself

•          Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects

•          If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require changes in the medication.

•          Any other psychiatric or medical problems you have, including a history of bipolar disorder

•          All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have

•          Other non-medication treatments you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.

•          If you are pregnant, plan to become pregnant, or are breastfeeding

•          If you drink alcohol or use drugs

Desvenlafaxine (Pristiq) pills

How Should I Take Desvenlafaxine (Pristiq)?

Desvenlafaxine (Pristiq) is usually taken one time per day with or without food.

Typically, patients begin at a low dose of medicine and the dose is increased slowly over several weeks.

The dose usually ranges from 50 mg to 400 mg. Only your healthcare provider can determine the correct dose for you.

The tablets should be swallowed whole. They should not be chewed, crushed, or broken.

If you are taking desvenlafaxine, you should not take other medications that include venlafaxine (Effexor®).

Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or a friend to remind you or check in with you to be sure you are taking your medication.

What Happens If I Miss A Dose Of Desvenlafaxine (Pristiq)?

If you miss a dose of desvenlafaxine take it as soon as you remember unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.

What Should I Avoid While Taking Desvenlafaxine (Pristiq)?

Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.

What Happens If I Overdose With Desvenlafaxine (Pristiq)?

If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

A specific treatment to reverse the effects of desvenlafaxine does not exist.

Can a pregnant woman take Desvenlafaxine (Pristiq)?

If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers. For women who take antidepressant medications during weeks 13 through the end of their pregnancy (second and third trimesters), there is a risk that the baby can be born before it is fully developed (before 37 weeks).

Can a breastfeeding woman take Desvenlafaxine (Pristiq)?

Caution is advised with breastfeeding since desvenlafaxine does pass into breast milk. Studies indicate that some amounts of desvenlafaxine are excreted into breastmilk, but serum drug levels of breastfed infants are less than 10% of simultaneous maternal levels. Total drug exposure of breastfed infants is about half of that experienced by breastfed infants whose mothers are taking venlafaxine.

What Are The Possible Side Effects Of Desvenlafaxine (Pristiq)?

Desvenlafaxine (Pristiq) may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

•          changes in sexual desire or ability

•          constipation

•          difficulty urinating

•          dizziness

•          dry mouth

•          enlarged pupils (black circles in the centers of the eyes)

•          extreme tiredness

•          loss of appetite

•          pain, burning, numbness, or tingling in part of the body

•          sweating

•          uncontrollable shaking of a part of the body

•          unusual dreams

•          yawning

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

•          chest, arm, back, neck, or jaw pain

•          coma (loss of consciousness for a period of time)

•          confusion

•          cough

•          diarrhea

•          difficulty concentrating

•          difficulty swallowing or breathing

•          fainting

•          fast heartbeat

•          fever

•          fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness

•          hallucinations (seeing things or hearing voices that do not exist)

•          headache

•          hives

•          hoarseness

•          increased falls

•          memory problems

•          nausea

•          nosebleeds

•          problems with coordination

•          rash

•          seizures

•          small red or purple dots on the skin

•          swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

•          unusual bleeding or bruising

•          vomiting

•          weakness

Desvenlafaxine (Pristiq) may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Is Desvenlafaxine (Pristiq) a safe medication?

This medicine is safe when used as prescribed. However, Desvenlafaxine (Pristiq) can cause increased heart rate, low blood pressure, increased salivation, irregular menstrual cycle, increased frequency of urination, changes in taste, increased liver enzymes, low sodium (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering), teeth grinding, difficulty urinating, angle-closure glaucoma (symptoms of angle-closure glaucoma may include eye pain, changes in vision, swelling or redness in or around the eye), serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), hypertensive crisis (severely elevated blood pressure), myocardial infarction (heart attack), Stevens-Johnson syndrome (rash)

Are There Any Risks For Taking Desvenlafaxine (Pristiq) For Long Periods Of Time?

To date, there are no known problems associated with the long-term use of desvenlafaxine. It is a safe and effective medication when used as directed.

What Other Medications May Interact With Desvenlafaxine (Pristiq)?

Desvenlafaxine (Pristiq) should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azilect®), and selegiline (Emsam®).

Although rare, there is an increased risk of serotonin syndrome when desvenlafaxine is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), the antibiotic linezolid (Zyvox®), and amphetamines.

The following medicines may increase the levels and effects of desvenlafaxine: ketoconazole (Nizoral®).

Desvenlafaxine (Pristiq) may increase the effects of other medications that can cause bleeding (e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®), and aspirin).

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