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  • Jan. 27, 2009

    Pristiq: New antidepressant medication approved

    By Gabrielle J. Melin, M.D.

170 comments posted

Need more help?
  • National Suicide Prevention Lifeline
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    1-800-950-NAMI (6264)

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.

170 comments posted

blog index
  • July 18, 2009 9:46 p.m.

    Have any of you gained weight on other anti-depressants but have not experienced weight gain with Pristiq? I'm thinking of switching from 300 mg. Wellbutrin XL to Pristiq. Wellbutrin is the only anti-depressant that I have taken that did not cause weight gain.

    - Kay

  • July 17, 2009 3:19 p.m.

    Has anyone gone from taking Paxil to Pristiq? I have been taking 20 mg. Paxil daily for several years with pretty good results. Lately I've been battling sadness & an inability to sleep at night due to the inability to "turn off my brain" from worries & anxieties. My doctor suggested switching from Paxil to Pristiq. Has anyone out there done this, & what was the transition like?

    - Marilyn

  • July 14, 2009 6:55 a.m.

    I started on Pristiq 7 days ago and I am doing much better. No longer feeling sad all the time, no more ruminating, and able to cope better at work and social settings. Best of luck to everyone.

    - Dennis

  • July 12, 2009 1:49 p.m.

    Thank you for responding John, I will stick it out another 2 or 3 weeks I am at week 3 and feel a little better but not as much as I had hoped for. it seems like two people on this blog who have taken Pristiq for more than 6 weeks do feel better

    - Nancy

  • July 6, 2009 9:58 p.m.

    I've been on Prestiq for a couple months now, and I've never felt more balanced. I can focus better than ever, and am actually able to look towards the future as well as plan for it. This is the first time in years that I have not felt like just a pinball bouncing around!

    - John

  • July 2, 2009 4:38 p.m.

    I've taken 50mgof Pristiq for just over 2 weeks now and don't feel any better. How long has it taken for those of you that feel better? I took effexor for about 5 or 6 years and it seemed to stop working so I stopped it for 6 months and that was a big mistake to take nothing for 6 months. I hike and swim and walk almost every day but it only releaves the depression a short time.

    - Nancy

  • July 2, 2009 9:53 a.m.

    Is there anything for the sexual side effects with prestiq??

    - Vincent

  • July 1, 2009 12:35 p.m.

    I just started today taking it my first dose at 11:30am I've been reading a lot about it and most of its reviews are mixed. Not sure what to expect hope I don't the side affects. My doctor recommended me pristiq after taking lexapro which made me gain weight.

    - anxiety man

  • June 30, 2009 2:27 a.m.

    i just started taking pristiq 4 days ago after coming off of lexapro for 8 months before that i was on afew others mainly prozac for over 15 years prozac seemed to work for me for a long time but then just stopped,so i've been on a roller coaster ride tring different ones.So far the pristiq feels pretty bad,hoping it will get better,but like some of you i have a wonderful husband and a five year old little girl,i don't want to put them through this anymore. I feel crazy most of the time and just want to feel stable and normal so i can enjoy my life.It seems impossible right now,is there any hope?

    - ruby

  • June 29, 2009 4:02 p.m.

    I HAD TWO DAYS OF EXTREME HEADACHES AND NAUSEA...HAD TO DISCONTINUE USE OF PRISTIQ

    - R JOHNSON

  • June 28, 2009 3:42 p.m.

    I've been on lexapro for several months with only mild improvement so was moved to Pristiq. Been in it for two weeks with NO positive results. Actually feeling worse so I'm looking for advice on how to stop. Will call my dr. for advice but was wondering if anyone else had a clue.

    - having no success

  • June 24, 2009 3:16 p.m.

    Started taking pristiq after the death of our young son - have found it to be very helpful on getting thorugh each day, yet it lets me mourn my son. I did try to go off after 6 months - cold turkey - bad, bad idea!! Between the headaches, flu symptoms, crying, fatigue - you name it I finally went back into the dr. and asked a few more questions. this drug only comes in 50 mg. so to cut down you have to visit with your dr. on those options - also do NOT cut them in half!

    - Sherry

  • June 22, 2009 1:55 p.m.

    I just starting taking pristiq today. I was taking celexa before but it wasn't enough. At first I felt great but went back to feeling depressed after a few weeks. My doc brought my prescription up to 40mg but that still wasn't enough after about two months; I still had bouts of depression, anger and anxiety. My doctor thinks pristiq will be better and I hope so too because I want to stop feeling depressed, angry and hopeless; it's destroying my relationship and keeps me in a destructive cycle. My doctor said I might start feeling better right away. I'm taking 50mg. Lets see.

    - just want to get better

  • June 19, 2009 12:56 p.m.

    I have chronic major depression. Pristiq seems to be working fantastically,with my other multiple anti-depressants I take. Pristiq was a change from Effexor XR. Pristiq's allowing me to be aware of the improved workings and connectings within my brain. I feel more alert; less anxious; can focus and accomplish large and small tasks; less of an appetite (I am overweight, so that is a God-send); and improved night time sleep. My psychiatrist is enthusiastic about these positive changes, and so am I. Hope this can be a lesson... about hanging in there, and not giving up, and that a positive outcome can be the result.

    - someone who cares

  • June 17, 2009 9:09 p.m.

    "Each one has caused symptoms ranging from intense anxiety, panic, thoughts of impending doom, nausea, diarrhea, tremors, and other physical symptoms; but the mental ones are the worst: preoccupation with thoughts that are not helpful, emotional instability, feeling terribly hopeless and broken." Serenity Seeker- you are showing all of the classic signs of a bipolar or cyclothymic person using an SSRI. Please consider talking to a psychiatrist for evaluation. You might want to consider using Lamictal, a commonly used medication for bipolar, which has almost no side effects, and is very effective in treating depression in persons with mood disorders. I spent years trying different SSRI's with similar results as you experience. I discovered Lamictal through a friend's recommendation and it has been a god-send. Keep in mind that the manic phase of a person with bipolar II or cyclothymia often presents itself as restlessness and agitation and not always the extreme happiness we are used to hearing about. Anyway, it's worth talking to a psychiatrist or your PCP.

    - Ron

  • June 16, 2009 12:14 a.m.

    I am fifty-two years old who has suffered with chronic depression since my teens, My one major piece of advice is to ONLY take antidepressants prescribed by a PSYCHIATRIST. Your GP or FP is not qualified to prescribe. They cause more problems than they solve, but chronic depressants are a wonderful source of income because they are frequent return customers because of the stress related illnesses that accompany improperly treated depression. If you have heart disease you go to a Cardiologist and an Oncologist if you have cancer. Depression is an illness best treated by a Psychiatrist. In the long-run it is cheaper because there is less trial and error and return GP and FP office visits.

    - Anastasia

  • June 15, 2009 3:46 p.m.

    See mayoclinic.com, topic Cytochrome P450 genotyping test If you get this done, it eliminates so much trial and error with the meds.

    - ccn

  • June 15, 2009 2:47 p.m.

    I am 35 years old and have been taking Pristiq (50MG) for 6 weeks now and I feel so much better. I had anxiety/depression symptoms and I have never taken anything ever. My body physically shut down after years of stress and me trying to handle it on my own, and finally I had a Panic Attack. I did have side effects at first (dry mouth, nausea, stomach irritation, etc) but now I have no side effects and I sleep better than ever. This meds isn't for people that are bipolar so that should be checked into with your Dr. Also, why on earth are people on any of these meds for so long. My goal is a year Max and that will be the end. I hope this will be possible. I also take Synthroid for Hypothyroidism. Which has been great.

    - Lynn

  • June 12, 2009 11:53 a.m.

    it has only been in the last 5 or 10 years that i have begun to "find my voice". i"m sure you all know that after living this life for so long you become well informed about a lot and so depressed that you don't care about a lot. it makes it hard to speak up and harder ( at times ) to keep quiet. this constant back-and-forth serves as a constant reminder of how "mixed up" we are. the length of time we suffer with this disease and the number of times we try to get the better of it, only to face failure after a brief reprise is like watching the ice cube that is our hope melt in the hot unforgiving sunlight that is reality. even worse is being exposed to parents, children, friends and doctors who see us as the disease and not the suffering human being. i want to scream at you " i'm sick, not stupid, how can i make you understand with- out coming across like a real crazy person. just because i understand what's happening and why, doesn't mean i can fix it" this disease is a real life killer, it makes me grab at ANY feeling and the most common one is "down". the next is anger and it has me lashing out just to prove i can still feel, and ( to be honest,) to make you share some of my feelings. pardon the "rant" nature of this entry, i'm not in any danger of hurting myself. i know i'll make it over the week-end. i know i'll make it through next week. i've learned to live this way, and what a very bad shame that is. i've learned

    - ken

  • June 12, 2009 11:48 a.m.

    I have read some postings for the new drug Pristiq. I do wish the postings had stated which miligram was prescribed. I have a friend who has recently been prescribed this medication, and if she read the postings that I had read, she wouldn't take another pill. She is only slightly anxious because of family issues at the present. Her Dr prescribed 50 mg tablet. She is only feeling a little off, and hoping this will help her.

    - Jo Ann

  • June 10, 2009 11:53 a.m.

    I do not know why, but every AD tried has had too many side effects for me to stay on long enough to sustain any benefits. Lexapro was the best, til my MD increased my dose and I had the feeling of not being able to be in my own skin. Each one has caused symptoms ranging from intense anxiety, panic, thoughts of impending doom, nausea, diarrhea, tremors, and other physical symptoms; but the mental ones are the worst: preoccupation with thoughts that are not helpful, emotional instability, feeling terribly hopeless and broken. I also am so overweight that anything that caused more weight gain is not an option. I used to go walking and exercise helps alot. Anyway I asked my doctor for Abilify - she prescribed this "new" medicine Pristiq. In good faith I tried yet another AD ~ not for me! Had a horrible night. First I just felt sleepy, OK it was time for bed - that's a good thing, right? Then I got euphoric and had racing thoughts, then I alternated between sleepiness and jolts of adrenalin coursing through my body. My hands got numb, I sweated profusely, tossed and turned, and awoke every 45 minutes or so. When I got up for work this morning, I was incapable of going! I was shaking and my thoughts would not come together. In the past I have had the best results with yoga and meditation; walking and consciously focusing on anything that was right in my life - to counteract my depressive thoughts and feelings of doom. I wish all of us success in finding a way through.

    - serenity seeker

  • June 9, 2009 4:53 p.m.

    Hi To all who posted comments, I got sad reading all of your posts. Depression is really a life killer. I have sjogrens syndrom ,symptoms are to name a few ,chronic fatigue fibromyalgia dry eyes. Needless to say it depresses me I went on celexa well I felt good but got FAT 5ft1 156lbs I had to go off now having a hard time loosing the weight. I want to try Pristiq but I cant afford to gain weight. Anyone who is on it is weight gain a side effect?? and by the way we are not alone as far as I can see there are alot of us that suffer with depression ....I wish I had a support group for the sjogrens and the bad childhood I had.

    - Shelley

  • June 8, 2009 12:44 a.m.

    I have experienced many of the same gut wrenching depression, anxiety and in my case hallucinations and nigh horrors that I am sure others here have. I spent a good many years drinking heavily which kept me going but would have killed me. Approaching middle age I checked into a wonderful clinic, got sober and was diagnosed with major depression, anxiety disorders, and psychosis. They prescribed ne Seroquel for the hallucinations, Effexor and Wellbutrin for depression and buspar and propranolol for anxiety (propranolol has no side effects and block adrenaline - worth a try for any social anxiety). I gained 60 pounds and I lost interest in sex yet I felt like the luckiest person because for the first time since college I could think straight, deal with people, and start living not just surviving. However, as so many have reported, the effects of the SSRI's can wear off, the depression can worsen. So what do you do? Well, what many did a hundred years ago would be considered immoral and illegal today. Yet used in small doses and in a disciplined and controlled manner there are substances that are "taboo" yet can be really useful on top of the SSRI's. I decided at some point that I should do whatever it took to feel normal. That is what I do, it works for me. There is the argument about the dangers of overdose and addiction. Well, try quitting Effexor, Wellbutrin or Seroquel, cold turkey - these are all at the least psychologically addictive. I have lost 30

    - Anonymous

  • June 7, 2009 4:23 p.m.

    is there weight gain on this drug ?

    - debi

  • June 7, 2009 3:50 p.m.

    I've been on Pristiq foro about 5 weeks and it has helped get me out of a depression that lasted 9 months. I'd been on Prozac for 17 years, but it apparently quit working, tried Zoloft, but it didn't work well and had gastrointestinal side effects, and then tried Pristiq which has seemed to do the job so far. I think the fact that it works on norepinephrine as well as serotonin is something that works in my favor. It's so great to feel happiness and purpose again after all those yukkie months of depression. Yay Pristiq!

    - Thomas

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