Compare Lexapro vs. Pristiq

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Lexapro
(Escitalopram)

Pristiq
(Desvenlafaxine)

Improves mood and helps you relax. Lexapro (Escitalopram) is good for treating depression and anxiety. Might be less likely to cause side effects than some antidepressants, but not the best choice for people with heart or liver problems.Improves mood. Pristiq (Desvenlafaxine) is basically the same medication as Effexor, which is cheaper because it's available as a generic.
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Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.89Lexapro
Reviews for Lexapro (Escitalopram)
61%
of people (All ages) say Lexapro (Escitalopram) is worth it
48%
say it works well
15%
say it's a big hassle
1063 reviews
Have you used Lexapro (Escitalopram)?
Worth itNot sureNot worth it
Reviews for Pristiq (Desvenlafaxine)
53%
-8% worse vs. Lexapro (Escitalopram)
49%
+1% better vs. Lexapro (Escitalopram)
23%
-8% worse vs. Lexapro (Escitalopram)
196 reviews
Have you used Pristiq (Desvenlafaxine)?
Worth itNot sureNot worth it
Side effects
LexaproPristiq
  • Nausea 8%
  • Ejaculation disorder 9%
  • Sleep difficulty 5%
  • Diarrhea 3%
  • Dry mouth 1%
  • Drowsiness 4%
  • Inflammation inside the nose 1%
  • Dizziness 2%
  • Flu-like symptomsa-like symptoms 1%
  • Sweating increased 3%
More Lexapro side effects »
  • Nausea 16%
  • Dry mouth 8%
  • Sleep difficulty 6%
  • Excessive sweating 7%
  • Dizziness 5%
  • Drowsiness 5%
  • Constipation 5%
  • Decreased appetite 6%
  • Fatigue 3%
  • Anxiety 3%
More Pristiq side effects »
How it works
LexaproPristiq
Lexapro (Escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.Pristiq (Desvenlafaxine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It increases serotonin and norepinephrine activity in the brain, which regulates mood.
Type of medication
LexaproPristiq
Prescription only
Prescription only
Available as
LexaproPristiq
  • Pill
  • Liquid
  • Extended release
Used for
LexaproPristiq
Risk factors for serious side effects
LexaproPristiq
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Lexapro (Escitalopram) suddenly
  • Higher dose
  • History of heart problems
  • History of liver problems
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
    Detailed Lexapro (Escitalopram) risks & warnings »
    • Age 24 years or younger
    • Using other medications that affect serotonin
    • Stopping Pristiq (Desvenlafaxine) suddenly
    • History of high blood pressure
    • Taking other blood-thinning drugs
      • History of bipolar disorder
      • At risk for bipolar disorder
      Detailed Pristiq (Desvenlafaxine) risks & warnings »
      Pregnancy

      Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      Food
      LexaproPristiq
      • Take with food to avoid upset stomach.
      No food related info.
      Kidneys and liver
      LexaproPristiq
      • Not a good option for you if you have heart or liver problems.
      No kidneys and liver related info.
      Sex
      LexaproPristiq
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      No sex related info.
      Weight
      LexaproPristiq
      • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
      No weight related info.
      Upsides and benefits
      LexaproPristiq
      • Effective at relieving depression and anxiety symptoms.
      • Lowers relapse rates of depression.
      • Causes less sleepiness than some other antidepressants.
      • Six out of ten people who use an antidepressant for the first time find that it works for them.
      • Effective at relieving symptoms and lowering relapse rates for depression.
      • Six out of ten people who use an antidepressant for the first time find that it works for them.
      Downsides and risks
      LexaproPristiq
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
      • Can cause an irregular heartbeat if you take a high dose (20 mg a day, or more).
      • Not a good option for you if you have heart or liver problems.
      • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people younger than 24.
      • The first antidepressant you try doesn't always work, and might have side effects you really don't like. You might need to try a few different medicines until you find one that works for you and that you can tolerate.
      • Similar to Effexor, without any extra benefits in clinical studies.
      • Can cause sexual side effects (usually low libido or the inability to have an orgasm or ejaculate).
      • Not available in generic form, so it's more expensive.
      • Like most antidepressants, can cause higher risk of suicidal thoughts and behavior for people age 24 and younger.
      • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
      Tips from our pharmacists for people taking the medication
      LexaproPristiq
      • Take with food to avoid upset stomach.
      • Takes about 8 to 12 weeks to see the medication's full effects on your mood.
      • Stop taking it slowly to avoid getting withdrawal symptoms.
      • Tell your doctor if you notice sudden mood changes or unusual thoughts.
      • Takes 8 to 12 weeks to see full effects on mood.
      • Can cause sweating and high blood pressure.
      • Stop taking slowly to avoid withdrawal symptoms.
      • Tell your doctor if you notice sudden mood changes or unusual thoughts.
      Learn more
      More about LexaproSide effectsReviews & ratingsAlternativesFDA package insert
      Have you used Lexapro (Escitalopram)?
      Worth itNot sureNot worth it
      More about PristiqSide effectsReviews & ratingsAlternativesFDA package insert
      Have you used Pristiq (Desvenlafaxine)?
      Worth itNot sureNot worth it