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
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4.832985386221294Lexapro
Reviews for Lexapro (Escitalopram)
59%
of people say Lexapro (Escitalopram) is worth it
46%
say it works well
15%
say it's a big hassle
Reviews for Pristiq (Desvenlafaxine)
48%
11% vs. Lexapro (Escitalopram)
45%
1% vs. Lexapro (Escitalopram)
25%
10% vs. Lexapro (Escitalopram)
Side effects
LexaproPristiq
  • Ejaculation disorder 12%
  • Ejaculation disorder (primarily ejaculatory delay) 11%
  • Sleep difficulty 10%
  • Nausea 10%
  • Diarrhea 9%
  • Headache 7%
  • Drowsiness 6%
  • Fatigue 6%
  • Dizziness 5%
  • Lower sex drive 5%
More Lexapro side effects »
  • Nausea 31%
  • Excessive sweating 17%
  • Dry mouth 16%
  • Dizziness 11%
  • Constipation 10%
  • Impotence 10%
  • Sleep difficulty 9%
  • Decreased appetite 8%
  • Drowsiness 8%
  • Fatigue 7%
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
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Antidepressant
Serotonin-norepinephrine reuptake inhibitor (SNRI)
Prescription only
Available as
LexaproPristiq
  • Pill
  • Liquid
  • Extended release
Used for (click to learn more)
LexaproPristiq
How well it works for depression
The free Iodine Start program helps people track how well they are improving, and find the right antidepressant faster.

After 4 weeks using Start and Lexapro (Escitalopram), here’s how much better people feel.

After 4 weeks using Start and Pristiq (Desvenlafaxine), here’s how much better people feel.

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 category
      LexaproPristiq
      CFDA pregnancy category (Weigh risks vs. benefits)

      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.

      See the FDA package insert
      CFDA pregnancy category (Weigh risks vs. benefits)

      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.

      See the FDA package insert
      Alcohol
      No specific alcohol-related info.No specific alcohol-related info.
      Food
      • Take with food to avoid upset stomach.
      No specific food-related info.
      Kidneys and liver
      No specific kidneys and liver-related info.No specific kidneys and liver-related info.
      Sex
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      • Lexapro (Escitalopram) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
      • Can cause sexual side effects (usually low libido or the inability to have an orgasm or ejaculate).
      • Pristiq (Desvenlafaxine) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
      Sleep
      • Stopping Lexapro (Escitalopram) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
      • Stopping Pristiq (Desvenlafaxine) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
      Weight
      • More likely to cause minor weight gain (1 to 5 pounds) than other antidepressants.
      No specific 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
      More about PristiqSide effectsReviews & ratingsAlternativesFDA package insert