Compare Prozac vs. Pristiq

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

Prozac
(Fluoxetine)

Pristiq
(Desvenlafaxine)

Improves mood and helps you relax. Prozac (Fluoxetine) is good for treating depression and anxiety. It's more energizing than other antidepressants, but may not be the best choice for people who have trouble sleeping.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
Button Group. All currently active
Button Group. All currently active
4.7375Prozac
Reviews for Prozac (Fluoxetine)
61%
of people say Prozac (Fluoxetine) is worth it
40%
say it works well
16%
say it's a big hassle
Reviews for Pristiq (Desvenlafaxine)
48%
13% vs. Prozac (Fluoxetine)
45%
+5% vs. Prozac (Fluoxetine)
25%
9% vs. Prozac (Fluoxetine)
Side effects
ProzacPristiq
  • Rash 57%
  • Sleep difficulty 20%
  • Nausea 18%
  • Muscle weakness 12%
  • Drowsiness 10%
  • Tremor 9%
  • Dry mouth 9%
  • Lower sex drive 9%
  • Loss of appetite 7%
  • Anxiety 7%
More Prozac 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
ProzacPristiq
Prozac (Fluoxetine) 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
ProzacPristiq
Antidepressant
Selective serotonin reuptake inhibitor (SSRI)
Prescription only
Antidepressant
Serotonin-norepinephrine reuptake inhibitor (SNRI)
Prescription only
Available as
ProzacPristiq
  • Pill
  • Delayed release capsule
  • Liquid
  • Extended release
Used for (click to learn more)
ProzacPristiq
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 Prozac (Fluoxetine), 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
ProzacPristiq
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Prozac (Fluoxetine) suddenly
  • History of heart problems
  • History of liver problems
  • Drug interactions
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
    Detailed Prozac (Fluoxetine) 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
      ProzacPristiq
      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 in the morning with food to avoid side effects.
      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.
      • Prozac (Fluoxetine) 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 Prozac (Fluoxetine) 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
      No specific weight-related info.No specific weight-related info.
      Upsides and benefits
      ProzacPristiq
      • Effective at relieving depression and anxiety symptoms.
      • Lowers relapse rates of depression and bulimia nervosa.
      • Causes less sleepiness than other antidepressants.
      • It's more energizing than other antidepressants, so it's good for people who have low energy.
      • It has been used to treat depression for a long time, so there's a lot of information available about how it works and how safe it is.
      • 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
      ProzacPristiq
      • Can cause sexual side effects like low libido and an inability to orgasm or ejaculate.
      • Can increase feelings of anxiety or cause headaches during the first few weeks of taking it. These effects should go away over time.
      • More likely than other antidepressants to interact with other medications you're taking.
      • 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 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.
      • 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
      ProzacPristiq
      • Take in the morning with food to avoid side effects.
      • 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 ProzacSide effectsReviews & ratingsAlternativesFDA package insert
      More about PristiqSide effectsReviews & ratingsAlternativesFDA package insert