Prescription onlyLower-cost generic available



  • Extended release
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Improves mood.

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Prescription onlyLower-cost generic available

Our bottom line

Pristiq (Desvenlafaxine) is basically the same medication as Effexor, which is cheaper because it's available as a generic.


  • 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.
What do people say?
175 reviews


  • 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.

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What to expect when you take Pristiq (Desvenlafaxine) for Depression

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Tips from our pharmacists
  • 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.
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Side effects for Pristiq (Desvenlafaxine)

From clinical trials of Pristiq / Major depressive disorder (50 mg)  ( 953)

  • NauseaNausea22% for Pristiq vs.10% for placebo
  • DizzinessDizziness13% for Pristiq vs.5% for placebo
  • Dry mouthDry mouth11% for Pristiq vs.9% for placebo
  • Excessive sweatingExcessive sweating10% for Pristiq vs.4% for placebo
  • ConstipationConstipation9% for Pristiq vs.4% for placebo
  • Sleep difficultySleep difficulty9% for Pristiq vs.6% for placebo
  • FatigueFatigue7% for Pristiq vs.4% for placebo
  • Decreased appetiteDecreased appetite5% for Pristiq vs.2% for placebo
  • DrowsinessDrowsiness4% for Pristiq vs.4% for placebo
  • AnxietyAnxiety3% for Pristiq vs.2% for placebo

Manufacturers don’t say how common these side effects are

  • Difficulty with urination flow
  • Disturbance in attention
  • Nervousness

Risks and Warnings for Pristiq (Desvenlafaxine)

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    • Higher risk if:
    • Age 24 years or younger

    Pristiq (Desvenlafaxine) may increase the risk of suicidal thoughts or behavior. Watch for worsening depression or any unusual changes in mood or behavior, especially during the first few months of treatment or when the dose changes. Report anything concerning to a doctor immediately. Pristiq (Desvenlafaxine) is not approved for use in children younger than age 18.

    This is a black box warning. The FDA requires this warning when there is a significant risk of serious or life-threatening effects that anyone taking the drug should consider.

Means that some groups have a high risk of experiencing this side effect

Tips from pharmacists and people taking Pristiq (Desvenlafaxine)

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The FDA category for this medication is C. It is advised that you: Weigh risks vs. benefits
  • Upsides and downsides from our pharmacists
  • Can cause sexual side effects (usually low libido or the inability to have an orgasm or ejaculate).
  • Risks from our pharmacists
  • 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.
  • Take before bed because it makes you sleepy. Always take on time and every day as withdrawal symptoms are terrible (even within 12 hours of missing dose). Occasional sexual side effects (inability to orgasm), but much less than other drugs.
  • lowers sex drive
  • Sex drive went wayyyy down.
  • Risks from our pharmacists
  • 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.
  • Definitely take in the morning. I had no drowsiness, but rather felt more alert. I couldn't sleep when taken in the evening. Uptake is practically nonexistent with 50mg being both a starting and therapeutic dose. Took about a week and half for noticeable change. Within a month, great benefit along side psychological talk therapy.
  • Take each day at the same time... (It helps a lot to avoid side effects such as nausea). I encountered many side effects like dry mouth and sleep difficulty, but my mood is way better.
  • Not sure how I feel about it yet. I feel better on this than I Effexor and I was on that for years. I do get really intense nightmares and have trouble sleeping sometimes. And sometimes I feel confused, like out of it.
  • It was supposed to be weight neutral but I gained over 15 pounds. It did nothing for my anxiety & depression.
  • Although this is supposed to be weight neutral I gained 15lbs in 4 months. I was constantly hungry and bloated. Some of this could have been due to the Extreme APATHY I encountered on this medicine. It reduced the extreme anxiety encountered while being unemployed and I can say it did help turn that around, but almost to an extreme point of apathetic procrastination & Fatigue.
  • Although my doctor told me this medication was weight neutral, I gained 20 lbs on it, despite following a 1200 calorie diet and exercising regularly. Detoxing from med included: brain zaps, nausea, migraines, chills, insomnia, panic attacks