Prescription onlyLower-cost generic availableClass: Mental health



Prescription onlyLower-cost generic availableClass: Mental health
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Improves mood.

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Our bottom line

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

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  • 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.
People say this drug is:
196 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.
How it works

Pristiq (Desvenlafaxine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It increases serotonin and norepinephrine activity in the brain, which regulates mood.

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

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Side effect rates for Pristiq (desvenlafaxine)

953 From clinical trials of Pristiq / Major depressive disorder (50 mg)
  • Nausea
  • Dizziness
  • Dry mouth
  • Excessive sweating
  • Constipation
  • Sleep difficulty
  • Fatigue
  • Decreased appetite
  • Drowsiness
  • Anxiety

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

Common concerns from people taking Pristiq (desvenlafaxine)

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  • Avoid withdrawal at ALL COSTS. Vivid nightmares, migraines and insane mood swings. I take 100mg 1x 24/7 with buspirone. It was effective in the beginning, but has tapered off. I would suggest another medication before this one.
  • Alcohol definitely has a stronger effect on this medication. I am usually pretty warm compared to before I started this medication and sweating happens relatively easy. Occasionally, I feel jittery, get hot flashes, or have ringing in my ears. I also noticed I yawn more during physical activity.
  • Do not miss. Back of your neck hurts and it feels as if little electrical shocks are going up into your brain. Take it at the same time every day. It saved me. Period.
  • 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.
  • 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
  • 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.