Table of ContentsView AllTable of ContentsOverviewUsesSide EffectsTimelineDosagePrecautionsWithdrawal
Table of ContentsView All
View All
Table of Contents
Overview
Uses
Side Effects
Timeline
Dosage
Precautions
Withdrawal
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What is the most important information I should know about Pristiq?You should not take Pristiq if:you are allergic to desvenlafaxine succinate or venlafaxine hydrochloride; oryou have taken an MAOI anytime in the previous 14 days.Pristiq may increase the risk of suicidal thoughts in young people, so close monitoring is essential.
What is the most important information I should know about Pristiq?
You should not take Pristiq if:you are allergic to desvenlafaxine succinate or venlafaxine hydrochloride; oryou have taken an MAOI anytime in the previous 14 days.Pristiq may increase the risk of suicidal thoughts in young people, so close monitoring is essential.
You should not take Pristiq if:
Pristiq may increase the risk of suicidal thoughts in young people, so close monitoring is essential.
Antidepressant medicationsare frequently prescribed to help manage the symptoms of anxietyand panic disorder.One such option is Pristiq. Learn how Pristiq can help these conditions, along with its potential side effects, the timeline for working, dosage amount, precautions, and the capacity for withdrawal.
What Is Pristiq?
Pristiq (desvenlafaxine) belongs to a class of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications reduce the absorption of serotonin and norepinephrine in the brain and were first used to treat mood disorders, such asmajor depressive disorder(MDD).
SNRIs were later found to be an effective treatment for a variety of mental health conditions.Today, in addition to being used to help treat MDD, they are also prescribed for anxiety disorders, panic disorder, and social phobia.
Other UsesSome SNRIs have also been found beneficial in the treatment of medical conditions such as diabetic peripheral neuropathy, chronic musculoskeletal pain, stress urinary incontinence, and hot flashes from menopause and breast cancer.
Other Uses
Some SNRIs have also been found beneficial in the treatment of medical conditions such as diabetic peripheral neuropathy, chronic musculoskeletal pain, stress urinary incontinence, and hot flashes from menopause and breast cancer.
Pristiq for Anxiety and Panic Disorder
The U.S. Food and Drug Administration (FDA) has approved Pristiq for the treatment of MDD. However, it also has a few off-label uses, of which anxiety and panic disorder are two.
Prescribing Pristiq to treat anxiety and panic disorder is considered an off-label use of the medication because the FDA has not approved it for those specific indications.
Anxiety
For example, in a 12-week double-blind study, desvenlafaxine was found effective for easingsocial anxiety disorder. In this case, the group receiving the drug had a 9.7-point greater reduction in their anxiety scores than those receiving a placebo.
A 2019 study compared the effects of desvenlafaxine with escitalopram, a generic drug with the trademark nameLexapro, for postmenopausal women with anxiety and depression. While escitalopram was more effective for treating depressive symptoms, the drugs were equally able to reduce anxiety.
Panic Disorder
Naturally occurring chemicals in the brain, known asneurotransmitters, are responsible for various bodily functions. These chemical messengers are believed to be imbalanced for those with mental health conditions.
Antidepressants work to restabilize certain neurotransmitters. Pristiq, specifically, impacts the neurotransmitters serotonin and norepinephrine, both of which are thought to be dysregulated in people with panic disorder.
Serotonininfluences many functions, including mood and sleep regulation.Norepinephrineis connected to the fight-or-flight response, which is the way we react to stress and anxiety. Pristiq can help bring equilibrium to both, leading to reduced anxiety, less severe panic attacks, and enhanced mood.
Taking SNRIs for Treating Panic Disorder
Potential Side Effects of Pristiq
As with any prescribed medication, there are potential side effects of taking Pristiq.
Common Side Effects
Some of Pristiq’s most common side effects include:
You may experience some, all, or none of these effects. If you do, they typically diminish or become more manageable within a week or two of starting this medication. If they persist or worsen, consult your healthcare provider.
If you experience sexual side effects or your blood pressure increases when taking Pristiq, these typically won’t improve with time.
Serious Side Effects
Other Pristiq side effects can be more serious, making it important to contact your healthcare provider or seek emergency medical attention if any of these occur. Some of the rare but also more serious side effects of Pristiq include:
If the patient has an allergic reaction to this medication, this can also be serious. Signs of an allergic reaction include hives, swelling of the face or tongue, and difficulty breathing. If any of these occur, seek medical treatment immediately.
How Long Does It Take For Pristiq to Work?
You probably won’t notice an immediate improvement in your anxiety or panic disorder when taking Pristiq. This is because it takes approximately four to five days to reach a steady state of this drug in the blood.
After one to two weeks, you may notice that you are sleeping better, have more energy, or that your appetite is improved. Mood-related effects generally take a bit longer, or up to eight weeks to improve fully.
Pristiq Dosage Information
Pristiq is delivered via extended-release tablets that come in one of three doses:
The recommended dosage is 50 mg, taken once daily; although, more may be needed to provide the desired effect. The 25 mg tablets are generally used to reduce the drug slowly when discontinuing treatment.
If you are prescribed Pristiq for anxiety or panic disorder, the tablets should be taken whole (don’t crush or cut them), and you can take them with or without food.
Pristiq Overdose
Pristiq overdose is rare but can occur if this drug is taken in high amounts. One study found 182 cases of desvenlafaxine overdose over a six-year period, 75 of which involved taking this medication only and 107 involving the use of this drug and at least one other.
Symptoms associated with Pristiq overdose included mild hypertension (high blood pressure) and tachycardia (heart rate over 100 beats per minute). None of the overdoses studied required intensive care treatment or resulted in death, and the risk of having seizures or developingserotonin toxicitywas low.
If a Pristiq overdose is suspected, contact the person’s healthcare provider or call the Poison Control Center at 1-800-222-1222 for guidance.
Precautions for Pristiq
Some of the precautions to be aware of when taking Pristiq for anxiety or panic disorder include:
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see ourNational Helpline Database.
Interactions
Pristiq can interact with certain medications, potentially increasing or decreasing the drug’s response. Drugs that can negatively interact with Pristiq include:
MAOIs should not be taken within 14 days of stopping or starting Pristiq.
Withdrawal From Pristiq
When discontinuing Pristiq, your healthcare provider will likely reduce your dosage slowly to help reduce any unwanted effects. If Pristiq is stopped abruptly,withdrawalmay occur, creating symptoms such as:
These withdrawal symptoms can also occur in people who have been taking Pristiq for a long period of time.
Medications for Treating Panic Disorder
15 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelowBighelli I, Castellazzi M, Cipriani A, et al.Antidepressants versus placebo for panic disorder in adults.Cochrane Database Syst Rev.2018;4:CD010676. doi:10.1002/14651858.CD010676.pub2Sansone RA, Sansone LA.Serotonin norepinephrine reuptake inhibitors: A pharmacological comparison.Innov Clin Neurosci.2014;11(3-4):37-42.Mental and Behavioral Health.Serotonin norepinephrine reuptake inhibitors (SNRIs).Anxiety & Depression Association of America.Anxiety disorders - Facts & statistics.Liebowitz MR, Salmán E, Johnso A, Hanover R.A 12-week double-blind placebo-controlled, flexible-dose trial of desvenlafaxine extended-release tablets in generalized social anxiety disorder.J Depress Anxiety. 2015:S1. doi:10.4172/2167-1044.S1-014Shinde Mahajan S, Tandon VR, Arora M, Mahajan A, Kotwal S.Comparative efficacy and safety of escitalopram versus desvenlafaxine in postmenopausal women with depression and anxiety: A randomized, open-label, comparative trial.J Midlife Health. 2019;10(3):141-146. doi:10.4103/jmh.JMH_139_18Pristiq (desvenlafaxine)[package insert]. Philadelphia, PA: Wyeth Pharmaceuticals Inc.; 2008/2016.National Alliance on Mental Illness.Desvenlafaxine (Pristiq).U.S. Food and Drug Administration.Pristiq (desvenlafaxine) extended-release tablets, oral.Pfizer.Pristiq dosage and administration.Cooper JM, Brown JA, Cairns R, Isbister GK.Desvenlafaxine overdose and the occurrence of serotonin toxicity, seizures and cardiovascular effects.Clin Toxicol. 2017;55(1):18-24. doi:10.1080/15563650.2016.1223847Friedman RA.Antidepressants' black-box warning—10 years later.NE J Med. 2014;371:1666-1668. doi:10.1056/NEJMp1408480Atkinson S, Lubaczewski S, Ramaker S, et al.Desvenlafaxine versus placebo in the treatment of children and adolescents with major depressive disorder.J Child Adolesc Psychopharmacol. 2018;28(1):55-65. doi:10.1089/cap.2017.0099Behlke LM, Lenze EJ, Carney RM.The cardiovascular effects of newer antidepressants in older adults and those with or at high risk for cardiovascular diseases.CNS Drugs. 2020;34:1133-1147. doi:10.1007/s40263-020-00763-zAdditional ReadingDell’Osso B, Buoli M, Baldwin DS, Altamura A.Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacy.Human Psychopharmacol Clin Exper. 2009;25(1):17-29. doi:10.1002/hup.1074Silverman HM.The Pill Book.
15 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelowBighelli I, Castellazzi M, Cipriani A, et al.Antidepressants versus placebo for panic disorder in adults.Cochrane Database Syst Rev.2018;4:CD010676. doi:10.1002/14651858.CD010676.pub2Sansone RA, Sansone LA.Serotonin norepinephrine reuptake inhibitors: A pharmacological comparison.Innov Clin Neurosci.2014;11(3-4):37-42.Mental and Behavioral Health.Serotonin norepinephrine reuptake inhibitors (SNRIs).Anxiety & Depression Association of America.Anxiety disorders - Facts & statistics.Liebowitz MR, Salmán E, Johnso A, Hanover R.A 12-week double-blind placebo-controlled, flexible-dose trial of desvenlafaxine extended-release tablets in generalized social anxiety disorder.J Depress Anxiety. 2015:S1. doi:10.4172/2167-1044.S1-014Shinde Mahajan S, Tandon VR, Arora M, Mahajan A, Kotwal S.Comparative efficacy and safety of escitalopram versus desvenlafaxine in postmenopausal women with depression and anxiety: A randomized, open-label, comparative trial.J Midlife Health. 2019;10(3):141-146. doi:10.4103/jmh.JMH_139_18Pristiq (desvenlafaxine)[package insert]. Philadelphia, PA: Wyeth Pharmaceuticals Inc.; 2008/2016.National Alliance on Mental Illness.Desvenlafaxine (Pristiq).U.S. Food and Drug Administration.Pristiq (desvenlafaxine) extended-release tablets, oral.Pfizer.Pristiq dosage and administration.Cooper JM, Brown JA, Cairns R, Isbister GK.Desvenlafaxine overdose and the occurrence of serotonin toxicity, seizures and cardiovascular effects.Clin Toxicol. 2017;55(1):18-24. doi:10.1080/15563650.2016.1223847Friedman RA.Antidepressants' black-box warning—10 years later.NE J Med. 2014;371:1666-1668. doi:10.1056/NEJMp1408480Atkinson S, Lubaczewski S, Ramaker S, et al.Desvenlafaxine versus placebo in the treatment of children and adolescents with major depressive disorder.J Child Adolesc Psychopharmacol. 2018;28(1):55-65. doi:10.1089/cap.2017.0099Behlke LM, Lenze EJ, Carney RM.The cardiovascular effects of newer antidepressants in older adults and those with or at high risk for cardiovascular diseases.CNS Drugs. 2020;34:1133-1147. doi:10.1007/s40263-020-00763-zAdditional ReadingDell’Osso B, Buoli M, Baldwin DS, Altamura A.Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacy.Human Psychopharmacol Clin Exper. 2009;25(1):17-29. doi:10.1002/hup.1074Silverman HM.The Pill Book.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelowBighelli I, Castellazzi M, Cipriani A, et al.Antidepressants versus placebo for panic disorder in adults.Cochrane Database Syst Rev.2018;4:CD010676. doi:10.1002/14651858.CD010676.pub2Sansone RA, Sansone LA.Serotonin norepinephrine reuptake inhibitors: A pharmacological comparison.Innov Clin Neurosci.2014;11(3-4):37-42.Mental and Behavioral Health.Serotonin norepinephrine reuptake inhibitors (SNRIs).Anxiety & Depression Association of America.Anxiety disorders - Facts & statistics.Liebowitz MR, Salmán E, Johnso A, Hanover R.A 12-week double-blind placebo-controlled, flexible-dose trial of desvenlafaxine extended-release tablets in generalized social anxiety disorder.J Depress Anxiety. 2015:S1. doi:10.4172/2167-1044.S1-014Shinde Mahajan S, Tandon VR, Arora M, Mahajan A, Kotwal S.Comparative efficacy and safety of escitalopram versus desvenlafaxine in postmenopausal women with depression and anxiety: A randomized, open-label, comparative trial.J Midlife Health. 2019;10(3):141-146. doi:10.4103/jmh.JMH_139_18Pristiq (desvenlafaxine)[package insert]. Philadelphia, PA: Wyeth Pharmaceuticals Inc.; 2008/2016.National Alliance on Mental Illness.Desvenlafaxine (Pristiq).U.S. Food and Drug Administration.Pristiq (desvenlafaxine) extended-release tablets, oral.Pfizer.Pristiq dosage and administration.Cooper JM, Brown JA, Cairns R, Isbister GK.Desvenlafaxine overdose and the occurrence of serotonin toxicity, seizures and cardiovascular effects.Clin Toxicol. 2017;55(1):18-24. doi:10.1080/15563650.2016.1223847Friedman RA.Antidepressants' black-box warning—10 years later.NE J Med. 2014;371:1666-1668. doi:10.1056/NEJMp1408480Atkinson S, Lubaczewski S, Ramaker S, et al.Desvenlafaxine versus placebo in the treatment of children and adolescents with major depressive disorder.J Child Adolesc Psychopharmacol. 2018;28(1):55-65. doi:10.1089/cap.2017.0099Behlke LM, Lenze EJ, Carney RM.The cardiovascular effects of newer antidepressants in older adults and those with or at high risk for cardiovascular diseases.CNS Drugs. 2020;34:1133-1147. doi:10.1007/s40263-020-00763-z
Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelow
Bighelli I, Castellazzi M, Cipriani A, et al.Antidepressants versus placebo for panic disorder in adults.Cochrane Database Syst Rev.2018;4:CD010676. doi:10.1002/14651858.CD010676.pub2
Sansone RA, Sansone LA.Serotonin norepinephrine reuptake inhibitors: A pharmacological comparison.Innov Clin Neurosci.2014;11(3-4):37-42.
Mental and Behavioral Health.Serotonin norepinephrine reuptake inhibitors (SNRIs).
Anxiety & Depression Association of America.Anxiety disorders - Facts & statistics.
Liebowitz MR, Salmán E, Johnso A, Hanover R.A 12-week double-blind placebo-controlled, flexible-dose trial of desvenlafaxine extended-release tablets in generalized social anxiety disorder.J Depress Anxiety. 2015:S1. doi:10.4172/2167-1044.S1-014
Shinde Mahajan S, Tandon VR, Arora M, Mahajan A, Kotwal S.Comparative efficacy and safety of escitalopram versus desvenlafaxine in postmenopausal women with depression and anxiety: A randomized, open-label, comparative trial.J Midlife Health. 2019;10(3):141-146. doi:10.4103/jmh.JMH_139_18
Pristiq (desvenlafaxine)[package insert]. Philadelphia, PA: Wyeth Pharmaceuticals Inc.; 2008/2016.
National Alliance on Mental Illness.Desvenlafaxine (Pristiq).
U.S. Food and Drug Administration.Pristiq (desvenlafaxine) extended-release tablets, oral.
Pfizer.Pristiq dosage and administration.
Cooper JM, Brown JA, Cairns R, Isbister GK.Desvenlafaxine overdose and the occurrence of serotonin toxicity, seizures and cardiovascular effects.Clin Toxicol. 2017;55(1):18-24. doi:10.1080/15563650.2016.1223847
Friedman RA.Antidepressants' black-box warning—10 years later.NE J Med. 2014;371:1666-1668. doi:10.1056/NEJMp1408480
Atkinson S, Lubaczewski S, Ramaker S, et al.Desvenlafaxine versus placebo in the treatment of children and adolescents with major depressive disorder.J Child Adolesc Psychopharmacol. 2018;28(1):55-65. doi:10.1089/cap.2017.0099
Behlke LM, Lenze EJ, Carney RM.The cardiovascular effects of newer antidepressants in older adults and those with or at high risk for cardiovascular diseases.CNS Drugs. 2020;34:1133-1147. doi:10.1007/s40263-020-00763-z
Dell’Osso B, Buoli M, Baldwin DS, Altamura A.Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacy.Human Psychopharmacol Clin Exper. 2009;25(1):17-29. doi:10.1002/hup.1074Silverman HM.The Pill Book.
Dell’Osso B, Buoli M, Baldwin DS, Altamura A.Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacy.Human Psychopharmacol Clin Exper. 2009;25(1):17-29. doi:10.1002/hup.1074
Silverman HM.The Pill Book.
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