This is the inaugural entry of a new occasional feature we’ll have here on World of Psychology, On the Couch with Dr. John Grohol. These entries will be interviews with various movers and shakers in the world of psychology, mental and behavioral health, and psychiatry. The schedule is to do at least one a month, so if there’s someone you’d like to see interviewed, please drop us a note!
Last Wednesday, I had the chance to sit down and talk to Dr. Phil Ninan, the Vice President of Wyeth’s Medical Affairs, Neuroscience on the telephone about their newest antidepressant medication, Pristiq. Pristiq is a “chemical cousin” of Wyeth’s existing successful antidepressant, Effexor (and its descendants like Effexor XR).
Dr. John Grohol: Pristiq has been approved for use in the treatment of depression in the U.S. The pipeline for depression drugs has been not as full, I think, as some people would like to see it sometimes. So, I was wondering if you could talk a little bit about how Pristiq is better, or different, than its chemical cousin, Effexor.
Dr. Phil Ninan: To start out with, you are quite correct that there has been a tremendous amount of effort over the past decade, decade and a half, to try to come up with what I would say would be revolutionary advances in the treatment of depression and anxiety.
And by and large, those attempts have not been successful, which is why we haven’t had medication with new mechanisms of action available on the market. And we at Wyeth too have put a tremendous amount of resources into those, and have not been successful so far. But, we continue to do that, and we have several other options in the pipeline that we are exploring.
But in the meantime, while we are waiting for the revolutionary advances, it’s important to understand that there are still patients who are not getting treatment. They’re not tolerating the medicines that are currently on the market, or they’re not getting the degree of benefit or the subjective sense that they have when they are on the medicines is not something that they are satisfied with, and therefore they discontinue medication.
In that sense, Pristiq an evolutionary advance that allows some advantages in individual patients, and hopefully that will result in them getting the full degree of benefit, so that they can get back to living their lives to their fullest potential.
Dr. Grohol: What were some of the most common side effects discovered in the clinical trials for Pristiq?
Dr. Ninan: The most common ones were GI ones, like nausea, decrease in appetite, constipation. Some side effects that are common with medicines that affect the norepinephrine system, like dizziness and sweating, as well as sleep disturbance.
We also had some patients who experienced an increase in anxiety, and also had sexual dysfunction. So, those are the most common ones.
Dr. Grohol: How typically would Pristiq be prescribed? What would be a common starting dose, and how would that be titrated up?
Dr. Ninan: This is in some ways a unique situation for this class of medications, the serotonin and norepinephrine uptake inhibitors, where the starting dose is the effective dose. And at that dosage, which is 50 milligrams a day, what we found in our clinical studies is that the proportion of patients who discontinue the medication because of adverse events is no different from placebo.
And what that means, generally, is that it would be very well tolerated, so that a larger proportion of patients could have the medicine delivered so that they would get the benefits.
Dr. Grohol: I haven’t heard of very many medications where that’s the case. Is Pristiq unique in the anti-depressant class of medications, where the starting dose is really the clinically effective dose as well?
Dr. Ninan: Within the SNRI class that is unique. If you do that with some of the other medications, then what happens is the side effect profile shifts and therefore a greater number of people can’t tolerate that initiating dose, and therefore they have potential trouble with it.
So, in that sense, particularly for general practice physicians who are seeing a large number of patients who are struggling with depression, it uncomplicates the management of depression. And the kind of contact that might be necessary to adjust the dose of medication may not be necessary. You would still need to have close contact with people when you’re initiating treatment, but the dose adjustment is something that is not necessary in this situation.
Dr. Grohol: What is the price point for Pristiq compared with something like Effexor XR?
Dr. Ninan: I’m in medical, and I’m not in the commercial part of the company, so all I know is that a pill of Pristiq at the retail level is supposed to be $3.41. And it’s the same price whether you are buying a 50 milligram pill or a 100 milligram pill. And I’m told that’s about 15-20% lower than the price of Effexor.
Dr. Grohol: There’s been more talk in recent years about greater concerns about withdrawal syndrome. And so I was wondering what the research has shown what the withdrawal profile on Pristiq looks like compared to other drugs in its class.
Dr. Ninan: First of all, I think, one should distinguish what is a withdrawal syndrome from what we would call discontinuation symptoms. Withdrawal is traditionally associated with medicines that one has got physiologically dependent on. And there is a whole set of not only symptoms, but physiological changes that occur that can be potentially dangerous.
You see that with alcohol, you see that with benzodiapams, the anti-anxiety and sleep medications that can cause physiological dependence. And you see that with pain medications, particularly opiates and that class of medications. So, those can be medically problematic and potentially dangerous in some people.
We should distinguish that from discontinuation symptoms, where those medical risks are not present. And these are not medicines that you become physiologically dependent on, but you can get adaptive changes that have occurred, that then the body and the brain needs to readapt to not having those medications onboard.
And you see this with blood pressure medications where if you suddenly stop certain blood pressure medications you can get a rebound increase in blood pressure that is very transient. And you see that with several other medications. You see that if you take Benadryl on a regular basis and you suddenly stop taking the Benadryl, there are rebound symptoms that could occur.
So, what we have here are discontinuation symptoms that have been reported with antidepressant medications that get out of the system very quickly. And most medicines that get out the quickest are more likely to have discontinuation symptoms, because the brain is not having a chance to adapt to not having that medication occupy the receptors in the brain.
And the longer you’re on the medication, the more the adaptation has taken place, and therefore the more likely you are to have the discontinuation symptoms. So, we know that there were medicines that were the biggest culprits in terms of having discontinuation symptoms. Effexor was one. Paxil is the other.
And Prestiq being an active metabolizer effecter and also having a fairly short half-life, we would expect would have the potential to discontinuation symptoms. And that is exactly what we have found in our clinical trials.
So, these discontinuation symptoms can be anything from just physical kinds of symptoms, which would be things like dizziness, headaches, nausea, those kinds of symptoms that are common side effects of these medications to symptoms that might be unique.
So, patients who are coming off Effexor and Paxil have described various words like "brain shivers" and things like that, which we consider to be under a term called paresthesia, which are physical symptoms that you might be having within your body. And you can also have associated anxiety depressive symptoms.
Now unfortunately, the scales that we use to measure these are not very good. Because what we find is that anywhere from 20 to 30 percent of patients who are on placebo are also demonstrating some of these symptoms. And so there’s the high level of noise in the mechanisms that are standard in the field to try and measure these symptoms.
What we find is that what happened in our studies is when we discontinued these medications rapidly, was that a substantial number of people had these discontinuation symptoms. So, when we started tapering the medication, a number of these patients who were having discontinuation symptoms were reduced. But, they were still present.
And so we would recommend clinically that if a patient is planning to stop the medication, they should do it under medical supervision so that they’re being guided about what are the mechanisms that you can use to reduce the discontinuation symptoms, so that they don’t cause excessive distress, and they can be managed medically.
119 comments
I have recently decided to stop taking Pristiq. It has been about 1 week since my last dosage. Does anyone know when it is safe to consume alcohol again? Please email me at [email protected] if you have any idea. Thank you
Interesting to read all the comments.Was given pristiq to try but have decided against it now.I’ve tried avanza(mirtazapine).Great for sleeping and didnt have any withdrawal syptoms at all.Also no sexual side effects.The worst side effect is weight gain,which is depressing in it self.Sometimes you just know what to do.If I cant sleep my life is awful,but then you get the weight gain.Goodluck all ,it’s not easy as only we know.
I haven’t had good luck with this drug. I began to experience extreme anxiety and depression in the summer. My PCP suggested pristiq. I was against it because I didn’t have good luck with anti-depressants in the past. It was terrible to get on – severe nausea, etc. But I kept hoping that I’d feel better eventually. I’ve been in counseling, which seems to be helping. As for this drug, I’m still anxious and depressed. I’ve noticed that it makes me more so and even OCD, irratable and impatient. I feel like I’m too tired to get up but so anxious that I can’t sit still. My work and romantic relationship and my home life is suffering. I was looking at pics of myself before this med and I actually have emotion in my eyes. Now I look tired and worn out. I feel numb and want to hide all the time. This is despite the fact I am making a lot of strides in counseling. These meds are holding me back. I want off this ride once and for all. My PCP told me to wean myself off by cutting it in half. Last night was the second day of that. I experienced all of the symptoms of overdose. I’m scared and I just want this to end. I’ve already had the brain zaps and hostility after missing a dose. The sooner I get this stuff out of my body the better.
My body is intolerable to most meds and as others have state here, I got the free samples of pristiq for a few months. I had started on 25 mgs and then to 50. I didn’t like it at all so I started weening myself off, to one before I told him.It did make me feel a little better (not much) but not enough to outweigh the side effects. When I told him I wanted something else he put me on Prozac and gave me something for my anxiety. He never told me I would go through hell withdrawing from pristiq.
Even with the Prozac and the anti anxiety I have sever withdrawal symptoms, all before reading anything on-line about it. Another words, it wasn’t psychological. Id have to day the brain zaps are the worst, getting them ever time I move my head or stand up. I also get dizzy and clouded thinking. I’m sorry if this isn’t worded right as I’m having trouble putting my thoughts together.
I agree that the company that makes pristiq should be investigated or at least more studies should be done about the withdrawals.
I would not recommend anyone taking this drug. It’s not worth the side effects and or the withdrawal symptoms.
The only question I would have is how long before my brain stops zapping. I feel like I’m being given electrical shock therapy several times a day and it has me worried about lasting affects.
While on a 50mg dose of Pristiq for a month, shocking symptoms like memory loss/confusion, pacing, panic attacks and total numbness of emotions and increased anxiety, loss of concentration appeared. This medication does not work well for everyone, if anything it makes everything worse.
It’s been two weeks since my last dose of this poisonous med. Some of the withdrawal symptoms include: muscle twitching, anger/bitterness, still a loss of memory(cant recall words), constant ringing in ears, unusual muscle pain.
Well, I am so happy that I finally found a site that speaks of Prestiq – both for taking it and also the withdrawl symptoms.
I was given it after being on Prosac for 4 months. I was given free samples also along with the discount card!
All I can say is that I felt alright – for a while… then started the weight gain – lack of sexual interest and absolutely no satisfaction in that area either. I was almost compulsive in things and my cholesterol went through the roof!
I approached my doctor and said that I want off of this med – he didn’t recommend it at all- I waited a little while – but then decided to do it on my own. Started with the weaning of 1 day on – 1 day off – then 1 day on – 2days off – now am at 1 day and 3 days off.
My withdrawl is horrible!!!!!!!!! Along with the diziness, there are the flu like symptoms – and now I am dealing wit”burning tongue” syndrome! The bridge of my nose is always tingling and I feel like I really don’t give a s*** about anything at all! I want to get this stuff out of me all together! I hate dealing with this. I also quit smoking and am trying to diet cause of all the weight I gained – it is never ending!!!
These people who say that there are no side effects of withdrawing from the drug -no nothing!!!!!!
One question – is there anyone else out there that has come off of this drug completely and has gotten past all of the above symptoms????? How long did it take and when should I take the “last” one????? Should I get it down to 1/week???? For how long???? My Dr is of no help in this matter – Thanks!
Forgot to mention in the above that I was on it for about 7 months and started the weaning process by taking it at night instead of the morning – this I think did help me with quitting smoking – (maybe that was one good thing that came out of this drug!)
I am so happy I found this site. I am coming off Prestiq after about 4 months. I hate it! Since taking this drug I have lost my sex drive…I AM 25 YEARS OLD! My husband thinks I have lost my mind and I have litterally lost intrest IN MY OWN KIDS! I have to keep re-focusing myself on MY OWN LIFE! Oh-yeah, I have been getting the “samples” the whole 4 months! Anyway, my doc gave it to me because I told him about my anxiety, which is/was not bad; I wanted something to calm down WHEN I DID have an anxiety attack. I actually asked for Xanax, something I could take ONLY WHEN I NEEDED IT! He told me that was habbit forming and I didn’t need that. WTF! I like what someone else said about comparing Prestiq to HEROIN! I swear! I am taking the pill every-other-day now and it’s day 4…I feel okay, but I have moments of utter HELL! I am NOT myself anymore! I am going to talk to doc today about what to do next…I may mention about cutting myself and banging my head against the wall too…yeah, that shit still hurts and I have a huge knot! Atleast it’s in my hair so no one can see it! HOW LONG IS THIS MADNESS GOING TO LAST? WILL IT EVER END? PLEASE!!! DO NOT DO THIS TO YOURSELF! DO NOT TAKE PRESTIQ!!!!
Hi Dr.,
There is a side affect that is hinted at but never mentioned in any of these discussions. These drugs are known to cause agitation, manic behavior (irrational spending, risky sexual behavior, agitation, aggression, poor decisions, over confidence, increased use of alcohol and other drugs, and anger), reduced libido, thoughts of suicide, and emotional bluntness. I ask the reader to consider what would happen to a happy and healthy marriage if these symptomatic behaviors enter the formula.
My wife was given Zoloft shortly after the birth of our child. This brought out aggressive and agitated behaviors I hadn’t ever seen in the 10 years together. She had always suffered from mild anxiety and mild OCD. She quit the Zoloft and was given Prozac a few months later. The symptoms of mania appeared. Every one of them. Our relationship screeched to a halt one night when she tried to throw herself on 4 people (men and women) at a party. She eventually assaulted me in front of two police officers and was arrested. For 12 years she was a passionate, committed, caring, and individual with a zest for life. After starting on AD’s she became the complete opposite. Not a single marker of a tumultuous marriage existed prior. I now must share custody with my 3 yr old with a person I do not now. Worse her decision making has often endangered the well being of my child. I miss the person I built a 12 year foundation with.
I am not alone. there is a forum of both ex-users and spouses dedicated to this topic. http://www.topix.net/forum/drug/effexor/TQ4I2UR28DFD3N759.
The dysfunctions (psychological, emotional, cultural, and financial) caused by a divorce, especially with children involved, are well accepted. The more I understand these drugs, the more I believe that the benefit is outweighed by the “costs”. It seems in this case, these drugs make their own new patients.
Hi LOL,
My life too was ruined by Prozac 15 years ago when my GP put me on it. It sent me into mania – I had two small beautiful children. Now I am divorced and been that way for 14 years trying deparateky to live life out of the ruins of SSRIs.If I give out too many details I’ll go into depression again. Just yesterrday my dr. suggested tyhis Pristiq and after reading all of the above –NO WAY wuill I go on this crazy drug. As hard as it is I’ll stay on my small dose of Cipralex and prayer a lot.
Thanks for sharing,
looking for peace.
p.s. I think I’ll check out that blog too.
A point about this interview.
“First of all, I think, one should distinguish what is a withdrawal syndrome from what we would call discontinuation symptoms. Withdrawal is traditionally associated with medicines that one has got physiologically dependent on.â€
According to NIH, “withdrawal symptoms†from cocaine and from benzodiazepine is characterized as Physiological dependence on benzodiazepines is accompanied by a “withdrawal syndrome” which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes.
Later in the NIH description it goes on to say there can be “physiological†symptoms as well. But all of these fall under “withdrawal syndromeâ€. Anyway you look at it, what a patient is really asking about is “what kind of suffering am I going to have to endure should I want to quit these things? This is a dodge of the question.
It all feels like I am listening to a political debate.
i took pristiq for four days. it was the worst thing ever. i havent took it for almost 2 weeks and im still having alot of pain. my heart is still beating fast, my head feels like there is water running down the inside of it, my arms and legs are sore it hurts to more them to much, shortness of breath, pain in my neck and shoulders, chest pain, tingling every so often in the face,legs and all though my body. so now i have alot of medical bills all because of this stupid medican.
This is all very scary. I was on Cymbalta and decided to stop it. Being a nurse I knew to wean myself off of this. Well I tried everything and even went to the Dr. for help. He had never heard about any of the side effects I was having and didn’t know what to do. I decided to try another med and started Pristiq. The symptoms went away quickly. Now I have decided to quit it and I have the same symptoms Again! And like you all say it is like HELL!! I’ve made it 3 days after trying it every other day for greater than a week. I am having the same issues again and don’t know what to do. And no one else does either. With all these emails I don’t see any solution to get off the Pristiq. I have a job that I need to be very focused and patient for.. withdrawl is making this very difficult. PLEASE SOMEONE TELL US WHAT TO DO OR TAKE TO GET OFF THIS POISON!!
I’ve been on Pristiq for about a year and a half. Switched from Lexapro, which I felt had stopped working.
Experienced the nausea and Vertigo firsthand when I had to stop taking the Pristiq for an ENG test.
I want to go back to the Lexapro! I was supposed to be off all meds for that test and by the 2nd day, I had to cheat and take a pill. The nausea, the dizziness (who needs dizziness FROM the meds when I take antivert for the Vertigo?) and the teeth grinding feelings of anger had me by the throat. That’s when I knew it was addictive.
Of course it is! Any drug that plays with the Serotonin levels is going to cause nausea when the chemical level is reduced.
S***. I can’t stay on it and have to get off it. I’ve gained 20 pounds since my heart surgery and that is NOT good.
I think I’ll have to take a week off work just to withdraw from this poisonous drug called Pristiq and pray that it works…..
Hi I had been on zoloft which worked wonders but eventually stopped working and I slept way too much! My dr and best gf suggested pristiq. I tried it and the first week I expierenced bouts of anger, anxiety. Crying spells and panic attacks. I was out of control. My best gf advised me there is two reasons
1. You have to combine pristiq with an anxiety medication. Such as buspar Ativan klonpin or Xanax or even a small dose of an ssri.
I did this and instantly my anxiety n anger n panic vanished!
Step2. You have to STICK IT OUT!!!!!!!!!!!
I wanted to throw the towel in my gf urged me to wait out the 6 weeks and I did because I wanted to get better! And wow!!!!! Combined with my anxiety med I have never felt so happy and productive focused and giddy it’s incredible this drug is like screaming ‘dont judge a book by the cover or first few chapters! It’s like those movies that start out horrible but suprisingly end up being your favorite! I’m telling you follow these two steps and you will feel great! Also for coming off I never had been discontinuation withdrawls because you take either Xanax or valium or a pain killer like norco and I have no problems without this I am a wreck. I have been on in my past effexor, lexapro, zoloft,wellbutrin, and tons of anti anxiety etc etc if you have any questions regarding any of these feel free to email me Id lo e to give feedback and share expierenced and things I have learned in college studies before switching to [email protected].
Correct email uclalaw23@yahoo
this are problems that most at times come with age.but i will like to let you know that even you people today have this same problem.all of this is happening because the world is fast coming out of the natural to the artificail.but those who find themselves in this situation should do everything to go back to the natural.i think the only way to do so is to get natural health medecines or supplements.they ra ebest as of now.if you will really like to solve this problem i will help you with a link that will help.
email:[email protected]
web:www.tienshealth.co.uk
My friends, Please listen. I am a nurse, I take klonipin, and two months ago, my doctor put me on and additonal drug, Prestiq. Of course he gave me about six months worth of pills, since the drug reps are tryin to push this medicine. Let me tell you, I not only educated myself, but also my family, on what could happen if i take it. I took the drug for six weeks. I thought i was ok, my family told me that it was like i was someone else, a cold hearted, non feeling person. I called my doctor to go off of it. He told me I had to taper down. I tapered down for an entire month. Yesterday, after being off of Pristiq for 4 days, I had what everyone mentioned,sleep disturbances (sleepwalking/sleep talking, and even falling asleep sitting at the computer) brain zaps (and by the way doctors think you’re nuts when you say it, but its so true and i hate it with all that i have, nausea,vomiting, migraine, couldn’t look at lights, extremely dizzy, and the worst part..in front of my patients, i passed out onto the floor. They took me to the hospital, the e.r. doc never heard of pristiq, they did cat scans, xrays, bloodwork, urinalysis, they found nothing wrong. This med is aweful. Now i’m missing work, not paid of course, waiting for my doctor to prescribe another pill to mask the side effects of withdrawing from Pristiq. No idea how long this will last, but my heart goes out to each and everyone of you
READ THIS IF YOU ARE THINKING OF GOING ON PRISTIQ: I’ve been on Pristiq since it was introduced to U.S. consumers. This will be my FOURTH attempt to get off this medication. Discontinuation symptoms, withdrawal syndrome – call it what you will; the symptoms I’ve experienced when trying to get off this medication has been HORRENDOUS. I have been doing this with the assistance of psychiatrist, not just on my own. My first attempt threw me into a mixed episode, something I had never experiences and haven’t since. I have never had to call my shrink in crisis, until this experience. My second and third attempts have been so physically and/or emotionally painful I have not been successful in getting off this med yet. The “brain shivers” more accurately reflect “brain zaps”. I would describe it as having a feeling of having your brain zapped with a cattle prong. The frequency for me was every few minutes to every few seconds. This is not a pleasant feeling, but this was not the worst of the symptoms. The aching in my bones and joints becomes so incredibly painful. This combined with the intense mood swings has thus far inhibited my success in getting off Pristiq. This will be my fourth (and hopefully final attempt) in getting off this medication. Had I known that my mind and body would experience such INCREDIBLE pain and discomfort, I would never had taken this medication. Unfortunately this information was not available at that time, which is why I am sharing it with you know. Make an educated decision for yourself. Good luck.
My brother, 25, was on Lexapro and Abilify for almost 8 years. He recently is not in college and does not have health insurance. Therefore, when he went to meet with his psychiatrist, he took him off both lexapro and abilify, and gave him Pristiq. *(He had tons of sample packs he could give him for free)*
Now, I understand that it’d be pretty much impossible for my brother to pay almost $500/per month for his abilify prescription. At the time I was really surprised (kind of upset) that his dr. could just completely stop his other meds, that he has taken for as long as I can remember, and throw him on this Pristiq.
He has been taking Pristiq now for about 2 months and has been suicidal nearly everyday. Some days are much worse than others, but it is a constant battle for him. He just can’t seem to shake these suicidal thoughts that he has. He has WAY more bad days than o.k. days. I live with just my brother and it’s sooo hard for me to deal with, especially because I dont know what to do for him other than tell him I love him and need him and that everything is going to be alright. I’m also 3 years younger than him, and it kills me to see my big brother like this. I help him make it through the day, but it really takes its toll on me. At the end of the day, I end up feeling hopeless and really sad and worked up. I end up crying every night because I feel so bad for him and I’m so scared for what the next day is going to bring.
It is absolutely no way to live and soon I feel like I’m going to lose my mind.
So what it comes down to is that PRISTIQ is ruining my brothers life and my life. And I dont care if the damned psychiatrist is making bank from the drug company by giving everybody this Pristiq, THIS IS MY BROTHER’s LIFE.
I went from about 5 years on Zoloft, to what I was told would be in upgrade in Pristiq. Pristiq seemed to smooth out the rough edges in life to the point where I was feeling like a mummy. I decided to get off pristiq after close to a year. It has been about 7 weeks and I’m finally feeling a little better. It has been horrible existence for the past 7 weeks. Awful dizziness, body aches, mood swings, nausea, and many moments of detachment from the controls, so to speak. I also managed to catch bronchitis and another cold during this time, which makes me wonder about the impact on my immune system. The process has been awful enough that I am not interested in returning to any medication. My life circumstances are different now and I’m hoping that some exercise and some mental discipline will allow me to be med free. It has been nice to be med free. So, I would not recommend this drug, Pristiq. Perhaps someone in a different situation might benefit from its mind-numbing affect, but I did not. The withdrawal symptoms showed just how powerful this substance was on my system. This gave me a wake-up call to find different ways to address my “issues” that don’t involve chemicals. Taking these drugs should be done with careful consideration. They are not like taking vitamins or advil or something.
To Emorgan, the young girl living with her brother,
I extend my concern. Emorgan, you must get some extra help here…is there another adult out there who can help you, or a health cnetre you can get to? This is a most serious situation which you are in and you and your brother need help. From reading about this pristiq it seems that firstly he needs help to get off it! Please seek some real help sweetie. I am in australia and am afraid that there is not much that I can do. My best wishes and prayers are with you,
Vivienne Stephens-Reicher
Weight Gain on 100mg Long term
I have been on Pristiq probably for about a year. I have put on some weight somewhere between 5-10kg.. I am taking 100mg. From researching the many blogs a common thread is that Prisitq in the short-term helps to maintain your weight or reduce it because it depresses appetite, especially 50mg. However long-term use weight gain is common. Especially for people who increased from 50mg to 100mg.
I have put on weight because I lost weight when I was depressed and not eating. I am now eating again but very far from over eating. Actually my blood tests results are the best they have seen my good fats are perfect. The weight is returning on my hips and for the first time in my life my rib area and very much my tummy. It is slowly increasing every few months now. Not sure what to do? I would rather be fat then depressed any day. Has anyone swapped to another anti-depressent that has been on Prisitq long term because of weight gain? Has the alternate anti-depresent worked in stopping the weight gain. Or should I just stick to Pristiq?
if you are contiplating on taking pristiq…..STOP! DONT TAKE IT! going to the dr in 3 days to try and get off this s***! so angry feeling, shaky, still dealing with anxieties, and god help me when i miss 1 dose! i know what im in for when i get off of it b/c ive read all the reviews of withdrawls and i know from missing 1 dose, what happens! the weight gain is horrific after i was assured ad’s dont cause weight gain! YES THEY DO! Last year more than 2 million perscriptions were writtin for antidepressants! and we wonder why obesity is such a problem in america right now. WELL HELLOOOOO?
BTW; FORGOT TO MENTION THE FORGETFULNESS! AND THE FOGGY BRAIN, UNABLE TO CONCENTRATE, TENSE MUSCLES, LACK OF SEX DRIVE……I JUST WANNA BE ME AGAIN!!! I WANNA LAUGH AGAIN, HAVE MY ENERGY BACK, AND LOOK IN THE MIRROR AND LIKE WHO I SEE
I was on Pristiq (first 50mg, then 100 mg) for about 18 months. I decided to go off due to weight gain as well as my fear of the strong dependence on it. I tapered off over 2-3 weeks. I have been living in my own personal HELL for over 3 weeks now. Some days I feel like I have the flu. Every day I hurt from head to toe. I walk like I am 95 years old. I was given this medication to help with Monopause symptoms. PLEASE do not start this medicine. I am so sorry that I did. I researched to see if possibly I had Lupus or Fibromyalgia. That is how bad I have felt. I have an appointment with my GP tomorrow and I intend to leave there after I educate him about the dangers of this drug thoroughly. I know that there is nothing he can do to help me at this point (unless maybe he just prays for me.)
Please tell me that eventually the pain will stop. Also, I cry at the drop of a hat. Not at all like me.
Thanks for letting me vent.
I’ve taken Pristiq for about a month now. Was on Lexapro for about 5 years but that started to lose its efficacy even at increased dosages.
I’m currently on 150 mg of Pristiq (taking 3 of the 50 mg dosages). So far it’s doing very, very well. My appetite is much less than when I was on Lexapro. I still cannot exercise — for some reason my depression manifests itself as exercise intolerance. After I work out my depression symptoms are magnified to such a huge degree that I am incapacitated. Anti-depressants eventually balance out whatever is going on in my brain to the point that I can exercise again. I’m going to wait a few more weeks of the Pristiq before I try to exercise.
Anyway, I’ve been on every anti-depressant out there. Prozac and Lexapro worked the best. Effexor worked but caused me to sweat too much. So far Pristiq is not causing sweats. I feel very energized and my physical symptoms of depression are virtually 100% gone. Mood is positive as well. The only side effects I’ve had are some headaches (not migraines). I can tolerate the headaches because I know that the medicine is working to make things right. Every medicine that has worked for me in the past caused headaches. The ones that didn’t work had no side effects — no pain, no gain I guess.
I’ll try to keep updated on my progress. There are so many negative reviews of Pristiq out there that I wanted to post something positive. I honestly think most of the negativity is from patients who had to go off the Effexor cold turkey and then switched to Pristiq. I went off Effexor myself years ago and the brain zaps and withdrawal symptoms are freakishly intense. I sympathize. But please remember that what you are experiencing are probably the withdrawal effects of the Effexor and not the side effects of the Pristiq.
Wait it out. These meds take weeks and months to work not days. I’ve been doing this for 15 years and speak with some authority on the subject. Please be patient and remember, “it gets better…”
Hello, I know everybody reacts differntl to medication but from what i’ve read on this site everybody here seems to have had a negative reaction me i’ve had absolutely no side effects 19 yo male. If its helping or not its hard to tell its only been 2 weeks but i’ve found that in general i’m less depressed and some days even abnormall happy hopefully it will get better.
ok, so i have been on pristiq for about two years. i missed a dose yesterday and to say the least, i am paying the consequences today. i am having “brain zaps” and “lightening storms” in my head every ten minutes. i feel very sick. i can’t even function right now, my body is aching. it is the most unpleasant feeling i have ever experienced. people who don’t believe that these “withdrawal” symptoms are real need to only speak for themselves if they have been on this medicine and missed a dose.
i am extremely frustrated with this medication. i have been on pristiq for over a year and am now currently “trying” to get off of this med. i have been on and off antidepressents for over 17years now and this is the only medication that i have severe withdraw symptoms. i was not told about these symptoms when my dr. first prescribed me this medication. i went form 100mg to 50mg fine, but the moment that i started weening myself i started having these debilitating symptoms. i can go only 12 hr. with out a pill before they start. i have made it to 48hr. and have been extremely sick. once i take another dose though my symptoms go away until i discontinue again and i start the whole horrific cycle again. I am a stay at home mother of three and i do not have the time to be ill due to detoxing from a drug. i am now on day 5 of not taking my med and I am still having severe withdraw symptoms. these are hot/cold flashes, sweating, nausea, gas, vomiting, diarrhea, headache, vertigo, body tremors. I am at my wits end and i do not know what to do anymore about this. i am extremely disappointed in the lack of info i received from my phyiscian and the lack of things to help counter act the effects of this medication.
My friend committed suicide and is now dead because of this drug. The bs that came out of that dr’s mouth is intolerable. I did go to that site he ‘suggested’ to look up clinical study results. I put in the drug’s name. Here is what I got: No results were found matching the selected criteria
Wow! I have read most of these comments. And they are negative. Why is this drug on the market??
omg, this is really scary, ive been on luvox for about a year now, but i have no motivation to do anything, not even daily chores and im a mother of an 8 year old who is amazing, she looks after me alot, but it should be the other way around. And ive gained alot of weight, i cant lose it no matter what i try, and i used to hav a perfect figure. i went to my doctor today and he’s putting me on pristiq, but the more i read about it, im thinking differntly now. please help! not sure what to do now.
just to give you an idea of how unmotivated i am, typing this comment is such a huge effort, im about to lay down for a rest
@sharn33: Has anyone tested you for an autoimmune disease? Thyroid imbalance? Please, go to a new medical doctor — one who you haven’t seen before — and don’t ask for more meds. Ask to be tested for medical conditions that could cause your symptoms. You have described the symptoms I had before finding t reatment for lupus. My doctor thought I was depressed. I knew better. When the severe depression surfaced (it’s a symptom of untreated autoimmune disease) it was ‘See, I told you you’re depressed.’ I found another doctor and in a few months was being treated appropriately. My life came back. Yes, you will have decisions to make about medications no matter what is going wrong with your body, but please find a physician who understands autoimmune diseases and can see that you may have one.
Pristiq saved my life. Period.
I have been on Pristiq for over 18 months. I take 100mg daily and I feel great–I am just the person I would like to be without this medication. Lately, I’ve noticed weight gain, which happened to me in the past with another antidepressant, so I am hoping to get off this medication soon (waiting for the winter to be over). The only thing I am worried about is severe dizziness that I experience if I miss a dose. Hopefully going down on dosage will help.
Great medication for me and I love discount card!!
Discontinuation syndrome is very real and very difficult. Taper very slowly, take 6 weeks if you can. Even with that, it is challenging. The brain shivers and sparks are real, for me they go down to my hands. They start a day or two after stopping taking pristique entirely. To my knowledge, there is no cure other than time, which can be 7 days or more.
Pristiq is every pharmaceutical companies wet dream. A medication that may be extremely hard hard for any person, let alone a person suffering from depression, to get off of. The “good doctor’ above says that one must distinguish withdrawl symptoms from discontinuation symptoms and says that they are different and compares getting of an antidepression medication to getting off of a blood pressure med or benadyl. So if you stop taking the blood pressure medication your blood pressure will go up…ok got it. Pristiq on the other hand is most likely taken to combat depression, but from what I am reading from people who are trying to stop the use of Pristiq they aren’t even using the word depressed to describe what they experiencing while trying to get off this medication. They are using words like “brain zaps”, dizziness, nausea, body pains, headaches, ect. I bet they didn’t have those symptoms before using Pristiq. My point being…this medication should most likely never be used and if it is and one wants to get off it, they are going to have a hell of a ti me doing so. I have been on everything. I believe this antidepressant as well as others can be more detrimental to a person than being on it. A study was done linking violence to medications, Pristiq was in the top ten of that list… http://www.naturalnews.com/031017_violence_prescription_drugs.html Check it out. Also antidep can be linked to bipolar II. Not cool. Good luck to everyone trying to get off this horrible medication. Take back contol of your life and your body.
Sorry, I hit the publish button…I was saying, I was on pristiq 50 mg for a couple years and my psychopharmacologist gave me one week of prozac to come off the pristiq. I took it for three days instead of a week (don’t ask why! Just did not want to!) so I expected some symptoms. it has been 3 or 4 weeks and I am dizzy and tired but I am ok with it as I expected it. I have been edgy and cranky also. I think that everyone on ADs should have a specialist psychopharm, these drugs are way too complicated for a regular doc or psychaitrist.
took pristiq for almost 2 years…became too expensive for me so decided to go off of it… What the hell happened? my body started hurting all over,,,,, could hardly turn my neck because of the pain. Very dizzy, so tired I can hardly move much less make it through a day a work. Im a hairdresser and the back and neck pain is almost unbearable…. alieve and other counter pain meds dont even make a dent in relief… Determined to get off and through this….just hope it wont be very long….I;m into week 2 with no signs of letting up. DO NOT USE THIS DRUG!!!! SHOULD NOT BE SOLD TO ANYONE!
My family is mourning the loss of my uncle, a kind, motivated, considerate husband, brother, and a father of two lovely girls with bright futures. He had everything to live for, and family all around him. He committed suicide after less than a week on this drug.
If you or anyone you know is using or considering using this drug, beware. I have every reason to believe he would still be alive today if he had not been given this prescription. My grief is giving way to fury at such needless loss.
If I had read all of the above comments 12 months ago I never would have started on this drug (the first and only antidepressant I’ve ever been prescribed. I only found this site by googling withdrawal side effects because of being concerned about my own symptoms on Day one of weaning off the drug. I have experienced debilitating dizziness, these ‘brain zaps’ people have spoken of when I move my head, feelings of being on mind altering drugs, nausea, hot and cold sweats, and vivid dreams last night. I can only hope that these side effects wear off quickly, otherwise I am worried it will be impossible to come off this medication. Scary, scary stuff.
I was put on Pristiq, for depression an fibrymyalga (probably spelled that one wrong!)
At first it was great, I had all this energy, that I had not had in a very long time, but guess what, that energy would not stop! I was going 24/7, I was not sleeping, which eventually triggered some seizures (I have epilepsy). Pristinq also made me soooo constipated, it landed me in the hospital. The pain was so great, and when they did a x-ray, they found my intestine had collapsed into itself! There is a name for this, but I forget. But if all this Pristiq torture was not enough, the simple reason I went off this med, was because of the sweating!!! It was uncontrollable, and so embarrassing, even in the winter. I then tried Cymbalta, which made my fibrymyalga and body feel great, but still the sweating, so I went off of that, and am still searching!
Dr. Grohol:
There is no information on how to taper from the usual dosage of Pristiq 50mg per day. The lowest dosage for these extended-release tablets is 50mg.
As they are extended-release, one assumes they cannot be cut up. Or can they? What is the tapering technique to safely discontinue Pristiq?
On the face of it, it’s irresponsible for Wyeth to recommend a conventional dosage of 50mg per day but not make available a lower-dosage extended-release tablet to enable tapering.
I tried to discontinue pristiq on my own by tapering it was a disaster.I guess im stuck as my doctor sees no need for me to go off of it,so hes no help!but i feel three antidepressants is far to much.
I just want to know what happens to the body physically when you quit Pristiq 50 mg once a day? Well, I can tell you. It makes you extremely sick. Something that the psych doctor forgets to tell you when he doesn’t prescribe enough for you until the next visit. I guess that he wanted to see what happened. I have the feeling that he already knew.
Withdrawal symptoms: Nausea, Headache, Joint/Muscle Aches, Agitation, Elevated Blood Pressure, Elevated Cholesterol, Pure Exhaustion, Insomnia, Flu-like symptoms and much more.
I just don’t think that this is an effective medication for depression. I have lived on antidepressants for nearly 3 years. Yeah they helped but I am ready to get off these mind altering drugs for a while and get on with my life.
Hi Dr. – I was wondering whether it was better to take Pristiq in the morning or in the evening. I understand that the half-life is pretty short. So would it be better to take it in the morning to get me through the day instead of at night when I’d be asleep. I am taking 50mg. Thank you.
@ John
OMG! You are the only other person I’ve heard say that exercise exacerbates their depression symptoms. For the longest time I thought I was a freak!!! I would literally be in tears for days after a good workout. Eventually, those symptoms went away and I was able to exercise and enjoy it, but for the life of me I didn’t understand what was going on.
I would like to see the withdrawn of this drug discussed further. After being on Pristig for almost a year and spending the last 6months ALL BUT begging the Doctor to take me off as it had no affect to correct my problem, I was FORCED to do it ALONE. I weened my self for a month and could take no more quitting it all together 4 days ago. Since then the stabbing pain in the left side of my head and behind my eye is almost unbearable! Brain shakes and a general feeling of high Blood Pressure and a lot of Nausea. Not sure I will EVER let anyone talk me into taking MEDS of this nature AGAIN. Im 57!!!!!!!! Good thing the heart is in great shape
As it turns out, there is no way to taper off Pristiq. It comes in 50mg and 100mg tablets with a slow-release coating that cannot be broken.
The 50mg dosage is the usual dosage. There is no way to taper off Pristiq from there.
Dr. Ninan’s discussion of withdrawal or discontinuation syndrome is disingenuous. He and his employer Wyeth/Pfizer have failed to provide a way to taper off, putting anyone who takes Pristiq at risk of severe withdrawal syndrome, possibly even neurological damage.
This interview made me so angry. What a load of crap. My prediction is that Pristiq will eventually be taken off the market and rightly so. I was prescribed this drug over 3 years ago and had an immediate increase in blood pressure for which I was prescribed another drug, a blood sugar problem for which I was prescribed yet another drug and insomnia for which, you guessed it, another drug prescribed. So I am now on 3 additional drugs to deal with the horrible side effects of a drug to use for anxiety/panic attacks. The only thing I felt from day one of Pristiq was a loss of any desire for living my life. I became a walking zombie with no incentive, motivation, spark, etc. NO sexual desire whatsoever, about a 15lb weight gain, and major major sweating no matter the time of day or weather, all of which can make one depressed if one wasn’t already!
When I told my doctor I wanted off this drug, he advised me to take one every other day for a week then every two days for a week then stop. HA! No way. I made it to day 4 before all hell broke loose. Unbelievable brain zaps and dizziness, aggression unlike anything I’ve ever experienced in my life, and a sort of depersonalization or out-of-body sensation that was truly frightening. So back on the 50mg for me and I contacted the company rep who told me there was no lower dose available and that I should just taper slowly with the help of my physician. Yeah, right. OK so I can’t break or crush the pill and there is no lower doseage available for lowering slowly, so WHAT THE HELL WERE THEY THINKING?! Could it be they don’t want patients to ever be able to stop taking the drug? My guess is YES…all part of the diabolical scheme for higher profits and market share.
So I finally found a compounding pharmacist who has had success in helping many others get off of this nasty dangerous drug Pristiq. He will be compounding my pills into time-release lower dosages so that I can begin a slow steady withdrawal at a 10% rate depending on the withdrawal symptoms. I will also be taking 1200 of high-quality fish oil and a small dose of 5htp during the process. I feel for anyone who has ever been hurt by this drug. I pray the damage to our brains and lives is not permanent, and I pray they take this drug off the market. It is poison to the body and soul.
I experienced a lot of losses in our family so went on Pristiq to help with anxiety and depression. I never made it to the full dose of two pills a day as I didn’t need it, it did help with the crying so I could get through counseling. In fact, 1/2 a pill was fine for me. I tried to only be on it for a couple of months. I tried to go off & it is a horrible drug!! Brain zaps that come in waves, dizziness, nausea, diarrhea, tired, fogginess, when I move my eyes. I get down to 1/2 a pill every other day and feel so sick if I go longer without it I can’t stand it. So, this weekend I’m telling everyone I have the “flu” so I can try to get off this horrible drug. How did FDA EVER EVER approve this. Shame on them, shame on this Dr. who promotes it. I am worried if it causes long term impact on my brain. I’m trying to research what the brain zaps are because that really scares me, especially since my mother has Alzheimer’s and our brains are precious! I was foolish thinking my doctor knew about this drug. If there is a class action lawsuit against them, I’m in!!
Everyone trying to get off desvenlafaxine will experience significant withdrawal symptoms. Tapering of dose or switching will only stretch out the acute discomfort. I feel so much sympathy for those people who may be without the resources I am blessed with.
John this is a TERRIBLE TERRIBLE drug. It does not treat depression – there are FAR more effective non-psychopharmaceutical interventions for depression as you would be aware.
John please alert your readers to the pain and anguish they will experience when they choose to discontinue. It seems that Pfizer are aware that many people will never be able to discontinue from Pristiq, and Pfizer will profit handsomely from this.