Desvenlafaxine for Mental Health Treatment: How Pristiq Works

Author:

Jemma Strain

B.S. Psychology

Editor:

Emma Loker

B.S

Living with a mental health condition can affect every corner of your life, from your mood, relationships, appetite, self-worth, energy levels, to your ability to function in general. Hoping for these issues to just disappear won’t work – and it can be difficult to cope with the problems by yourself.

So what are your options? Fortunately, you don’t have to manage a mental health condition alone. Seeking professional support means that you can get the answers you need, and sometimes, medication enters the equation.

If medication comes up in a conversation with a healthcare provider, the question “What is desvenlafaxine?” may cross your mind. Your provider can talk you through the ins and outs of desvenlafaxine and whether it’s suitable for your needs. This article can also help by clarifying:

What desvenlafaxine is and how it works
The conditions desvenlafaxine can be used for
How long it takes desvenlafaxine to work
The common side effects of desvenlafaxine
If it’s possible to stop taking desvenlafaxine suddenly
How to taper off desvenlafaxine
Answers to frequently asked questions about desvenlafaxine

What Is Desvenlafaxine (Pristiq)?

Desvenlafaxine, also known by its brand name “Pristiq,” is an antidepressant medication that is Food and Drug Administration (FDA) approved for treating major depressive disorder in adults.¹ It’s also commonly used off-label to treat a variety of other conditions, including generalized anxiety disorder (GAD), social anxiety, and panic disorder. Additionally, it’s frequently used to manage chronic pain conditions and hot flashes during menopause.²

Desvenlafaxine belongs to a category of antidepressants known as “serotonin norepinephrine reuptake inhibitors,” or SNRIs for short. As a second-wave antidepressant, desvenlafaxine works in similar ways to older models like tricyclics, but tends to be better tolerated by a wider range of people.

But how does desvenlafaxine work? It comes down to how it targets chemicals in the brain responsible for mood, alertness, focus, and attention: serotonin and norepinephrine.

Mental health conditions are complex, often resulting from a combined effect of genetics, environment, biology, and circumstances. However, evidence shows that people with conditions like anxiety and depression tend to have lower levels of serotonin and norepinephrine.³

SNRIs like desvenlafaxine block the brain’s ability to reabsorb these chemicals after they’re released. This means they’re more available to “bounce” between synapses, signalling messages more freely from nerve cell to nerve cell. As a result, people with mental health conditions often feel more positive, able to function, and better overall.

While desvenlafaxine certainly benefits a lot of people, different SNRIs affect people uniquely. Therefore, what works for one person may not work for another. A mental health professional can offer valuable guidance on which SNRIs could work best for you.

What Is Desvenlafaxine Used For?

As mentioned, desvenlafaxine is currently only approved by the FDA for major depressive disorder. But it’s commonly used off-label for a range of other conditions. You may be wondering what “off-label” prescribing is. Simply, off-label prescribing is when a provider recommends a medication for a condition aside from what it was created for. It’s not illegal, and can benefit people who haven’t previously responded to approved treatment or have a condition that doesn’t currently have a specific course of treatment.

The following information covers the conditions desvenlafaxine is commonly prescribed for.

Pristiq for Major Depression

Major depressive disorder is a condition that can affect anyone, from anywhere, and can have debilitating effects on someone’s ability to function and quality of life. Evidence shows that desvenlafaxine works for improving the symptoms of depression, offering less hopelessness and more interest in activities. Additionally, benefits were seen with the starting dose, meaning that there’s less risk of the side effects sometimes associated with larger doses.⁴

Pristiq and Anxiety

Anxiety disorders, including generalized anxiety, social anxiety, and panic disorder, can lead to overwhelming fears about the past, present, and future. These fears can take over someone’s life and make them feel consumed by negative thoughts. Although not FDA approved for anxiety, desvenlafaxine has been shown through research to reduce both physical and emotional symptoms, allowing people to find a greater sense of balance.⁵ However, selective serotonin reuptake inhibitors (SSRIs) tend to be the first “go-to” for anxiety due to their more limited risk of side effects.

Desvenlafaxine for Menopause Symptoms

Hot flashes affect around 75% of women in menopause, creating high levels of discomfort. Not all menopausal women respond well to estrogen due to its association with breast cancer and other issues, so desvenlafaxine often works as an alternative option. Both desvenlafaxine and venlafaxine have been shown to improve the severity and frequency of hot flashes, allowing an increased sense of comfort.⁶

How Long Does It Take for Pristiq to Work?

When mental health conditions such as depression and anxiety – or chronic discomfort – have a firm grip on your well-being, it’s normal to wonder How long does Pristiq take to work?

The answer to this question doesn’t follow a straight path. The speed desvenlafaxine takes to work can depend on symptoms, dosage, weight, and age. For instance, one study shows that desvenlafaxine can ease the symptoms of major depressive disorder in as little as a week – but full symptom relief likely takes longer.⁷ In general, it can take up to eight weeks to properly see the benefits of desvenlafaxine. Try not to be discouraged if it takes this long to see the medication’s effects – it doesn’t mean it won’t work for you.

Early signs Pristiq is working can be subtle, so we highlight these below to help you identify them.

Signs Pristiq Is Working:

Improved sleep
More energy and concentration
Less troubling thoughts
Reduced physical pain
Feeling more like yourself
More positive thoughts and emotions

The latter two signs may come later in the desvenlafaxine adjustment period, but recognizing the earlier ones can give some hope that the medication is working. If you’re concerned that you’re not seeing any of these signs as you progress through the adjustment period, speak to your provider. They’ll be able to discuss your options with you, including upping your dosage or trialing you on another medication.

What Are Common Side Effects of Desvenlafaxine?

All medications come with the risk of side effects, including desvenlafaxine. Even though Pristiq is an SNRI, which comes with less risk than some other antidepressants, it can still pose more difficulties regarding tolerance than SSRIs. However, not everyone will experience these side effects. Plus, most people who do tend to transition past them after the adjustment period.

The following are the most common desvenlafaxine side effects.

Common Pristiq Side Effects:⁸

Gastrointestinal issues, such as nausea or stomach upset
Dry mouth
Perspiration
Headaches
Dizziness
Fatigue
Constipation
Sleep difficulties
Appetite changes
Sexual dysfunction

If these symptoms persist past the first few weeks or become too uncomfortable, talk to your provider about your concerns. Additionally, there are also rare, serious side effects associated with desvenlafaxine, which require immediate medical attention if experienced. These include the following:

Low blood sodium levels: Leading to confusion, memory and concentration issues, and physical weakness
Angle closure glaucoma: Characterized by eye pain, blurred vision, headaches, and a “ring” around light sources
Serotonin syndrome: Leading to rapid heart rate, agitation, confusion, delirium, vomiting, tremors, perspiration, fever, and seizures
Suicidal thoughts: All antidepressants are required to carry a warning due to the risk of increased suicidal thoughts

Can I Stop Taking Pristiq Abruptly?

If desvenlafaxine is causing too many side effects or you no longer want to use the medication for your symptoms, you may consider stopping Pristiq suddenly. Truthfully, it’s not a good idea to stop Pristiq abruptly. Even people who are on a low dose for a short time still risk the return of mental health issues and Pristiq withdrawal symptoms. Not everyone will experience withdrawal symptoms, but they can be highly unpleasant and long-lasting for those who do.

The following are Pristiq withdrawal symptoms to look out for – it’s a good idea to contact your provider if you experience any of these.

Pristiq Withdrawal Symptoms:⁹

Return of mental health symptoms
Dizziness
Sensory issues or brain “zaps”
Stomach cramps
Vivid dreams
Movement issues
Stomach discomfort
Flu-like symptoms, such as a runny nose or sneezing

Tapering Off Pristiq Safely

When tapering off Pristiq, the safest way to do so is slowly and under the guidance of a healthcare provider. Just as it takes the brain time to adjust to increased amounts of neurotransmitters, it also needs time to readjust to lower levels. Tapering is the best option for a successful outcome as it limits the risk of a return of mental health issues and desvenlafaxine withdrawal symptoms.

Mission Connection can help you create a tapering plan that takes into account your symptoms, dosage, and length of time on medication.

Frequently Asked Questions About Desvenlafaxine

This article aims to cover as many need-to-know topics about desvenlafaxine to ensure you feel fully informed about this antidepressant and its benefits and risks. However, there may still be some questions on your mind. For this reason, we provide answers to some FAQs about desvenlafaxine below.

What Should I Avoid When Taking Pristiq?

When first adjusting to Pristiq, it’s important not to introduce any new medications into your lifestyle without first consulting your healthcare provider. SNRIs can interact with other antidepressant medications, leading to the risk of serotonin syndrome. Additionally, there may be a risk of increased bleeding when combined with certain painkillers, such as ibuprofen.

Also, alcohol can decrease the benefits of antidepressants and increase the risk of negative side effects, such as drowsiness.

Is Pristiq the Same as Effexor?

While Pristiq is similar to Effexor, as, when metabolized, they have the same active ingredient, the two medications have slightly different drug interactions, side effects, and benefits for certain conditions. When it comes down to desvenlafaxine vs venlafaxine, the best medication for you may come down to your personal circumstances and symptoms.

Can Pristiq Cause Insomnia?

Although many people consider antidepressants to help with depression and anxiety-related sleep disturbances, they can lead to further sleep issues – especially in the early stages of treatment.¹⁰ For most people, these issues ease as they adjust to the medication. However, if they don’t, a healthcare provider can discuss adjusting the dosage or trying out a new medication.

Is Pristiq Safe During Pregnancy and Breastfeeding?

Untreated mental health conditions, such as depression, can pose risks during pregnancy. For this reason, it’s important to discuss your symptoms with your provider if you’re currently or planning to become pregnant. They can advise you on the benefits and risks associated with using Pristiq during pregnancy.⁸

Additionally, while taking Pristiq during breastfeeding can cause some excretion into breast milk, this amount is minimal. A medical professional should monitor newborns for signs of excessive sedation and typical weight gain.11

Is There a Link Between Pristiq and Weight Gain?

Antidepressants, in general, are associated with some weight gain – which is often why people either refuse to take them or decide to stop. The weight gain associated with SNRIs is minimal, if it occurs at all. In fact, one study shows that there was no significant weight gain between people on desvenlafaxine versus those on a placebo.¹² Nevertheless, if you’re concerned about weight gain on Pristiq, a provider can discuss the options of creating healthy nutrition and lifestyle plans for your needs.

Mission Connection: Improving Quality of Life Through Mental Health Treatment

Making the decision to seek mental health treatment is a sign of strength – it’s the start of taking the control of your present and future back. Yet, when the option of medication enters the picture, countless questions and worries may run through your mind. It’s normal to be concerned – antidepressants can significantly benefit peoples’ lives, but they’re not for everyone.

Mission Connection can help you in making this decision. We understand people’s concerns and can alleviate them through a meaningful evaluation and discussion. Even if medication does enter the equation, it works best when balanced with therapy. For this reason, we can discuss the following treatment options to help you find the right fit for your needs:

Our team can also tailor packages to optimise your outcomes, including residential, outpatient, and telehealth services. If you’re ready to talk about Mission Connection’s treatment options or just have more questions to ask about medication, our team is here to help. Contact us today via phone call or fill out our confidential contact form.

References

Pae, C. U. (2009). Desvenlafaxine: A new antidepressant or just another one? Expert Opinion on Pharmacotherapy, 10(5), 875–887. https://doi.org/10.1517/14656560902828351
Dhaliwal, J. S., Spurling, B. C., & Molla, M. (2023). Desvenlafaxine. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534829/
Jauhar, S., Cowen, P. J., & Browning, M. (2023). Fifty years on: Serotonin and depression. Journal of Psychopharmacology, 37(3), 237.
Lieberman, D. Z., & Massey, S. H. (2010). Desvenlafaxine in major depressive disorder: An evidence-based review of its place in therapy. Core Evidence, 4, 67–82. https://doi.org/10.2147/ce.s5998
Tourian, K. A., Jiang, Q., & Ninan, P. T. (2010). Analysis of the effect of desvenlafaxine on anxiety symptoms associated with major depressive disorder: Pooled data from 9 short-term, double-blind, placebo-controlled trials. CNS Spectrums, 15(3), 187–193. https://doi.org/10.1017/s1092852900027450
Johnson, E. D., & Carroll, D. G. (2011). Venlafaxine and desvenlafaxine in the management of menopausal hot flashes. Pharmacy Practice, 9(3), 117. https://pmc.ncbi.nlm.nih.gov/articles/PMC3870169/
Katzman, M. A., Nierenberg, A. A., Wajsbrot, D. B., Meier, E., Prieto, R., Pappadopulos, E., Mackell, J., & Boucher, M. (2017). Speed of Improvement in Symptoms of Depression With Desvenlafaxine 50 mg and 100 mg Compared With Placebo in Patients With Major Depressive Disorder. Journal of Clinical Psychopharmacology, 37(5), 555. https://doi.org/10.1097/JCP.0000000000000775
National Alliance on Mental Illness. (n.d.). Desvenlafaxine (Pristiq). Retrieved May 21, 2025, from https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/desvenlafaxine-pristiq/
Harvard Health Publishing. (n.d.). Going off antidepressants. Harvard Health. Retrieved May 20, 2025, from https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
Zhou, S., Li, P., Lv, X., Lai, X., Liu, Z., Zhou, J., Liu, F., Tao, Y., Zhang, M., Yu, X., Tian, J., & Sun, F. (2023). Adverse effects of 21 antidepressants on sleep during acute-phase treatment in major depressive disorder: A systemic review and dose-effect network meta-analysis. Sleep, 46(10), zsad177. https://doi.org/10.1093/sleep/zsad177
National Library of Medicine. (2024, January 15). Desvenlafaxine. In Drugs and Lactation Database (LactMed®). National Institute of Child Health and Human Development. https://www.ncbi.nlm.nih.gov/books/NBK501592/
Tourian, K. A., Leurent, C., Graepel, J., & Ninan, P. T. (2010). Desvenlafaxine and Weight Change in Major Depressive Disorder. Primary Care Companion to The Journal of Clinical Psychiatry, 12(1), PCC.08m00746. https://doi.org/10.4088/PCC.08m00746blu