Pristiq: Potential Adverse Reactions and Recommended Steps to Manage Them

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Pristiq (desvenlafaxine) is a well-known extended-release tablet used to manage major depressive disorder in adults. Similar to other medications, Pristiq comes with potential side effects, like headaches and nausea.

Additional side effects associated with Pristiq

Pristiq may trigger various side effects, some being more prevalent than others. These side effects might be fleeting, lasting from a few days to weeks. However, if the side effects persist beyond this period, become bothersome, or worsen, it's essential to consult with your healthcare provider or pharmacist.

Some of the more common side effects reported in clinical trials involving Pristiq include:

  • Queasiness
  • Lightheadedness
  • Sleeplessness
  • Excessive sweating
  • Constipation

Mild side effects associated with Pristiq

Mild side effects are possible when using Pristiq. This list does not include all potential mild side effects of the drug. For detailed information, refer to Pristiq's prescribing information.

Mild side effects reported in connection with Pristiq include:

  • Queasiness
  • Lightheadedness
  • Sleeplessness
  • Excessive sweating
  • Constipation
  • Sleepiness
  • Decreased appetite
  • Feeling anxious
  • Fatigue
  • Tremors
  • Dry mouth
  • Vomiting
  • Headache**
  • Sexual side effects*
  • Mild allergic reaction*

These side effects might be temporary, lasting from a few days to weeks. However, if the side effects persist beyond this period, become bothersome, or worsen, consult with your healthcare provider or pharmacist.

Note: After the FDA approves a drug, they monitor and review side effects of the medication. If you experience a side effect while using Pristiq and wish to report it to the FDA, visit MedWatch.

* For more information, see the “Side effect specifics” section below.

Severe side effects associated with Pristiq

Pristiq may lead to serious side effects. The list below does not include all possible serious side effects of the drug. For more information, refer to Pristiq's prescribing information.

If you develop serious side effects while using Pristiq, contact your doctor immediately. If the side effects seem life-threatening or you suspect a medical emergency, dial 911 or your local emergency number without delay.

Serious side effects reported with Pristiq and their symptoms include:

  • Serotonin syndrome (elevated serotonin levels). Symptoms can include:
    • Elevated heart rate
    • Agitation
    • Flushing (temporary warmth, redness, or deepening of skin color)
    • Muscle stiffness or tic
    • Nausea, vomiting, or diarrhea
  • Seizures. Symptoms can include:
    • Drooling
    • Loss of consciousness
    • Difficulty controlling your bladder or bowels
    • Sudden unusual eye movements
    • Involuntary muscle spasms
  • Low sodium levels in the blood. Symptoms can include:
    • Trouble concentrating
    • Confusion
    • Feeling weak and unsteady, which may result in falls
    • Headache
    • Memory changes
  • Respiratory problems, including pneumonia or interstitial lung disease (lung scarring). Symptoms can include:
    • Cough
    • Difficulty breathing
    • Discomfort in the chest
  • Excessive bleeding. Symptoms can include:
    • Bloody or black-colored stools, which can resemble tar
    • Easy bruising
    • Nosebleeds
    • Vomiting up blood, which can appear pink
  • Increased risk of suicidal thoughts and actions.*†
  • Discontinuation syndrome.†
  • High blood pressure.†
  • Severe allergic reaction.†

* Pristiq features a boxed warning for this side effect. This signifies the most serious warning from the FDA.† For more information, see the “Side effect specifics” section below.*

Long-term side effects

Although Pristiq can trigger some severe side effects, these are rarely reported in clinical studies. Many are temporary and will resolve if Pristiq use is discontinued.

However, in rare instances, Pristiq might cause long-term side effects. For example, interstitial lung disease (lung scarring) might not improve, even if you cease taking Pristiq. Furthermore, if high blood pressure develops due to Pristiq use, you may require ongoing medication to manage this condition.

Pristiq may also instigate long-term side effects in individuals with underlying medical conditions. For additional information, review the “Precautions for Pristiq” section below.

Frequently Asked Questions about Pristiq's side effects

Pristiq may produce various side effects. Below are some frequently asked questions relating to the drug's side effects and their responses.

Do Pristiq side effects fade away?

If your doctor prescribes Pristiq for you, you may be curious about how long Pristiq side effects persist.

Most mild side effects caused by Pristiq usually subside on their own after a few days to weeks. Although the medication can also induce serious side effects, many of these can be alleviated and improve if you stop using Pristiq.

In certain uncommon circumstances, Pristiq might result in long-lasting effects that persist. Substantiate this claim by referring to the "Long-term side effects" section under "Serious side effects" in the original text for further information.

Is weight fluctuation a possibility with Pristiq usage?

Few individuals have reported experiencing weight gain as a side effect of Pristiq. However, it remains unclear whether this side effect materialized during the clinical trials conducted prior to the drug's approval, or it might have emerged afterwards. As opposed to this, diminished appetite was a frequent side effect reported in people using Pristiq, which could potentially cause weight loss.

Keep in mind that depression, which Pristiq is prescribed for, can impact both appetite and weight. It might be challenging to ascertain whether weight fluctuations stem from easing depression symptoms, medications like Pristiq, or a combination of factors.

If you're concerned about your weight, it's best to discuss the matter with your doctor. They can offer suggestions to help you maintain a healthy weight that aligns with your depression treatment plan.

Could halting Pristiq therapy lead to withdrawal side effects?

Yes, discontinuing treatment with antidepressants, such as Pristiq, can result in withdrawal symptoms, also known as antidepressant discontinuation syndrome. For further information on this syndrome, as well as its relation to Pristiq, check out the "Side effects specific" section below.

Does the potency of Pristiq (25 mg, 50 mg, 100 mg) influence its side effects?

Although not necessarily, the risk of experiencing certain side effects may be amplified with higher doses of Pristiq. For example, nausea and dizziness were reported more frequently in individuals who took higher doses during clinical trials.

To obtain detailed information about how side effects varied depending on strength in clinical trials, consult the prescribing information for Pristiq.

Can Pristiq contribute to side effects when initially initiating treatment?

It's possible for Pristiq to cause side effects upon starting treatment. Common side effects that might emerge during the beginning stages include nausea, dizziness, reduced appetite, and anxiety. In most cases, these side effects tend to be mild and subside within a few days to weeks.

Keep in mind that side effects might surface at any point during Pristiq treatment, particularly if your doctor increases your dose.

If you experience side effects that persist or intensify throughout your Pristiq treatment, make sure to communicate with your doctor.

In-depth information about specific side effects

Headache

It's likely that you might experience a headache as a side effect from Pristiq. Nevertheless, this wasn't a common complaint among individuals taking the medication in clinical trials.

A headache can also be a symptom of potentially serious side effects associated with Pristiq. Although these side effects are uncommon with the drug, they can include:

  • high blood pressure
  • low blood sodium levels
  • closed-angle glaucoma, in specific patients

Steps to take

If you experience a sudden, severe headache while taking Pristiq, consult with your doctor immediately. This could be a sign of the serious side effects mentioned earlier.

Should you have a mild headache during Pristiq treatment, discuss the issue with your doctor or pharmacist. Some over-the-counter pain relievers might enhance your risk of bleeding if taken with Pristiq. This is why it's prudent to avoid taking any medication for headaches without first consulting your doctor or pharmacist.

Sexual dysfunctions

Rarely, Pristiq can cause sexual side effects, a risk associated with antidepressant medications, including Pristiq.

Males in clinical trials reported experiencing sexual side effects at higher rates, which could include reduced libido, erectile dysfunction, and delayed ejaculation or inability to ejaculate. A small number of females in these studies reported reduced libido and inability to reach orgasm.

The risk of sexual side effects rises with higher doses of Pristiq.

What you can do

If you experience sexual side effects while taking Pristiq, communicate with your doctor. These side effects may subside over time. However, if they persist, your doctor might suggest transitioning to a different antidepressant. They can recommend the most suitable treatment strategy for your depression.

Discontinuation syndrome

Withdrawal symptoms can emerge when discontinuing treatment with antidepressants, such as Pristiq. This is also commonly known as antidepressant discontinuation syndrome. It's unclear how frequently individuals in clinical trials experienced withdrawal symptoms when taking Pristiq.

Withdrawal symptoms can be severe, especially if you abruptly discontinue a high dose of Pristiq. Examples of potential symptoms include:

  • irritability
  • dizziness
  • difficulties with sleep
  • electric-shock sensations
  • flulike symptoms
  • anxiety or panic attacks
  • irritable bowel syndrome (IBS) symptoms, such as diarrhea, nausea, or cramps

What you can do

If you're thinking about discontinuing Pristiq treatment, it's essential to consult with your doctor. They can help make a plan to gradually taper off your medication to minimize any potential withdrawal symptoms. This may also include suggesting alternative treatments to manage your depression.

  • hostile or aggressive behavior
  • cognitive confusion
  • diarrhea
  • lightheadedness
  • feeling restless, anxious, or agitated
  • tingling or electric sensations
  • migraines
  • difficulty sleeping
  • changes in mood
  • vomiting
  • seizures
  • heightened risk of suicidal ideation and actions*
  • ringing or other sounds in your ears
  • tremors

Missing a dose of Pristiq may lead to mild withdrawal symptoms such as dizziness, headaches, alterations in mood, and feelings of anxiety. These side effects should dissipate shortly afterwards once a dose is taken. To aid in remembering to take your medication, consider utilizing a medication reminder.

* Pristiq carries a black label warning for this side effect. This is the most serious warning issued by the Food and Drug Administration (FDA). For further information, see "Suicidal thoughts and actions" below.

You should not discontinue using Pristiq unless your doctor expressly instructs you to do so.

If you are considering stopping treatment with Pristiq, consult your doctor. They may suggest a gradual dose reduction as an alternative, called a drug weaning. A drug weaning involves your doctor gradually lowering your dosage over an extended period until it is safe to stop using the medication altogether. Be aware that if you are taking a high dose of Pristiq, your drug weaning may take several months to complete.

High blood pressure

The administration of Pristiq may cause high blood pressure, even though this side effect was not prevalent in clinical studies.

High blood pressure usually does not present with symptoms.

People with certain medical conditions may find that those conditions are worsened when taking Pristiq and dealing with high blood pressure as a side effect. These conditions include:

  • high blood pressure
  • cardiovascular disease
  • history of stroke or transient ischemic attack

To learn more, refer to the "Contraindications and precautions for Pristiq" section below.

Before initiating Pristiq treatment, your doctor will typically assess your blood pressure. During your treatment, your blood pressure will be monitored.

If you already suffer from high blood pressure, it will need to be managed prior to commencement of Pristiq treatment.

If you develop high blood pressure while taking Pristiq, your doctor will typically reduce your dosage. If your blood pressure remains high, they may suggest another treatment option for your depression.

Allergic reaction

As with most medications, Pristiq can trigger an allergic reaction in some individuals. It is unclear if this side effect was observed during the clinical testing of Pristiq before or after its approval.

Symptoms of an allergic reaction can range from mild to severe and may include:

  • rash
  • itching
  • flushing (temporary warmth, redness, or darkening of the skin)
  • swelling beneath the skin, most often occurring around the lips, eyelids, feet, or hands
  • swelling of the mouth, tongue, or throat, making it difficult to breathe

For mild symptoms of an allergic reaction, contact your doctor immediately. They may provide recommendations for relieving your symptoms and determine whether it is safe for you to continue taking Pristiq. However, if your symptoms are severe and you believe you are experiencing a medical emergency, promptly contact 911 or your local emergency number.

Suicidal thoughts and actions

Pristiq holds a black-box warning for an increased risk of suicidal thoughts and actions. This is the most serious warning from the FDA. A black-box warning alerts doctors and patients about drug effects that may be hazardous.

Antidepressant medications, including Pristiq, can boost the risk of suicidal thoughts and actions in children and adults younger than 25 years. This risk is the most pronounced during the initial few months of taking an antidepressant and any time the dosage is adjusted.

Pristiq is not authorized for use in individuals under 18 years old.

It's worth noting that depression and other mental health conditions are often linked to suicidal thoughts or actions.

While using Pristiq, contact your doctor instantly if you:

  • display aggressive or hostile behavior
  • perceive that your depression is worsening
  • notice sudden changes in your behavior, feelings, mood, or thoughts
  • have suicidal thoughts
  • experience new or worsening anxiety
  • encounter panic attacks
  • intentionally harm yourself or attempt suicide

During your Pristiq treatment, it's essential to attend all scheduled appointments with your doctor. You can also engage in discussions with your doctor between visits if you have concerns about any symptoms.

Suicide prevention

If you discover someone at immediate risk of self-harm, suicide, or harming another person:

  • Ask the direct question: "Are you considering suicide?"
  • Listen to the person without judgment.
  • Contact 911 or your local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional assistance arrives.
  • If it's safe to do so, remove any potential harmful objects, weapons, or medications.

If you or someone you know is experiencing suicidal thoughts, a prevention hotline can offer assistance. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. When faced with a crisis, individuals who are hard of hearing can utilize their preferred relay service or dial 711 then 988.

Explore additional links and local resources.

Read on for vital information regarding precautions to consider before commencing Pristiq use.

Boxed warning: Enhanced risk of suicidal thoughts and behaviors

Pristiq carries a boxed warning for an amplified risk of suicidal thoughts and actions. This is the most serious warning issued by the Food and Drug Administration (FDA). For more details, refer to the "Side effect specifics" section above.

Additional precautions

It is crucial to discuss your medical history with your doctor before initiating Pristiq use. This medication may not be the suitable treatment for you if you have specific medical conditions or other health factors. The conditions and factors to take into account consist of:

Bipolar disorder, mania, or hypomania: Using Pristiq may not be safe if you or a close relative has a history of bipolar disorder, mania, or hypomania. Antidepressants such as Pristiq may exacerbate these issues or enhance your risk of a manic episode. Furthermore, Pristiq is not authorized for treating bipolar depression. Make sure to discuss your mental health with your doctor before starting Pristiq.

Increased bleeding risk: Treatment with Pristiq can boost your risk of bleeding. Your risk may be higher than average if you already have a bleeding condition, like hemophilia, or take particular drugs. These medications include blood thinners and nonsteroidal anti-inflammatory drugs (NSAIDs). You could likewise have an increased risk of bleeding following childbirth if you take Pristiq while pregnant.* Your doctor can evaluate if Pristiq is safe for you to use with your condition and current treatments.

Heart problems: Using Pristiq can cause increases in your blood pressure. This may worsen any preexisting heart problem, including heart disease, you may already have. Your doctor can provide advice on whether Pristiq is safe for you to use if you have a heart problem.

High blood pressure: Using Pristiq can cause increases in your blood pressure. Individuals with high blood pressure may require closer monitoring if they use Pristiq. Your blood pressure requires management before considering therapy with Pristiq. Your doctor can help determine if Pristiq is safe for you to use with your high blood pressure.

High cholesterol or triglycerides: Pristiq may raise cholesterol or triglyceride levels in some people, although this is not common. If your levels are already high, using Pristiq may worsen them. Your doctor can advise you on whether Pristiq is safe for you to use if you have high cholesterol or triglyceride levels. If they prescribe Pristiq, they may monitor your levels more often than usual.

History of stroke or ministroke: Using Pristiq can cause increases in your blood pressure. This can increase your risk of stroke or ministroke if you've had one previously. Your doctor can evaluate if Pristiq is safe for you to use if you have a history of stroke or ministroke.

Kidney or liver problems: After taking a dose of Pristiq, your kidneys and liver aid in removing the medication from your system. If you have kidney or liver problems, this may be more challenging for your body to accomplish. Consequently, your doctor may prescribe a lower dose of Pristiq than usual. If your kidney or liver problems worsen during treatment, they may have you stop taking the drug. Your doctor may also recommend an alternative medication.

Low blood sodium levels: Using Pristiq can lead to low blood sodium levels in some people. You may have a higher risk of this side effect if you're age 65 years or older or take a diuretic. If you already have low sodium levels, using Pristiq might exacerbate your condition. Your doctor can help determine if Pristiq is safe for you to use.

Seizures and epilepsy: Some people reported seizures after taking Pristiq in clinical trials. The medication was not studied in people who previously had seizures. As a result, it is unclear whether Pristiq is safe for people with epilepsy or another condition that causes seizures. Your doctor can advise you on whether Pristiq is safe for you.

Allergic reaction: You should not use Pristiq if you've ever had an allergic reaction to Pristiq or any of its ingredients. Speak with your doctor about alternative treatments if this is the case.

* For additional information about this risk, see the “Pregnancy and breastfeeding while taking Pristiq” section below.

Alcohol and Pristiq

The manufacturer of Pristiq advises against consuming alcohol while using the medication. Consuming alcohol may increase your risk of certain Pristiq side effects, such as:

  • dizziness
  • *sexual problems*
  • sleepiness

Consuming alcohol can also worsen depression (Pristiq is approved to treat depression).

Before initiating Pristiq treatment, inform your doctor if you consume alcohol. They can help develop the most effective treatment plan for your depression.

* For more details, see the “Side effect specifics” section above.

Pregnancy and breastfeeding while using Pristiq

Below is information about pregnancy, breastfeeding, and Pristiq.

Pregnancy: Pristiq has not been tested in pregnant women. Nevertheless, antidepressants like Pristiq may increase the risk of certain side effects if used during pregnancy. This may include severe postpartum bleeding.

Before you begin using Pristiq, it's crucial to inform your physician if you're pregnant or planning to conceive. They can provide insight into the potential risks and benefits of Pristiq treatment. Don't forget to discuss this with your doctor if you conceive while undergoing Pristiq therapy.

Should you choose to utilize Pristiq while pregnant, consider joining the National Pregnancy Registry for Antidepressants. This registry aids in identifying potential consequences that may arise when antidepressants are used during pregnancy. Learn more by visiting the registry's website or dialing 844-405-6185.

Breastfeeding: Pristiq is excreted into breast milk in minimal quantities. There's no documented evidence of side effects in a nursing infant exposed to the drug.

If you're nursing or considering it, consult your doctor. They can discuss the pros and cons of taking Pristiq and suggest suitable feeding methods for your child.

Discussions to have with your doctor

As with most medications, Pristiq may trigger side effects. Many are mild and usually subside within a few days to weeks. However, Pristiq can also induce serious side effects. Report any prolonged, bothersome, or severe adverse reactions to your doctor.

You should also discuss pregnancy with your doctor if it occurs during Pristiq treatment.

If you're eager to learn more about Pristiq, talk to your doctor or pharmacist. They can help address any questions you have regarding the medication's side effects.

You can also explore the subject further on your own. These resources might be helpful:

  • More about Pristiq: Seek additional details about other aspects of Pristiq from this source.
  • Dosage: Gain insights into Pristiq's dosage from this resource.
  • Interactions: Learn about Pristiq's potential interactions with other drugs from this site.
  • Exploring depression: Dive deeper into depression by visiting our mental health hub or perusing our depression articles.

Disclaimer: Medical News Today has made every effort to ensure the accuracy, comprehensiveness, and currency of all information. However, this article should not be used as a replacement for a healthcare professional's guidance. Always consult your doctor or another healthcare expert before taking any medication. The drug information provided here is subject to change and is not intended to cater to all potential uses, dosages, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not imply that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Pristiq's use may lead to diverse side effects, some being more frequent than others. These side effects might be temporary, lasting from a few days to weeks, however, if they persist, become bothersome, or intensify, consulting your healthcare provider or pharmacist is vital. Among the common side effects linked to Pristiq are sleeplessness and constipation, which are also mentioned in the 'Mild side effects associated with Pristiq' section. Alternatively, you could say: The side effects mentioned in both the 'Additional side effects associated with Pristiq' and 'Mild side effects associated with Pristiq' sections include sleeplessness and constipation as they are observed in people who use Pristiq.

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