Saturday, March 1, 2008

Top 5 Reasons to Forget about Pristiq

Yesterday, the FDA gave official approval to Wyeth's antidepressant Prisiq. Here are the top 5 reasons for doctors to keep it off their prescription pads.

1. It’s a blatant patent extender. Effexor XR, which brought in $3.8 billion for Wyeth in 2007, is losing patent protection this year, and Wyeth is introducing desvenlafaxine, which is simply Effexor’s main metabolite, as a “novel antidepressant.” There’s nothing novel about it. Every patient who takes Effexor produces Pristiq in their own body, at no additional charge.

2. It’s not very effective. In the studies released so far, Pristiq just barely squeaks by placebo on the Hamilton Depression scale. In the U.S. study, Pristiq decreased the HamD by only 2 points (-11.5 vs. -9.5 for placebo), and in the European study, the differences was 2.5 points. And for the higher 100 mg dose, there was no difference between drug and placebo for U.S. patients.

3. It is not more easily dosed than Effexor XR. The main Wyeth marketing point for Pristiq is that patients can get better by taking the beginning dose of 50 mg, eliminating the need for a complicated upward dose titration process. Sorry, but this is not different from Effexor. If you look at one of the original fixed-dose studies of Effexor, comparing patients taking 75 mg, 225 mg, or 375 mg, you’ll find that the 75 mg dose separated from placebo as well as Pristiq’s 50 mg. Psychiatrists typically begin Effexor at either 37.5 or 75 mg/day. At least with Effexor XR, when you keep increasing the dose, efficacy improves, meaning it actually has an efficacy advantage over Pristiq, because when you increase the dose of Pristiq, you lose efficacy, according to the U.S. study data.

4. It has no meaningful metabolic advantages. Wyeth will highlight the fact that Pristiq is not metabolized by the P-450 system and therefore does not have any drug-drug interactions. Well, guess what, Effexor has no clinically meaningful drug-drug interactions either.

5. Wyeth’s own lead investigator is unimpressed. I spoke briefly with Dr. Michael Liebowitz, the Columbia University psychiatrist who led the major Pristiq trials. Pristiq, he said, “is another SNRI--it is not a revolutionary drug.” It may be more tolerable at the starting 50 mg dose, he said, but only time will tell if it truly is clinically useful. “If it is useful, then it will make money for the company, and if it is not, it won’t.”


therapyfirst said...

I'm not a blogger expert, so I don't know all these short hand terminology terms, but I do know what lol means, and I am doing it so loudly after reading this entry!

Anyone with blind faith in the pharmaceutical industry must be clueless, delusional, or sociopathic. I just hope these "passionate" supporters of this industry get their comeuppetance when they are on the receiving end of the consequences these "new" drugs bear when widespread use occurs.

Remember the 4 P's of pharmacology:
promise(the initial indication for the drug), panacea(it goes on to treat everything, NOT!), placebo (it turns out to be not better than true placebo, if not meds that have been out for years and better trusted), and finally, poisons (and all drugs have their poisons, anyone tells you otherwise is simply a liar).
All drugs follow this.

Good day, good times, good luck.

Michael Benjamin said...

This is great--I'll link it on

We may just be talking to ourselves here, but I think we need to move beyond these "me-too" drugs and encourage real innovation. It's a little sad when the Genentech CEO says he's sick of the word "innovation."

Janonymous said...

While I agree that the Pristiq data are underwhelming, and perhaps more disturbingly, that there is no dose response as was observed with Effexor, I caution against directly comparing the two with respect to how well they separated from placebo until they are studied head-to-head (an unlikely proposition, I'm afraid, at least in the near future). Indeed, were Pristiq 50 mg as effective as one of the higher doses of Effexor, that could potentially explain a 'maxing-out' effect and thus lack of a dose response. I stongly suspect that is unlikely to be the case, however. Too bad for Wyeth...that could really cast a new light on Pristiq.

Daniel Carlat, M.D. said...

I agree that you really have to see head-to-head data in order to compare. I believe Wyeth has some head-to-head data because I've seen a poster on a study looking at the tolerability of switching from Effexor to Pristiq, and the switch was preceded by Effexor vs. Pristiq vs. placebo. Since the comparison data were not described in that poster, I assume the news was not good for Pristiq. In industry-funded trials, no data is usually bad data.

Janonymous said...

True enough. To their credit, they have published the results of (at least) one failed study (J Clin Psych 2007 68:1663).

Interesting about the poster...if that study was simply a safety/tolerability study, I wouldn't be surprised it was conducted; I just doubt that they'd be brave enough (or see the need) to look at efficacy head-to-head. They do have an ongoing trial (that is registered at comparing the two drugs, but it's a PK study.

janonymous said...

I stand corrected...there are at least 2 head-to-head trials ongoing!

Marissa Miller said...

Dr. Carlat,

You hit the nail on the head. Kudos.

Anonymous said...

Yes, its all about the Poisons of drugs never about people being overweight and having an unhealthy life style. Lets always blame the pharmaceutical companies not having medical care for everyone.
Hmmm where has accountability gone?

Anonymous said...

Hmmm...I don't know anyone who has started Effexor at 75 mg and I know a lot of people who are taking it or have taken including myself. In fact, I could not make the jump from 75 to 150 - I had tremors for 3 weeks trying to adjust to 150 mg. Every time my dose changed, I could only tolerate an increase or decrease of 37.5. I was on 225 mg for a couple of years successfully. Then it became too strong for me. I dosed down to 187.5 and then to 150. After 5 weeks I had a major depressive episode and had to go back to 187.5. Effexor easy to dose? Sorry doc, I have to disagree.

I will find out is Prestiq is any least for myself. I switched to it the other day.

Anonymous said...

I too am switching to Pristiq. After trying several other drugs with partial or no success, I am hoping for success with something new.

Anonymous said...

This is my 4th day on Pristiq, switching from Effexor XR. I was on Effexor for two years and begged my MD to take me off the medication numerous times. I could not tolerate the symptoms I would have if I went just an hour or two past my regular dosage. I had brain zaps (a term I picked up from other postings), mood swings, nausea...the brain zapping is horrible and scary. My MD would only increase my dosage until I had reached 375 mg. I then lost my job and insurance and tried to get assistance from the drug company for cost free Effexor. That was weeks ago and I think my MD is tired of having me call in for free samples. The way I feel right now--the drug company should give Effexor to the patients that are made to suffer through the horrible side effects. Right now, I virtually feel like a zombie. I feel like I can't move my head because with each movement or turn of my head the zaps worsen. I cry out to God to get this horrible drug out of my system. I don't know if Pristiq is better or not...but the makers of Effexor should all have electrodes attached to their heads so that they too can be zapped. Shame, shame on them. Also, within a couple of months starting Effexor I gained 35 lbs. I had huge carb cravings--this put me in the obese category--so I'm unhealthy to boot. Great drug, NOT.

Anonymous said...

I rarely use Effexor because of the tolerability issues early on, however I know that the drug works and reserve it for my SSRI failures.

I have been reading the information on pristiq and the efficacy is a real question, yet to be determined in clinical practice. However, the tolerability and dosing benefits are a significant improvement over Effexor. This appears to be much less of a "me too" drug then lexapro and celexa. Now that was clearly patent protection.

Anonymous said...

I am switching to Pristiq today after having been on Effexor for maybe 4 years. I never experienced a side effect such as the ones you describe. I personally failed a few other SSRIs and found Effexor to be a godsend. I have never had tremors, nausea, "brain-zapping", and am currently under weight trying to gain weight. Plus, after the initial low, my libido actually increased dramatically.

I am switching to Pristiq because I do not have as much energy as I would like, and the new "version" of the molecular component of Effexor, as found in Pristiq, is said to be a "cleaner" form.

Either way, I would recommend Effexor to anyone needing an SSRI. It certainly saved my life on numerous occasions.

Monique RS said...

You don't know how thrilled I am to find this site. I am a person who thoroughly researches before taking any meds. Let me say that I am also very ANTI-med of any kind. I'll admit that Lexapro DID save my life last year. Long story...I'm sure many know what I mean.

Anyway, I weaned myself off of it March 10th after nearly 9 months...noticing that I had become a pliable blob who was close to becoming a zombie. Plus I had huge cognitive problems with recognizing words while reading...and I read A LOT. It was most disturbing. Folks, the withdrawal symptoms are just as bad as getting on the meds. Believe what you read about the brain zaps, irritability, suicidal thoughts, etc. Not sure how I made it through...

Well, I had a couple of really severe depressive episodes the past couple of weeks and my husband forced me to go back to the doc. I have NEVER seen her so animated in any of the past six sessions I've had with her. She was over the top prescribing this 'new' alarm bells went off as I left the office. I did not take the first dose of the sample she gave me, knowing that I had to do research. Nope, I'm not a guinea pig...nope, I'm not taking this drug...yes, I'm getting back in touch with the doc and forcefully stating my concerns. Thank you all for being honest and bringing to light your concerns.

P.S. What the heck did drug companies put on us before the internet and the free exchange of info? Geez, they are now standing naked in the front window...not a comfortable place to be.

Anonymous said...

I am not a doctor. I have been dealing with depression for decades from the old MAO's. too SSRIs and now was put on Pristiq. I think I even saw Dr. Leibowitz at Columbia in this lifelong battle. (was pretty unimpressed with his GOD like atitude and impatience at 350/hr back in 1980.) Ive seen the best at Harvard and the worst in FL

SSRI's Celexa, Lexapro seem to work and I gain 60 -80 lbs each time I take them and follow a rigidly healthy diet. Celexa also had the gift of complete lobido loss.

Now I am segueing from Lexapro to Pristiq. I am still on Wellbutrin.

I cant stand the menu always being Obesity or Depression.

Day one, I am nauseous. Appetite suppressed.

I just hate this whole thing and I do not know anymore what to do.

Anonymous said...

I had been on Effexor XR 150mg for about a year and was doing great on it. I decided to wean myself off because I thought it was time. 6 weeks later I was having horrible depression and anxiety. I was put on Pristiq and after 1 month I am still having bad depression and anxiety. I will be going back on Effexor as soon as I see my Dr. It's upsetting that I was talked into this "new wonder drug" when I really just wanted to go back with what worked for me.

Kernos said...

Must be nice for all of you with med insurance or are not on fixed incomes.

I have been on Effexor XR since it has come out as part of a treatment for a severe, disabling Panic DIsorder with Major Depression. I could never afford the drug, but received samples every month. Effexor has made me functional again— [so take prozac you say... so yeh it made me crazy]

However, Wyeth in their eternal wisdom, is not leaving Effexor samples anymore with my psychiatrist, so I HAVE to take Pristiq. Have any idea how panicky it make me feel to switch to a new drug?

Wyeth, of course wants everyone switched so they can keep their billions coming in. Meanwhile they are probably trashing all that nearly out of date Effexor XR instead of leaving it for the less than wealthy.

Welcome to the worst medical system in the developed world.


42nd St. said...

I just want to say I've been on Pristiq for about a month now. And minus fogging my short term memory slightly, I have never been on an antidepressant that worked this well for me. Pristiq is my wonder drug.
So don't knock it 'til ya try it.

Anonymous said...

This is another excuse to get another company up and going on the money making mission. All these drugs are all temperary. They don't help you PERIOD, only control until you stop taking them. Therapy is the answer and if you ain't getting it there change to another one.

steve said...

to anonymous june 24. don't give up on pristiq it works just as good as effexor without the side effects.just add either 15mg or 7.5 mg of remeron and you will see great results!

Anonymous said...

I am a 40 y.o., female, and have been on Pristiq for treatment of depression for one month. I originally was put on Lexapro, but it caused severe lethargy, tiredness, and weight gain. I felt more calm and not as depressed, but I could barely get out of bed in the morning!

I was then transitioned to Wellbutrin, which made me extremely edgy and nervous. My hands were shaking at one point.

So finally, my doctor decided to try this new prescription, Pristiq. It is proving effective for me so far.

I am feeling relief from my depression, and have not had any weight gain or urges to overeat, as with Lexapro. I am also having enough energy to function and do the things I need to do each day.

Initially, for the first week on Pristiq, I did have to take Ambien in order to sleep through the night, but now I am sleeping fine without it. I am not having any other side effects at this point.

I want to encourage people to at least give it a chance. I am not finding it to be the terrible "placebo" that some people are saying it is. I agree that there is no one drug that is going to work for everyone. Each person's chemistry and metabolism is different. I am just thankful we live in a country where we have options.

Anonymous said...

Has anyone been taking effexor for chronic pain (e.g. fibromyalgia and arthritis)? My neuro gave me samples of pristiq last week to try. Wants me to taper effexor for a week while starting pristiq that week. I was taking 300 mg effexor a week for about three years.

Anonymous said...

hi. I am a 47y/o man with no history of depression until last year. My doc tried wellbutrin but it hyped me up too much. Then to Effexor. I absolutely could not stand it. It made me feel like I had taken a hit of Xtasy. I am now on my 7th day of Pristiq and so far I LOVE it. It has been a wonder drug for me. I am back to my energetic self, going to the gym daily at 5am, work is a breeze and I am getting stuff done at home that I had been postponing forever. The only side effect I have had is socially drinking. I go from sober to bombed. But I'm more than willing to give up alcohol at this point.

Kathleen said...

I was just prescribed Pristiq yesterday. I don't even know how many other drugs I have been on in the last couple of years but I was taking Cymbalta. I took Effexor years back with little or no relief. I agree that this is probably a ploy by the companies to make more money but I am hoping this works at least somewhat with not as many side effects. I am so discouraged my the difficulty of treating my depression with medication I cannot even believe it. Now I am trying to get treatment for my six year old son who had ADHD and some other yet to be really diagnosed anxiety issues. Meds for mental illness are a crap shoot and it is even worse when it is for children because they don't have many studies for kids because of all the ethical issues. Anyway, I wonder about this new drug. It seems to be the same as the other stuff out there just with a ridiculous name. Who thinks these names up? Same people who pick names for nail polish! Ha, Ha! Maybe that will help with the depression-the insanity of the drugs, their claims and their names! Well, we will see how this stuff does. Keep your fingers crossed!! Thanks for this site.

Anonymous said...

I too have had success with Effexor and now have no health insurance and cannot afford $12 a pill and the Dr. office has taken samples "off the menu" but generously gave me Pristiq- I HATE it! I am a B!@#$! I feel soooo fat and am miserable! How wonderful is it that finances or lack of them will determine functionality! Hope the folks at Wyeth are having a wonderful day!

Anonymous said...

I have been diagnosed with clinical depression since the age of 18,and am now 58. Have taken everything prescribed----old stuff, new stuff, prozac when it was experimental. Have just been prescribed this one. Fearful. Two of my three children, one of whom is now dead, also diagnosed. Both took Effexor---HATED IT---especially when they stopped. I believe that we are all searching for some relief, and as long as we have life, we have hope. Thanks for all who try to make things better, those who do not have to answer to themselves and to whomever their concept of God is.

Anonymous said...

Jean 1950 says...I too am one week off Cymbalta going to Pristiq for social anxiety,fibromy.,arthritis.  Cymbalta was terrible for 8mo. raised my blood pressure and sweat, oh my gosh, dripping while dressing with 2 fans and air condition cranked at 70.  Just couldnt get to stop. Jury still out on this Pristiq.  I had read about the horrible effects of getting off Cymbalta but Dr. said both these drugs in same family so no big deal.  Well I am on day 7 and dizzy,zapping when head moves,blood pressure still up even on meds but the terrible sweating is much much better.  I will give a little longer I am hoping this is the period of just getting the old out and the new med regulated.  But I agree side effects of all these meds so horrible I am ready to give up on meds if this doesnt work and get better. 

Anonymous said...

I think people are really really ignorant. I've taken Effexor and that is completly different that Pristiq. I had sooo many side effects on Effexor and hardly any so far on this. My blood pressure on Effexor sky rocketed and Pristiq hasn't effected that at all.
I've also taken Celexa and Lexapro(isonomers) and they recact like completley different drugs than eachother. I don't think drug companies are as bad as stupid people say they are. They bust theyre a**es and spend a crap load of money to create these things.

Anonymous said...

I'm a very active patient. I do a lot of research and am slow to trust doctors - I don't put anything into my body without first reading everything I can about it. I recently read everything I could about the recent placebo findings. However, please don't lose sight of the people that these drugs actually make a huge difference for.

I was on Effexor XR for ten (yes TEN) years. Over the past year I developed extreme fatigue. After every medical test in the book we decided it was the Effexor (oh and by the way I started and stayed at 150mg, saved my life, even longer story than this one). Getting off of it was bad - I had to switch to working only part time, and it took five months.

However the most important part of this story is once I was off Effexor, my brain went completely downhill. Major depressive episode. Doctor tried Wellbutrin... Prozac... we tried 6 different antidepressants, in different combinations. My insomnia was so extreme that 10mg of Ambien plus 2mg of Xanax would not put me to sleep or keep me there. I thought for sure that Prozac would work, it's the wonder-drug, right? It's the one thing we hadn't tried on me ten years ago. If there was ever a placebo effect for me, that would have been it. I was getting suicidal, couldn't even work part-time. I had two catatonic episodes. It was difficult to make it even hour to hour, let alone day to day.

Finally, he put me on Pristiq (right after it got approved), because the side effects are supposed to be decreased. One week later I was more myself. No more panic attacks, and by two weeks no more crying fits. I am back to work part time and hoping to be full time soon so I can begin paying off the monster loan I had to take out so I didn't lose my house as a result of not working!

Bottom line is, while the studies may show that these drugs all work the same for people (that is, less than 2% above placebo) the truth is that everyone is different. And some desperate people do fall in that 2%. Twice in my life now the only thing that has saved me from looking at extreme solutions such as shock therapy or hospitalization has been a form of venlafaxine. So I am a believer.

I do have side effects - no libido, higher blood pressure, higher cholesterol, stubborn weight gain, some nausea. But even if I were to go back to the extreme fatigue (sleeping 20 hrs a day) it would be worth it to not feel the way I did while in that major depressive episode.

When all is said and done, I have to ask if these findings about the placebo effect don't just underscore that as far as the brain goes, it's just one big guessing game.

Pristiq for energy? said...

To the anonymous who said -

"I am switching to Pristiq because I do not have as much energy as I would like, and the new "version" of the molecular component of Effexor, as found in Pristiq, is said to be a "cleaner" form."on June 5, 2008 8:59 PM

How has Pristiq been working with you? Any changes with energy?

Your description sounds really similar to me (failed w/SSRIs, Effexor worked, increased libido, slightly underweight/no weight gain experienced, hardly any other major side-effects) and the only thing that Effexor ISN'T currently helping me with is energy.

Anonymous said...

I have had horrible sweating with Pretiq and i have been on it for about 5 weeks. does this go away? If not, then i have to get off of this med, it's embarrasing and uncomfrtable to break out in a sweat for 15 minutes at a time in a 72 degree room, especially at work.

Anonymous said...

I have been on Effexor for 3 years or so with no problems. My Dr. said this just came out so try it. I have been taking Pristiq for about a month now. No major problems, but one. Nighttime bedwetting!!! Has anyone else seen this? Could this be caused by this medication or do I have a new medical problem? This has happened twice now, completely without my knowledge until I wake up soaking wet. Also, seems like no matter how much or little sleep I get I am always sleepy.

I don't think I like this med very much. Will go back to Effexor.

Aunestlei said...

I'm on day 3 of Pristiq & I have to say I'm glad it's the weekend because uncontrollable crying & not being able to walk without running into walls isn't socially acceptable. I know it's just the withdrawl effects of the Effexor but I thought this wasn't suppose to happen while switching to Pristiq.

In a nutshell - I've been treated for 20 yrs. 1st couple were trying to figure out what did & did not work. Prozac worked well for about 16 years then I started suffering from lack of concentration & depression again. In comes Effexor XR @ 225mgs & life is good. Really good. I'm clear headed, I can sleep, I've got energy & a sense of humor. The only downfall - I had to rely on samples. Now we have "new & improved" Pristiq no more more samples from Wyeth & day 3 feels a lot like 20 years ago.

My question is what do I/we do? What can we do? I want to be a productive & contributing member of society, and though I haven't been formally asked to take part in a test panel, I sure do feel like a guinea pig.

Look, my cynicism has returned as well...Any suggestions?

Anonymous said...

Just wondering if anyone has switched from Zoloft to Pristiq. I'm a 42 year old male and have been on 150mg of Zoloft (and now generic) for 4+ years with good success. No more fear or panic attacks, but am not a whole lot of fun anymore. My doctor suggested Pristiq, but I'm not sure. I'm really not in the market for a horror story to post to this blog. Any thoughts?

Anonymous said...

I've just completed 3 weeks on Pristiq with absolutely no sexual side effects...

Anonymous said...

I started Prestiq 2 days ago, switched from effexor with the sugggestion of psyc because of the "cleaner" attribute and added norepenepherine reuptake. I would take effexor at night becuase of the drowsey effect. Pristiq is keeping me awake all night. Does anyone take it during the day? Anyone have problems with sleep after becoming adjusted?

judi4hope said...

My 1st ever blog. Car accident 3 yrs ago, so my doc tried me on Zoloft last summer, but couldn't feel it. Then he tried me on 37.5 then 75mg of Effexor ER last Thanksgiving, and I could finally control emotions better. He just switched me to 112.5 a month ago, THE no more tears dose. But my spouse is really angry with the libido issue (I'm fine!), so my doc switched me to Pristiq yesterday. So far it's OK, but thanks for your site. It's so nice to know I'm not the only one with sleeping issues as well; I use dramamine to get about 4 hrs solid each night. Some dizziness and nausea are my only troublesome side effects. Hope this Pristiq keeps me numb like the FXR did.

Joey said...

I am a 42 y.o. male and have been taking Pristiq for about 7 weeks now. This is my first attempt at an antidepressant drug at the insistence of my wife for my irritability and total mood swings I have had for years. My first thought is that I do not want to be a zombie or a veggie or even a guinea pig in a drug experiment but I sure feel like one now. The doc has been ever so kind, giving me loads of free one week samples and now I can see why. As for the drug, the first week I felt like my balance was off and a number of times I ran into the inside corners of my house. I also experienced dizziness at times, mostly early on. I also didn't sleep well for about the first week and didn't get to r.e.m. sleep, then all of a sudden one night I have this terrific, very real like, dream. This has occurred to a lesser extent over time. The sex drive has been been almost completely gone up until about a week ago. The drug seems to put a small damper on my irritability but instead I feel anxious at times for no reason. My appetite was also severely affected up until within days of my wanting to have sex again and I have noticed that the drug is somehow less affective, like my body is used to it now or something. My overall energy for the day is less than it used to be although I have been out of work and off my schedule since May so that might be part of it too but I can drink a pot of coffee in the morning, strong coffee too, and will want to take a nap around noon and if I'm sitting down, I just might at any time of the morning/early afternoon. Looks like a dosage increase won't help so maybe it's time to look into other remedies.

Anonymous said...

I'm a 28 y/o female that has been on anti-depressants for the last 15 years. I switched from 75 mg of Effexor XR to Pritiq 50mg 3 months ago. With the Effexor I was experiencing horrible side effects, with the Pristiq I had initial side effects, but the only lasting one is Insomnia. Currently the Pristiq isn't cutting it; I'm swinging into depressive bouts and the only increase available is to 100mg. That seems a bit overkill to me, so I'm going to talk to my Dr. about switching to something that has more manageable dosing.

Anonymous said...

Been 2 wks on Pristiq - still horribly dizzy, several times each day, and I'm unable to control emotional crying again. A doc friend of mine suggested to give it 4-6 wks; not sure I can stand these side effects that long. Steve, 6/1/08, What does the remeron do internally?

Anonymous said...

I have been taking Pristiq for two months now and I am very happy with it. I have Fibromyalgia and I was first on Lexapro, Celexa (yes, they are different) and Cymbalta. Cymbalta had me so nauseous I lost 20 lbs. It really helped with pain, but with all 3 of these...bad sexual side effects. Not so with Pristiq.

Anonymous said...

Back on FXR 75, and the dizziness has almost disappeared. I'm able to hear and see all kinds of topics again without crying, so I'll cast my vote for the original molecule!! Best of luck to you all.

Anonymous said...

I had great results with Cybalta, but I went to a new doc and he told me Pristiq had less side effects....well im on day 5 and I actually hate my life even more than before! I can forget about the pain and my brain screaming, however I feel compelled to go back to the doc today, as I am now feeling suicidal. I guess meds are different for everyone.

Anonymous said...

Thank you guys for being so honest about what's happening in your lives. I was just dispensed the little "One Week Sample Pack" from my doctor when I told him I needed something for my nerves because my 14 yr old daughter ran away 2 months ago and has not been seen or heard from since. I found it a little strange that he wanted to put me on a depression medication. I quickly voiced my opinion about not wanting to take a depression medication for this issue, but he insisted that depression was the "real" issue we were dealing with here and "What else are you wanting me to give you?". I told him, "I don't know, you're the doctor!" Well, long story shorter, I finally agreed to take the pack home and try it for a week. BOY AM I GLAD I FOUND THIS SITE! I feel like I have just prevented having to deal with MAJOR issues, by taking this little pack of Pristiq and giving it back to the doctor.


Anonymous said...

47 year old here. I have been on Celexa, Buspar, Wellbutrin and now Pristiq over a 10 year period.

Celexa turned me into a zombie and totally shut down my sexual drive.

Buspar/Wellbutrin was great for a while, but the dosages were hard to maintain at three per day for the Buspar.

After 4 years drug free I started to feel untethered and anxious. My psychologist recommended I go back on the meds. I visited my PCP who recommended I try Pristiq.

Today is my third day. I'm not transitioning from another drug so I obviously haven't experienced any withdrawl symptoms.

I've been a little dehydrated, but other than that have felt great! My nerves have calmed down, my appetite a little suppressed, and I'm sleeping better.

My sex drive appears ok thus far.

Jaxsonjr said...

48 yr old male - eight years ago I had a panic attack - diagnosed with General Anxiety Disorder. Took less than 1 mg. Xanax a day for 2 years. Another panic attack. Prescribed Paxil - what an awful drug - zero libido - weaned off of it. Settled in on the Prozac/Wellbutrin combo with 100 mg. Trazodone for sleep. Eighteen months decided I was at a better point in life and did not want to have so many drugs in my system. I weaned off the Prozac. Slowly weaned off the Wellbutrin 6 months ago while starting to take the .5 mg. Xanax time released at night with the 100 mg. Trazadone. Two months ago stopped taking Wellbutrin. Everything was great with just the Xanax and the Trazodone until two weeks ago. Started waking up at 4a every morning. Went to my doc this past Monday - just five days ago - prescribed Pristiq for depression and 12.5 Ambien for sleep. My insomnia and anxiety are worse than ever on Pristiq!!! I cannot sleep more than 6 hours taking Xanax, Trazodone,and Ambien, along with the Pristiq. This is awful! As I write this it is hard to concentrate - I felt better before the Pristiq and Ambien. I am jittery, sweating, dry mouth,etc.

Anonymous said...

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Clinical Depression

joefy said...

OK, I've been reading this blog and feel compelled to put in my 2 cents' worth. I have a love-hate relationship with Effexor. I've been on it for about 4 or 5 years and it has helped me more than any other antidepressant I've ever been on (thus the reason I've been on it so long). That's the love part. The hate part comes in when I run out of the medicine. The withdrawals are worse than anything I've ever experienced in my life. And there is a very small window where I can be late with my dose before the withdrawals start. So...I recently changed jobs, lost health insurance for 3 months, and had to practically mortgage my home to refill my 150-mg dose for just one month. And because of the impending release of Pristiq, I can no longer get samples to get me through. So, my doc, with a very low level of enthusiasm, says, "Well, you can try Pristiq, which is exactly the same thing. If nothing else, it will get you through until you get insurance, because I have SAMPLES!" A wise woman, she is. But here's the deal. It's not exactly the same. I'm not really having withdrawals, thank God. But I've been on it about a week and feel more depressed than I have in a very long time. I had a similar experience with Celexa, to which I had a moderately positive experience. Lexapro did absolutely nothing for me. Maybe it's mind over matter. It just sets my teeth on edge that it is such a blatant patent-extender. Greedy bastards. Sorry. Anyway, my point is this: Number 1, Effexor, love-hate. Number 2, Pristiq, nothing but a scheme to extend their patent, and a very ineffective scheme, at that. The only thing I can say it is doing for me is staving off the withdrawals until I can get my insurance back and get back to the Effexor. Which I feel chained to for life...but at least I'll be at "functional" level of depression while in those chains!

Terry said...

I am starting week 3 on Pristiq. I dealt with the insomnia by changing when I take the medication. I used to take Pristiq first thing in the morning and I just could not sleep. Now, I take it at bedtime and I sleep just fine. The dry mouth has decreased, but in my opinion its never a bad thing to drink plenty of water.

I do have one interesting side effect, my legs get jittery, kind of a "creepy-crawly" feeling.

However, I am feeling so much better on this medication. I was diagnosed with depression and my doctor suggested Pristiq first off. So far, I have been pleased with the results. My mind is clearer, I enjoy the activities that I used to and my family has seen a real change for the better.

So, for what its worth to other readers, it works very well for me.

Anonymous said...

58 yr. old female here who has been on SSRI's over 14 yrs. for clinical depression. Started out on Zoloft (gastric problems), then Prozac (happy camper) for 3 yrs. but too lacsidasical about everything. Next came Paxil which made me sleepy all the time and dropped my blood sugar. Celexa made me cry, and finally Luvox which I was on for about 10 yrs. If I took a very minimal dose of 25-50 mg. a day, I function OK, but never had any ambition.

Then came Pristiq, which, so-far-so-good. Dr. gave my husband the samples, but he couldn't take them because of Coumadin, heart, and kidney problems. So, one day I said 'what the heck', and I'm happy to say that it is working great for me. I've got more energy, can sleep at night, and am more focused which is a major plus because I also have adult ADD. Had to stop my ADD meds a year ago, so now Pristiq takes care of both problems of ADD and depression.

Sorry Dr. Carlat, but your critique of Pristiq (no pun intended) doesn't hold true for everyone. I, for one, am pleased with this drug.

Anonymous said...

I've been on Prestiq since June, no side effects and it works great! I sleep well, have better concentration and do not cry every day like I use to - I was suffering after the death of a loved one - Thanks Prestiq

Anonymous said...

Maria 33

Suffering Depression & Generalized Anxiety Dissorder.
I have been taking Pristiq for 2 weeks.
I experienced the common side effects for the first week or so.. dry mouth/tiredness etc.
I was switched from 9 months of Lexapro - killed Libido but was great for the Anxiety.
Pristiq is allowing me to enjoy activities again however I do not feel any real GAD relief... do you think 2 weeks is too early to tell?
I would love to hear how others with GAD are finding Pristiq :)

Joseph said...

Joe 27 -- Bipolar I

I hate the idea of me-too drugs. However, one drug can be a life-saver for one person but provide terrible side-effects for other persons. Working closely with my Dr. and being medicated for years, I speak from experience.

To the point, My Dr. recently moved me from Prozac -> Pristiq. So far, tolerating it much better. Never had a chance to try Effexor XR, but have hope for Pristiq. It may be a me-too drug, pharmaceuticals are getting rich on it, but it may have potential.

Just keep in mind that each person's body chemistry is different. And read the labels of anti-depressants ... [we are not sure exactly how it works, but we think it effects this neurotransmitter and we think that is what helps depression] ...

And one lesson, depression should be treated with more than just drugs. I am certain that drugs help, but they are not the complete answer to 'curing' depression.

Anonymous said...

All of these entries have been very helpful and interesting, thought i'd share what I've been experiencing.

I was on Welbutrin 9 years ago for about 2 years for depression but have not been treated for anything otherwise. Recently I've been having major anxiety and mood swings so my doc prescribed Pristiq.

The first night I took it I was up all night with major nausea and in the morning I felt high as a kite. I had been drinking the night before so I stopped taking it and began after the weekend. Sunday night I took it again and it was great. I slept through the entire night (which hadn't happened in probably over a year) with no nausea and didn't wake up feeling extremely high. The only thing is it dilates my eyes and if I take it too late in the evening my eyes are well dilated into the morning. (Doc said to take it at night to sleep through the possible nausea and dizziness side effects)

So far the only other side effect i've experience is decrease in appetite and a very slight sexual side effect. (It takes me a lot longer to...finish). Otherwise it may be too early to tell how it will totally effect me, I'm about a week and a half in and the doc said it would take about 2 weeks. I feel my moods have evened out and I'm not feeling so super worried about everything all the time. I'm excited to see what it's like after a month or so.

Anonymous said...

First off, I cannot even begin to explain how many hours/sleepless nights I've wasted researching these drugs over the internet. Not only is it stressful, but it is literally making me sick to read about all of these horror stories after just being prescribed a medication by my doctor. Personally, I think that EVERY drug has it's pros and cons, but it seems to differ from person to person. I think it has been made clear that the "perfect drug" does not exist and probably never will.
My life has been a constant struggle from as far as I can remember. My intent was not to tell you my life story but the hell with it... It all started when I was about 6 years old. I had developed a major case of OCD. I would have to touch something about 10 times before it felt "right" in my mind. And not a word could be uttered by anyone in this process, or I'd have to start all over again. Not to mention, the horrible humiliation of having to look back at my heel every minute or so, only to be made fun of by my own "friends". Eventually, I also developed an eating disorder in middle school, to the point where my hands were blue and I was shaking uncontrollably. You could literally see all of my bones- I was paper thin. I would cry in front of the mirror every night and pace around my room in the middle of the night, hoping to lose that extra pound. I would throw a fit when my family would want to go out to dinner...even when they would say "oh just get a salad". I could not put ONE thing in my mouth or I would go hysteric. When you have an eating disorder, you don't see what other people see when you look in the mirror. You see a fat, ugly person and can point out flaws on your body that don't even exist. They exist because you imagine them, because you are so obsessed that you begin creating your own imaginary flaws. In fact, I began to hate myself and my body SO much, that I began cutting myself. I had no intention of killing myself, I just wanted to change my body- to be someone else. Sooner or later, I was admitted to an inpatient hospital where they "tried" to help me overcome my eating disorder. It actually made it worse. I was surrounded by people who had intense disorders and was traumatized by some of the things I witnessed in that hospital. My own room-mate actually asked me if I wanted to drown myself in the bathroom sink with her. My memories there haunt me to this day. When I finally got out, my psychiatrist decided to put me on Lexapro at the age of FOURTEEN, mind you. Don't get me wrong- It DID help, in fact, it probably even saved my life. Within a few months, I no longer had an eating disorder and my OCD symptoms were improving. But then, my life was thrown another awful curve when I started high-school. Long story short- I was raped, went back to square one. Except this time, i actually DID want to kill myself. I thought how could my life get any worse? Why is all of this happening to me? I just didn't understand. Soo, that was all the more reason to INCREASE my dosage higher than the recommended amount, that the pharmacist was even questioning it. I didn't notice any CRAZY weight gain- thank god. But obviously did gain weight since you know, I was a recovering anorexic. And in all honesty- i was fucking 14- i wasn't knowledgeable about the effects these drugs could have on you. If that wasn't enough- my sophomore year, I was having trouble concentrating in school, so my psychiatrist put me on Concerta. Yes, it helped me concentrate- lost a little weight.. whooppp dee dooo. Later on, my dad insisted I stop the Concerta after researching it over the internet and god only knows what else. So, stopped that..kept going with the Lexapro up until after my first year in college. Then I thought to myself- I am fine, I feel fine.. Why am I even taking medicine anymore and what is it doing for me? .. I couldn't even tell because I was so young when I first started it. This is where I made my BIGGEST mistake: I stopped Lexapro cold-turkey. I do not recommend this to ANYONE! This was the WORST few months of my ENTIRE LIFE!!!!! I was having crying spells, tingling of the hands and feet, chest pain, zapping pain through my upper arm- I literally felt like I was having a heart attack. Not to mention the horrible panic attacks I would experience on a daily basis. (at the hair salon, in school, even on the fucking AIRPLANE) It was so severe to the point where I couldn't even drive my car. I was scared to go out because I was afraid of having another panic attack in public. It was just plain embarrassing. I have also never had a panic attack before in my life before the Lexapro withdrawal, so I had absolutely no idea what was happening to me. (in all honesty- i thought i was developing some kind of heart disorder.. call me stupid- but i'm being honest!) I even took myself to the emergency room once because I thought I was going to die. (it is funny now but it definitely wasn't even close to being humorous at that point in time) Eventually, all of the craziness stopped. No more panic attacks, I could drive, I could go out in public and function normally. I thought I was "healed" and that time was indeed the cure to everything. Unfortunately, life doesn't work that way- at least not mine. Recently, I had gone back into my major depressive mode. I lost interest in everything- friends, work, school- you name it. I cried constantly, even in front of my friends and co-workers. It became embarrassing once again. My life felt un-manageable and I felt helpless and hopeless. I was a worry freak and almost always stressing about something. I finally decided to go back to see my psychiatrist only to be recommended the newest drug- Pristiq. The whole point of going off of Lexapro was to be drug-free. I was glad to have "made it through" the road of hell... and now I was being prescribed a new drug. I have never felt more hopeless in my life. Why is happiness so hard to achieve? Do we really need drugs to make us happy- or is it just all in our heads? Do antidepressants really make us gain weight- or is it our lifestyle changes and emotions that trigger this? Finally, Why are all of these questions so hard to answer?! Since the moment I was given the sample packs of Pristiq, I have been researching endlessly about this new medicine. . only to be overwhelmed by everyone's success and horror stories. All I'm asking is to be happy, successful, and worry-free... and not have to put on the extra however many pounds the antidepressants make us gain to obtain that. The sad thing is, the only person who can answer these questions is myself. Because it is MY body, my mind, and my life.. everyone reacts differently. But a lingering concern I have is the effect these medications will have on your body when taken long-term. There are so many side effects, they could have their own dictionary. Doesn't that alone set off a warning bell in your mind?

you might say- good for you, that you have come to all these conclusions. But what does that leave me with? ... Nothing, nothing but the un-satisfaction and uncertainty and hopelessness about the field of psychiatry, medicine, and most of all... life.

I think what matters the most is that you are staying true to yourself and your beliefs. Don't make decisions based on someone else's stories or experiences. I learn best by experiencing things on my own- you might too. Trust your instincts and have confidence that you can and WILL get better... after all, that might be just what you need.

Now i'm left with the un-nerving decision of continuing with the Pristiq (after 2 days of taking it) or just giving up on it all and leaving it up to me to make myself better.... who knows!

Big Steve said...

It's working for me. But it must all be in my mind, right?
Even though several other meds *haven't* worked over the years.
This on'es helping. Sorry to disappoint.

Anonymous said...

Been on it for about a week, a little insomnia. I am just trying to find one with no sexual side effects. we will see

Anonymous said...

I am a 34 year old female with a 18-year history of depression/ocd/anxiety. I've been on Zoloft, Celexa and finally Effexor, which was like a god send for me. I also take Ativan as needed, which was very seldom until recently when I started taking Pristiq. To save money, I switched from Effexor 150mg to the generic form. It must have been a bad batch because I felt achey all over and slightly depressed. I told my doctor and he suggested I try the Pristiq (gave me lots of samples!!) He said 50mg of it was as good as my old dose of Effexor. After getting over the sea-sick withdrawal feelings from the Effexor, I felt great and full of energy for about two weeks. Then I started having severe anxiety and panic attacks. Back to the doctor again because I just can't function with the anxiety and I have already spent a fortune on therapy. My doctor increased the Pristiq dose to 100mg about two weeks ago, but I am still struggling with the anxiety and sometimes panic attacks. I wake up anxious every morning and am taking 2 to 4 mg of Ativan everyday. I plan to give the Pristiq a few more weeks to quell the anxiety and then I'll let you know. I can't keep taking the Ativan because I don't want to depend on it. With the Effexor, I rarely needed Ativan. Hope this helps someone.

Anonymous said...

Hi. I'd only given Pristiq two weeks then gone back to FXR cause my dizziness/nausea were so terrible I couldn't concentrate. This person mentioned side-effect of a "seasickness" when coming out of Effexor - is that normal?? I've only been on it for a year, and I don't know anything about side effects/changing.

Anonymous said...

I started taking prozac around 1995 and it was a god send after several years of therapy and I was still deeply depressed seemingly for no reason. However, because of the sexaul disfunction I kept going off it,, but I would eventually lapse back into serious depression. That is where I am now, I have not been on prozac for 5 years. I need to do something so i have hopes for pristiq because the trials show a very low incidence male "delay."

pondskum1 said...

i just sat here 4 the past hr n read every 1 of these comments! WOW, these are like the story of my life, so i wont even bore u with the details. i just started pristiq on fri., 11/07/08 n found that the term "seasick" is an incredibly accurate term 4 the way i've felt 4 the last 3 days! i thought it was from the pristiq but it sounds like withdrawl from the fxr. wifes home, can't finish, sorry. hopefully, later. thanx 4 all your info n help in this battle.

susureid said...

I am a 52 year old post menopausal female, going on two years now without a menstrual period. I was prescribed Pristiq in september by my gynecologist. This was after I asked him for something for depression, anxiety, and insomnia. This was his immediate wonder drug of choice for all three problems. I recently have experienced heavy bleeding, almost to the point of hemorraging. Does any one know if there is any correlation?

Anonymous said...

Been on & off antidepressants since birth of my 5th child...tried Pristiq in July & feel fine!

I also went into therapy in Sept & she tells me I should be OFF P in 6 months...Is this woman MAD???!!!
What a scary possibility. Think about it...

Anonymous said...

Probably not a welcome comment, but aren't we all trying to get OFF the drug therapy, and back into control of our real lives?? I've been using FXR for a year, seeing two different counselors, to try to get control of my emotions, and be my cheerful, original self again. When a doc says that you can be off the antiD in 6 months, you should be GLAD!

Anonymous said...

Here's a wild side-effect of Pristiq I haven't seen much of (but experienced big time) the sensation of having a bladder infection.

I went from 50 to 100 mg and within 2 days felt the pressure and urgency of a bladder infection. Woke me and kept me up about 2-3 nights a week. I'd made an appointment with a urologist when my p-doc figured out the problem.

I've gone up again once and gotten the same effect. Not as horrible on 50 mg. Very strange. I wonder if it can eventually lead to actual damage to the bladder?

Anonymous said...

I have been prescribed Pristiq for a cough (bronchiectasis). After reading some of your comments on I reckon I should just stick with the cough and leave the Pristiq alone. For my cough I take 30mg of codein each night and have to wait for it to 'kick in' in order to get any sleep. I do not want to keep on taking the codeine each night but the Pristiq seems to be a worse path to take. My doctor gave it to me today, did not tell me it was for depression (I am not depressed) and I have not yet taken any. After reading some of your stories on here I really do wish you all the best for the future xoxoxoxxo

Anonymous said...

I was on Lexapro which was making me not care about anything .. apathetic. Dr. changed me to 50mg Pristiq, which got rid of the apathy but has made me feel hopeless. And the odd effect of giving my urine a peculiar aroma.

Tavie said...

Similar story to others: my doctor tried to switch me from Effexor XR (150 mg/day, for 11 years) to Pristiq (50 mg) without tapering. She gave me weeks and weeks of free samples.

After three days I was so sick I could barely walk straight. I had to call her from the pharmacy and beg for an emergency prescription for Effexor because I was so sick I couldn't work and was having crying jags, lightheadedness, dizziness - this after just 3 days.

She switched me back to Effexor after expressing surprise that I would have such a reaction. I think she must never have switched anyone before. It is ridiculous to assume you can take someone off of Effexor without tapering properly.

Pristiq is a patent extender because Effexor is going generic. Period. Wyeth is pushing doctors to push it on their patients. It's incredibly irresponsible. If your doctor suggests switching you without first tapering you properly, BE VERY WARY.

Anonymous said...

Hi, I'm 25yrs old and I was diagnosed with depression early this year and was given Pristiq. Unfortunately because it's a new drug my insurance doesn't cover it and was switched to Effexor, which I was told was exactly the same as Pristiq pretty much just an older version, what a bunch of @$%& that was. I have not gotten much sleep in the last month, I'm dizzy most of the time, nauseous and on top of that I am suffering of full blown out anxiety. After telling my doctor all she did was up the dosage and tell me to wait and see how it works :( well all you have to do is look at my nails and they will tell you everything. I have been bitting my nails and the anxiety has not gotten any better. I understand that it's a new drug but why can't they understand that some drugs work better on some people and that if we tell you it's not working it does not mean please up my dosage but get me the hell off of this meds. I personally love Pristiq while I was taking it, I didn't have any side effects other than being nauseous if I took it on an empty stomach but other than that I can call it my miracle drug. Without it I'm moody all the time, want to cry for no reason and snap at people for the strangest reasons. I would recommend people trying Pristiq to see if they work for them, give it a try it might work for you too!!!

Anonymous said...

Hi, just thought I would share my experience and anxiousness to forget about pristiq myself. My doctor prescribed this to me as treatment for insomnia. My complaint when I initially visited him was horrible insomnia only occasionally when there was too much on my mind thanks to work. I suppose this was seen as anxiety disorder which could possibly be true. The 'anxiety' never got in the way of anything besides sleep though... no problems turning off the work side of the brain when I worked out or watched television or went out with friends, etc. Only when I tried to sleep would I not be able to just drop it.

When I started taking pristiq I immediately felt many of the common side effects such as nausea, sexual, sweating, loss of appetite, and just feeling bad in general. Also, my muscles were immediately shaky. The doctor urged me to keep it up for a few weeks so I did. There was initially a very minimal help with my insomnia, but that wore off quickly. After two months, I began having tremors I'm assuming from the medicine, a feeling much like the shakiness of my muscles. This was too much so I've started to reduce frequency of dosage and it's complete hell with the vertigo. Today has finally been much better so I'm hopeful that forgetting about pristiq is upon me.

While I realize the effects that pristiq has had on my brain will take some time to go away, I'm curious if anyone knows how quickly the blood is actually gone from the blood stream. I'm also curious if anyone else has been given this prescription as a solution to insomnia.

Best wishes to all this has helped, but to those who haven't tried it, please be wary.

Anonymous said...

My father-in-law, a longtime sufferer of depression, was put on 100mg samples of Pristiq. Three days after beginning the drug, he attempted suicide/overdosed by taking approximately 3 weeks of pills. He was in and out of consciousness for three days before being cognizant. For those three days, he was in a state that could best be described as dream/night-mare like. Although it is too early to say, he appears to have regained motor and brain function.

Anonymous said...

Hi, thanks for all of your comments. I have been on Effexor for 10yrs ( beginning at 21yrs of age) 75mg up to 150mg and now back to 75mg. I really want to quit taking effexor and try and become pregnant. I was told that Pristiq might be the way to go. I am afraid to switch and/or stop b/c things have been so great on Effexor. I do get sick if it is more than 24 hours that I do not take my pill. I also used to take dexedrine for adhd but stopped that 7 months ago and am doing well.

Does anyone have any thoguhts or suggestions? I try to explain it to my husband.... but he has never suffered from anxiety and depression and insomnia and tries to understand but he just does not get it!

Thanks again


Thanks so much

Bill said...

My pdoc recently had me try pristiq because the anti-anxity pills were not working for me any longer, (allthough with whats happenning to our economy, don't think anything would work)so he said give pristiq a try it is supposed to not have the anxity effect effoxer has.
WELL, their new poison made me in a constant state of rage, whole body shakes, couldn't even hold my fork still to eat.
So, my pdoc said stop immediatly, and start back on effexor, I was only 1 week into ween off-on.
I stopped the pristiq and decided to waite a few days before taking effoxer again, and something amazing happened. I was no longer depressed, all day. I actually felt better than I have for the last 5 yrs.
I didn't take effexor till the shock waves started, took 75mg to stop the shock waves and suddenly I became depressed again.
Next day, didn't take the effexor, felt great again. No effexor for 2 days, fealing great,day 3 shock waves, 75mg of effexor, depressed again.
Told my pdoc what was happening,needless to say he was perplexed.
Non the less, since he is the best pdoc i've had in 20 yrs, he said he's not one to argue with success.
So I decided to deal with the shockwaves rather than try to introduce annother poison pill into the mix since it now became immpossible to ween off the effexor.
It's been 3 weeks of steady shock waves now, all though they are not the heavy ones I've experienced before where your head feels like it's going to explode, more like a constant ringing in my head.Still,after 3 weeks it gets old.
While my situation is forced on me because effexor seems to now have a reverse effect on me, namley, it makes me depressed instead of managing my depression, or should I say my former depression, because baring the constant zapping in my head, I still feal great, I would not recommend anyone going off this crap cold turkey, slow and steady weening is a much better way. Believe me, because I've been trying to get off this crap for 3 years, and have allways had to return to taking it again, even wound up in the psych ward twice.
Also, I'm not suggesting that anyone take pristiq, and return to effexor expecting the same results i've experienced, namly, depression gone, I'm sure it's a fluke, and I still do not know if it's a perminet fix for me, since my brain feels like it's being rewired and my outcome is still in the air. My main reason for writing this is because these drug compines are more than willing to put us through hell, lie to us about the effectiveness of their poison just to make $$$$$$$$$.
pristiq is nothing more than a new cash cow for them.

Anonymous said...

I have suffered from depression and mood swings since I was 15 (I'm almost 26 now) and have never tried any medication. Finally I said enough already and my doc put me on Symbiax. That was because I told him I was diagnosed with bipolar when I was in high school. That diagnosis was WRONG, and the symbiax just made me feel like I was sedated and I gained almost 15 lbs in 2 months. I went from 125 to 140. I stopped taking it. 3 months passed. I lost almost all the weight and was about 134 lbs.

Needless to say, my depression and moodswings were still there and I was still frustrated.

I have been taking Pristiq for over a month now, and I am not even kidding, I feel like I have my life back!

It started working almost immediately for me. The first few days were the only days I had any side effects and they were: feeling like I was mildly tripping on mushrooms (which was kinda cool), dialted pupils, loss of appetite and trouble falling asleep. Those are ALL gone, and they went away after just a few days. I never had nausea, vomiting, shaking, nothing like that.

I used to get headaches all the time and feel like just laying down when I got home from work every day. I haven't had a headache in a month and I have enough energy to get through everything. I'm not depressed, I've been in a great mood, I feel like I can concentrate and think clearer, focus on tasks, and talk to people without getting all psycho about everything. My negative thoughts are all gone.

I just found out that my insurance WON'T cover Pristiq, so that means I pay out of pocket: $132 per month!

At first I was very upset, because that's a lot more than I'd ever want to pay for anything, but I feel so much better, so happy, so wonderful, that I'm willing to pay that much for it. If I have to work 2 extra days a month I will.

It's saving all of my relationships. My husband calls me a new nickname on this medicine: "Sweet (insert my name here)" When I told him how much it cost, he offered to pay half AND on the day I refilled he asked me, "Did you get your medicine today!?" All excited. I KNOW this drug is making a difference in my life, a huge one. For the first time I don't spend my days off work obsessing and feeling sad. I spend my time doing things I enjoy/have to do- I HAVE MY LIFE BACK.

I won't switch to anything else because it's cheaper. It's not worth it when something works this well for me.

Anonymous said...

I read most comments trying to find one similar to my experience but haven't....Pristiq has had the nastiest side effects of any AntiD I've ever tried...Sweating, severe memory loss...could not remember what I had just said after I said it....chest was tight & felt I couldn't breathe, nausea, burning feeling in the lower abdomen, aching back around kidney area, panicky, heart felt as if it was beating very slowly, could not sleep, bad sinus headache, extremely sore throat, I thought I must have some sort of virus the first night I took it, it couldn't possibly be these wonder meds the doctor had described as a newer, cleaner version of some otherdrug (Effexor)-I had to hold back my laugh I just knew he was repeating some sales pitch from a drug rep. I took 50mg the first night, then cut the tablets in half and took 2x 25mg for the next two nights with exactly the same symptoms worsening straight after I had taken the drug. My worry is that this was a severe or allergic reaction and people are thinking that these are side-effects from taking a new drug. I have taken Lexapro previously and didnt experience anything like this. I am scared wittless now to try anything new, I feel I may as well have purchased some good old- fashioned Extacy or Crystal-Meth.(not that I've ever tried these either), hope this helps someone out there, I have read all other comments and did find them somewhat helpful.

Anonymous said...

I am new here, but there is good info on this site. I was originally diagnosed with
OCD and been on Prozac, Zoloft, Paxil and now Lexapro. The best being Lexapro.
Recently I have a number of things in my life that has gone haywire-such as jobs, bill,
the economy and so on and so forth. After speaking to my doctor he put me
on Wilburtin along with my Lexapro….Wow the Wellbutrin made me angry, edgy,
shaky and nervous…He took me off that and gave me Pristiq along with the
Lexapro..What are your thoughts? Is this too much at one time??

Anonymous said...

All I know it the Pristiq works for me! The effexor x/r had stopped working and the zaps were getting to numerous. My sex drive is back, PMS is controllable, I feel like a new women. It's so sad I had to deal with all this since having my children. It has almost cost me my marriage. I was in chronic pain after having my children, too, and effexor and pristiq helps so much with that. I'm only taking pristiq now and it works wonders! I hope it doesn't stop working like Effexor did.

Annie said...

I have been on Pristiq for 6 mo. Prior to that, I was on Effexor XR-300mg daily. On Effexor I was a complete jumbling idiot; skaking, memory loss-total, no recall, severe weight gain-you name it I experienced it. Weening myself off so I could take Pristiq SUCKED! I couldn't function for weeks. I am a single mother of a 2 y.o. That's just not a reality. But since I have become acclimated to Pristiq, the only weird side effects that I have are a small electrical twitch in my right nose up thru my left eye and severe uncontrolled, random body movements when lying down.(which might be my Lupus ) I am on Pristiq 100mg. 50 proved insuffiecent for my depression, lupus, fibro and chronic fatigue along w/ my panic/anxiety attacks. Remember, what works for one or some does NOT mean that it works for all. For myself, I can only testify that Pristiq is and and still is producing the best results out of all the countless numbers of other anti-depressents that I have tried for over 12 yrs. Perserverance pays off. U have to keep trying the alternate drugs to see what is best for you and you alone. Good luck everyone. Remember, YOU are you own advocate, not the doctor. U know what works and what doesn't, so never be afraid to be your own health advocate!!! May All the Blessing be yours!

Bill said...

just a follow up on my post 12/15/08.
Things going from bad to worse, brain shocks still alive and well,but now other things are happening.
I've read somewhere that when you start taking AD's, they rewire your brain, or (to sound less morbid) start to send your thinking processes along different paths in your brain, in effect, acting like a director of traffic. As time goes on your brain becomes reliant on this new traffic director and lets it do the job. When you suddenly remove the new director of traffic, your brain doesn't know what to do when it has to take over the job again, it doesn't really know how to reroute things, so it has to start from scratch and learn it's job again.
Having said that, it's probably why you need to tapper off so the brain can slowly take over the job again.
Well, I'm having one hell of a time getting things working again, i find that I can not stop thinking, I'm still not depressed, but my mind just constantly thinks,my emotions run wild, one minute I'll be ok, than something stupid will set me off into a rage,after I calm down I'll suddenly start crying, one time for a short instance i felt like killing someone, no one in particular, a feeling just came over me for about 5 min and left.
So all my emotions, all my thoughts are out of control. I can't sleep because my mind won't stop thinking, i told my pdoc and he wanted me to try rispidol to try and refocus my thoughts, I was willing till i read the side effects sheet, i told my pdoc that crap has more side effects than
dioxin, do they really give this junk to kids?????????????
Any way, i can't get to sleep, one evening when I was out of control, i took a 2mg of ativan, no effect after 1 hr., took another, 1hr, nothing till the fifth one i started to calm down, now it's 11pm so I figured I'll go to bed maybe I'll sleep, so to be sure I took my sleeping pills, 2 50mg caps of vistaril, laid down, 2 hours later I'm still not sleeping and my mind is still racing. 2 more vistaril, nothing, now it's 6am and haven't slept a wink, get out of bed, have a cup of jo, lay down on the couch and doze off for about 4hrs. So in a period of about 10hrs I took enough crap to put a normal person into a coma and got 4hrs of sleep.
Last night, pretty much ditto, but I went out for a few beers and got pretty toasted since I don't normally drink, got home, 2 vistaril, still awake 2hrs later, 2 more vistaril, still awake ate 5am, out of bed down to the couch and 3 2mg ativan, got to sleep after a hour for about 4-5 hrs.
Meanwhile, between all this, well, let me back up a minute.
I have also been diagnosed with sleep apnea (did the sleep test a few years ago) so when my AD's weren't working as well a they had been, asked my pdoc if I could try provigil, read that they use it in Europe for depression, but not in the US of Money, but since I had sleep apena my insurance allowed it. Worked great, but after about a week it starts dropping off, so I would quit taking it for a few days, and it would work again,been using it for about 2 yrs this way and at the end of the month I always had a few extras, over time i would have enough for a month and got behind on filling my scripts. Well when all this crap happened after pristiq,I stopped taking them. I had about 5 left from the last script, so after I told my pdoc to shove the rispidol, i tried a provigil, and it got me calmed down so my mind wasn't racing anymore, so I now have that under control, still have the brain zaps, still can't get to sleep.
Needless to say all this has taken a toll on my relationship with my wife of 30yrs, things were said while I was out of control, many of them true, but I am the type to just let a lot crap roll off my back, but now I'm not, so were planning our divorce. But in some strange way I feel better now that I've told her what a bitch she's been all her life and probably contributed to my problems.
I know I'm rambling now, so just take my word for it, this stuff is the hardest monkey I've ever had to get off my back, and in my younger days I've had to get a few of them off, but they pale in comparison to effexor.

Margaret said...

I have been on Pristiq for a little over three weeks now. I have never tried anything else previously, but have heard of the side effects of lexapro (weight gain) and told my doctor I wanted one that wouldn't cause me to gain weight. She recommended Pristiq saying it was "Weight neutral". I have to say that I can tell a big difference and feel that it is helping me. I tended to take everything that anyone said to me personally and have an exceptionally stressful marriage. I have a type A+ personality while my husband has a type A+++++++ so we got into a lot of heated arguments. He is also quite jealous with no reason to be and I have a lot of anger inside because of that. I find that the few occasions that we would have gotten into a knock out drag out argument that I have been able to remain calm and react rationally instead of emotionally. The side effect of waking in the middle of the night is gone (I experience for about the first 10 days). I have also lost about 5 pounds which was a very welcome side effect. I saw where someone else posted about very vivid dreams that they remember when they wake up and I too have those, but since they are pleasant I cannot complain about that. ALl I can say is that it is working for me!!!!!

Anonymous said...

Six days on Pristiq. I have most of the negative symptoms outlined in the flier. Nausea, dizziness,insomnia, loss of appetite, etc... I feel more anxious than without any meds. I had been off Wellbutrin for two months. I have a call into my doctor to see about shutting this stuff down.

Anonymous said...

I know that we all react differently. I, personally, have had great success with Effexor (225 mg) for the past 8 months. I had weaned myself off of Paxil on my own (took 8 months) because I had become lethargic and gained over 50lbs after being on it for over 10 years. I suffer from panic attacks, GAD, depression and thyroid probls. Unfortunately after i weaned off the Paxil I went through a "thyroid storm" that nearly killed me. Effexor was a life saver in more ways than one. I just want to say that if a person is diabetic, he would need insulin to remain healthy. Its no different if our brain chemicals are not producing what we need either. I have no problem taking something to help me get through life. I learned that there has already been enough suffering in my life. If there is medication to help along the way, why not. All I can say is that its working for me and I will continue to do what I have to do to be healthy, functioning and well. I wish you all peace and calm amidst your storm. Remember that it will eventually pass. Let medicine, therapy, and your support system help you through your tough times. And remember, share with others your successes too...they are just as important. Blessings to you all for mental health, clarity and peace. laura

Anonymous said...

I'm a 27 yr old female with severe ADHD (inattentive, not hyperactive). Today my doctor gave me samples of Pristiq to take along with my Adderall (I take a very low dose, approx. 20mg/day), to try and make me gain weight and basically "counteract" the side effects of the ADD. I've been under a lot of stress this past year, to the point where I stress about being stressed; but I'm not depressed or anything. In fact, life is pretty great. However, due to said stress, I've lost 30 lbs. in the last year. In my case this is not a good thing. I'm 5'7 and now weigh in at 110 lbs...this in itself is depressing for me as it has totally messed up my body image. Ever since I was 15 I've been built like Scarlett Johannson; now it's more like angelina jolie when she's really skinny. (just using them a body type examples by the way).
I haven't tried to lose weight, I eat like a horse, don't work out, etc... The doc also did blood work on all endocrine systems to rule out anything hormonal.
I'm very concerned about Pristiq since after reading the posts, quite a few people seem to have experienced loss of appetite & weight loss, and of course, insomnia...which due to Adderall, I struggle with already.
Should I give it a try just to see what happens? Has anyone else taken Pristiq for ADD as opposed to depression??

Michelle said...

I just discovered this blog this evening and appreciate reading about Pristiq from each of your experiences. I began taking Pristiq just over a month ago for generalized anxiety and depression. I had been taking Lexapro for a few months, but during that time I had frequent anxiety, weight gain, and insomnia. So my doc suggested Pristiq. The first week was rough, but that may have been from coming off of Lexapro. After nearly 5 weeks on Prestiq, I feel pretty good actually. I take it in the evening and now sleep well through the night. My weight has stabilized. I have improved energy and improving focus during the day. I hope it's not too good to be true!

Jozy said...

Hi. I suffer OCD and GAD. After being on Lexapro (and gaining weight), trying Luvox (and suffering terrible side effect) and now being on Pristiq (a very, VERY new med here in Australia)for 7 weeks I feel the best I have in quite some time. It took 2-3 weeks to get past the initial side effects but since then I am feeling in control of my life (for the first time in ages), I am not feeling so hungry and picking at food and I am sleeping soundly instead of the 4 hours at most a night that I had put up with on the Lexapro. My OCD episodes are there (and I think that they always will be) but no where nere as strong and crippling as they were, I can work through them. I only hope that I continue to feel this way. For now it is working really well for me.


Anonymous said...

I have been on antidepressants for almost ten years, wellbutrin and celexa, which has worked well so far. I did have to increase my celexa about a year ago due to increase stress at work. Now that there is even more and I went to the pdoc. How interesting that they try to give you the latest and greatest meds. Now that wellbutrin and celexa are sold in generics of course it is cheaper. So what did I get----Pritiq. Went off the celexa, first night was horrible, had insomnia. Well after waking up almost every hour, finally at 4am I threw in a benadryl, well that worked. Whats even funnier is I work in the medical field, that should tell you everything. I just can't believe the docs that as soon as one medication is off into the generic catagory here comes another medication to hand out just to increase profits. I actually makes me wonder how much pristiq is since she did give me a ton of samples. I think I'll go back to the old. Thank you all for all your input, at least I know I am not alone. God Bless.

Monkey said...

After 7 years on varying doses of Effexor XR, my new insurance company raised my copay to $200 for a one month supply, claiming that I'd been on it for "too long" and it wasn't on their list of approved medications. Since there is a generic available of the non-extended release, they apparently think it's fine for me to take a pill every 3 hours to keep from being suicidal. My doctor moved me to Pristiq in response... it's an amazing difference. The Effexor worked, but the Pristiq really has eliminated the side effects. I had a terrible brain fog on the Effexor but figured I would have to live with it since it was the only thing I could find that worked at all for me. I'm beyond happy that there's something that still works and keeps me able to think clearly and quickly. I feel like the world is finally what I remember it was before the depression started.

Anonymous said...

I am a 31 year old female who has been on Effexor for 7 years. I was initially put on it for postpartum depression. I have tried desperately to wean myself off of this horrible drug, and have failed miserably. I am an RN and have researched, spoken with colleagues, physicians and no one can offer any TRUE solutions for getting off of this medication. I also have ADD and take Adderol as well, recently I began having "panic attacks" and had to add yet another drug to my regime (Xanax). Yesterday I went to the Dr. b/c I am tired of all of the meds, costs, side effects etc. I am going to try Pristiq and hope that it will be an easier transition and allow me to eliminate the other meds as well. I wish I had had resources like this before I began this medication, I would have never taken it to begin with. I am a new nurse so I didn't have that resource available then either. Anyway, will keep you posted on effectiveness of Pristiq vs. Effexor, hopefully no electrical shocks will occur during the transitional stage.

Anonymous said...

I’ve read some studies and was eagerly anticipating Pristiq when it was released. I’ve tried the 50mg dosage on a few occasions, and for some reason, it just was not effective for my anxiety. Without any kind of stimulation, I often felt as if I was on expresso the whole day. Certain situations would increase my anxiety and tension to near panic like symptoms; and this was while I was taking Buspar and a low dosage of xanax (which would normally keep me calm). It also increased my hunger and disturbed my sleep. In the beginning, my irritability increased as well and never fully went away. I tried it both during high stress and low stress periods. To me, it feels like Effexor 112.5mg-150mg but without the anti-anxiety effects. I did perceive slightly less side effects than effexor, such as sexual and fogginess, but I just wasn’t feeling right and started to avoid some situations that would cause anxiety (although to be fair, sometimes I would do things I wouldn’t normally do like goto bars with co-workers after work and I had a few days that went really well). I am planning on going back to either Prozac or Effexor XR as this drug is not working for me. I think this might be a good choice for someone who doesn’t have any problems with anxiety. In theory, this should work nearly as well as Effexor, since its an isolated salt (with an improved SNRI ratio) , but until it gets some FDA approvals for anxiety disorders, I am probably not going to return to it. Also, unlike Lexapro which had scientfic studies backing its increased efficacy over Celexa, Wyeth hasn't provided any head-to-head comparisons with Pristiq vs Effexor, nor any ways to transition from one to the other. I also couldn’t tolerate it for more than 2 ½ weeks, and even then, I started to get really tired. Another strange thing is that stimulants such as Adderall and Provigil DON’T increase my anxiety, and in some ways make me calmer. Has anyone else had a similar response and stuck with it and it got better?


Anonymous said...

I am a 61 year old male and have been taking Pristiq for several months. 3 weeks ago I ran out of my 100mg supply. When I did not take it for a few days I became symptomatic like the very bad flu, vomiting diarreah extreme pain and cold sweats. I went to my dr, not psychrist, and she said I had the same symptons as someone going cold turkey off opiates. Yhis is a very dangerous drug and the side effects should be disclosed before given to patients. The day after I went back on this addictive drug the symptons went away. It does not take a brain surgeon to make the connection.

Anonymous said...

Well, on Friday after talking with my doctor and doing research I stopped taking Efexor and started taking Pristiq. Over the past few days I have steadily become more teary and irritable and the brain zaps are horrendous. When I found myself bashing my hands on the wall and then I kicked in a wall, before thinking I would go to the shed and see if there was anything I could drink to end it - I said enough is enough. Pristiq is not for me - Efexor is.

Anonymous said...

To the person who just did the quick switch from Effexor to Pristiq: I have a possibility for you. I've been on 75 to 137.5mg Effexor XR for a year and a half, and this week I've tried alternating the 75mg with 37.5mg every other day. Still really teary and down, but so far no nausea, and that was my worst battle. I've never been on meds before, and my family doc gave this to me for depression/PTSD after a car accident four years ago. My face is still a mess with scars, but I'm getting my new tooth next week, so I wanted to try doing it on my own. I'd suggest that you probably need to ramp down off the Effexor first, then try the Pristiq from a clean start. Pristiq might actually be good - the libido side effects of Effexor are great for me now personally since I have such neck and back pain that I have no desire for romping in bed anyway, but most people seemed to say that Pristiq is better in that respect. I read somewhere about a rare but gross side effect of Effexor where one's body starts uncontrollable writhing, and I'm scared to stay on it any longer than necessary. Good luck!

Anonymous said...

i've been on effexor for over three years and believe me the brain zaps are terrible along with severe headaches when i tried to wean myself off of it. But now i lost my job and insurance i found myself seeking cheaper meds. The dr. had some samples of Pristiq and trying it now and seems to be doing good. It is however cheaper.
Susan said

Anonymous said...

Let me just say that I'm the type of person who rarely goes to the Dr. for anything, ever. For the most part, I've always thought that people with so-called mental health problems just weren't "strong enough." However, after having a baby and 4-5 months of hardly any sleep and other stresses on top of it, I started to experience some mental health issues. I didn't want to go to the Dr. My family made me go, and I was in no mental or physcial state to resist. The Dr. prescribed Pristiq, and it has truly helped. I have not experienced any negative side effects. I agree with the posters who say, "Don't knock it 'til you try it." It does work.

Anonymous said...


Anonymous said...

To the seven day person: try it for a few days at the same time each day, seriously, the same HOUR of each day! I have trouble with nausea and crying even if I take mine at a couple hours difference (so sleeping in isn't fun at all!) From what I've heard, it does take at least a week to get used to a new med, but also, please don't stop the counseling. I found that it really helps to have someone on my side during the transitions. Best wishes. Judi4hope.

Anonymous said...

I had a bout of very severe depression (crying, no sleep, no appetite, fear of being alone)30 years ago which was brought on by generalized anxiety. I've never been depressed since then but we have moved 9 times and I have 3 children with severe medical problems (which I am sure come down my husband's side) so I still have lots of anxiety. Doctors still try to give me anti-depressants but I don't like the side effects. What DOES work? XANAX, VALIUM and all the other minor tranquilizers!! I became dependant on them in 3 days--DO NOT GO OFF WITHOUT QUARTERING YOUR PILLS AND DROPPING VERY SLOWLY, LIKE ANOTHER QUARTER EVERY MONTH. BUT WHY GO OFF? I'm 60. I take valium 3 times a day and have for 8years. It was given me because of muscle pain in my back! It has been a Godsend. i have NOT developed a TOLERANCE for it--not needed higher does. I almost always take HALF the dose prescribed for me! Most docs won't prescribe these meds long term which is a shame because they work. Most people do not abuse (take more and more of) these drugs. If you don't have depression, but just anxiety, why not take the good old benzodiazepines! They have gotten an unfair rap.

John said...

I'm 41 and have been on Effexor for 9 years. In those nine years I weaned off twice, tried celexa and cymbalta, and am now back on 300mg of effexor and feel fine. But that means nothing for YOU! Not all depressed brains are alike, and no one med is "good" or "bad". Effexor at 300mg is the only thing I have found that works for ME. Stay off the blogs and message boards and find what works for you. By the way I have no depressed friends on meds (or so I think) reading over these posts and knowing that my struggle is shared.... it's been a good night. If you have questions about effexor email me, I know it intimately ( I know I need effexor for life. I went off in August before my first child was born (out of guilt)... back on by december. A BAD 4 months. I am ME on meds, I am someone else off them. I know that now.

Anonymous said...

I too have been on Effexor XR 300 mg daily for several years and before my dose was increased to 300 mg. daily I did exp. increased appetite for carbs. However, my Dr. told me that the ravenous appetite often goes away with the increased dose and that is exactly what happened to me. In fact I lost weight for which I am very pleased. For me it has worked great-please don't depend on comments of others for whom it doesn't work. Each person has to take a medication and then decide along with their Dr. what is best for them. Everyone responds differently to medications of all types.
Thank you God for modern science!

Anonymous said...

I have been on Effexor xr for about 7 years. I have tried on several occassions to get off the med. only to realize what a depressed and anxious witch it made me. I have finally realized that was my personality until 7 years ago. I have finally come to the realization that if I need this med. to function like a healthy, normal, happy human being then so be it. I do not want my kids to know the "other me" - pre-effexor. I have experienced all the side effects mentioned, worst of which are the night sweats, but I figure it a small price to pay to be able to actally "live" my life.

Luap said...

I was on Lexipro for about two years, it never really worked for me.....I just took it cause I didn't have anything else, my depression/anxiety got worse and worse....I tried Lortabs for about three weeks, (5mg twice a day), it worked wonders, but there is too much stigma to opiates to explore them as a viable medicine.
Tried xanax for a few days, it worked wonders, finally went to my family doc, he gave me pristiq and ativan,(2mg of ativan twice a day).

The change has been wonderful.
I am trying to keep up with how it effects me here.......

Anonymous said...

I was just given the Pristiq prescription actually I've got a month worth of samples. I've been on Effexor XR for about 5 years and am up to 150mg. I actually tried to stop taking a few years ago got down to 75mg every other day and ended up begging the doctors to put me back on in fact my exact words were "if I ever try this again just shoot me". I was a basket case and cryed every 10 minutes.

Now I'm feeling the same way and I really didn't want to get up to really high doses so I talked to my doctor and we came up with the Pristiq. I just started taking Adderall for my ADD and I'm hoping that between the two of them I start feeling like a normal happy person again.

I'm hoping between the meds, my therapist and some divine intervention it all works out, and after reading some of these posts I think there's a good chance it might.

lowflyin lolana said...

I took effexor for 8 years---the last three, I don't think it was working for me. I fell lower and lower. I started at 37.5 and ended up at 225mg/day for the long term. It took 8 months to taper off of it..very difficult, especially at first. I took some sick days to deal with it.

Tried Zoloft last year and it did turn me into a zombie.

Started the pristiq about four weeks ago. Noticed a difference right away, in energy, concentration, and focus. I am very hopeful about Pristiq, because it is so good to feel normal again. I'm hoping it lasts.

Antidepressants really turned my life around. Nothing before that worked, not 3 hours of exercise a day, lots of talk therapy, believe me, I tried everything. I felt like it was my "fault" for a long time, that if I just "pulled myself up by my bootstraps" I should be able to do better at work, be able to get up out of bed in the mornings, etc etc etc etc. Didn't believe in meds because everyone I had known who took antidepressants, was very depressed...and I figured they didn't work.

I also struggled with obsessive thinking and an insane amount of anxiety and paralysis.

I was astounded at the difference---that it was possible to really feel normal, like I had when I was a kid, before a lot of terrible things happened to our family. I had wondered if what I was experiencing was just what happens when you get older. There were days when my mind was so bad, so paranoid and hopeless and paralyzed, that I literally could not talk to people. Some days it was very hard to write at work (I was a radio news anchor and wrote the headlines)---there were days when I would sit there staring at the computer just barely able to make my mind work enough to do the job.

Medication (along with a lot of therapy) really changed that. A few weeks in with Pristiq I am really hopeful that it will continue to help. It has been several years at a level of (for me) low functionality. The past four weeks have been different. Thanks for this blog, I will read more.

Anonymous said...

It should be, in my opinion, remarketed as a sleeping medication. Four days on Pristiq and I slept an average of 14 hours per day. In the ten hours I managed to stay awake all I wanted to do was go back to bed. Another day and I'm convinced I would have been declared comatose. One of the side effects of Pristiq is anxiety - exactly the reason it was prescribed for me. Does this not seem bizarre? Diazapam as needed does the trick. Why should I have to go into a coma for relief of occasional anxiety attacks? I just called my doc to say "no thanks, either give me something else or more than 10 diazapam at a time".

Anonymous said...

I was given Pristiq 50mg about 2-3 weeks ago but am going to quit it as it is doing nothing for me. The depression, anxiety, PTSD and extreme suicidal thoughts are at a really bad point. My Pdoc is putting back inpatient on monday morning after an ECT treatment and will stay inpatient all week with ECT on wednesday and friday also. Have had them many times before and for awhile they were being done on a monthly basis.
I have been on every medication made for depression, Prozac....I attempted suicide and taken off it. Cymbalta it was determined that I was extremely allergic to it. Lexapro, Wellbutrin, Paxil, name it I've been on it with little or no lasting results or with side effects like with Effexor, it skyrocketed my blood pressure which I can't take because I have heart issues and had 3 heart surgeries just last year with the last one resulting in a pacemaker. I hate it all. I hate being on the drugs because of the way they make me feel and I hate being off anything because of the way I feel. I'm either a zombie, sleep 15-20 hr days, loss of memory, driving home from the grocery store like always and getting lost and having to call my doctor and have her lead me home. Those are just a few. I take enough meds a day to keep the drug companies happy. Mornings are started with: 20mg Dextroamphetamine for Narcolepsy. 10mg more at noon and again at 6:00pm.180mg Cartia XT for heart. Midodrine 5mg x2 tabs...3 times a day. Xanax 1mg morning and 1mg noon and 2mg bedtime. Prazosin 4mg at bedtime for nightmares. Ambien 20mg bedtime and Seroquel 400XL 1 tab at bedtime. I take Florinef 5mg in the morning. I take 3 tablets twice a day and another 3 tabs at bedtime of Percocet 5/325 and along with that I take 2-3 5mg tablets of just plain oxycodone every 4 hours for a bad back and bad pain in my abdomen that often engulfs my back also. I have a problem pancreas with a large growth on the head of my pancreas. I feel like a 43yr old women that no one will ever want. It would take to long for me to list every good/bad reaction to my different drugs. I guess I will just take them and go on for as long as I can and when I reach the end of my hope than I'm also at the end of the rope amd life no longer means anything. My kids are grown with there own lives and do their own things and don't need me. No one does. There is abaolutely no reson for exsistance. Thanks for letting me ramble and goodbye.

Kevin said...

I am not sure where to begin so if I seem to ramble please forgive me. I am a 39 year old man that has been on Effexor for about 10 years. For most of that time i have been taking 300 mg a night. I told my doctor that it seems that my depression has gotten worse this past year. It has now gotten much worse this last week now that I have been on Pristiq. On a side note I have to ask why it shows that both of these drugs have been spelled wrong. That seems very odd. Okay... Back on track. I realize that I have only been taking Pristiq for one full week now. My doctor had me take 75 mg of the effexor while making the transition. Tonight was my last dose of that and I am slightly worried. I have been a very angry person while awake this week and when sleeping I have very bad dreams. Not only do I dream of my own death but also the death of the entire world. I must stress that I am not the one doing the killing in these dreams. I am actually a helpless observer. They sound so dull as I write about them but I assure you they are anything but. Okay... What's my point? I guess it is just that I am sharing my experience with you. I am sorry if I just seemed to ramble on. I called my doctors office today to ask if I could be put back on Effexor. I called a bit late because I couldn't wake up. Okay I am done I promise. I wish all of you the best of luck and thank you for sharing your thoughts.

Anonymous said...

I have never come across such a helpful batch of information on the web!

I have been on and off antidepressants for 15 of my 35 years and wonder if I will spend the rest of my life trying to maintain emotional balance (with or without medication.) I am willing to take medication without whining, but lose my patience when they seem to lose efficacy and I am across the desk from a psychiatrist asking me what I would like to try next.

Is this for real? and is it forever?

I have just recently made the transition from 225 mg of Effexor to 100 mg of Pristiq. I swear the 1st 36 hours were like having withdrawl symptoms as I stopped one and started another. I wonder if I should have tapered Effexor? However, 4 days in, and the fog is lifting...... and my hopes are up that this may last. The ball-and-chain burden of depression, on top of the symptoms themselves, leave me exhausted and overwhelmed.

Pristiq, please tell me you're the one......

And Dr. Carlat, are you even listening?

Anonymous said...

I started pristiq eight days ago after taken wellbutrin for several years. I haven't noticed a huge difference, but there are some more subtle differences. On the plus side, I'm sleeping better and I'm more mellow in terms of overall anxiety. It's as if things that usually bother me don't upset me as much. I had a few days of light nausea but nothing serious. I haven't had any sexual side effects but I have noticed a slight dropoff in memory and creativity. I'm a 45 yr old male suffering from depression for about 4 years. Best to all and hang in there.

Anonymous said...

I just started taking Pristiq after 11 years on Zoloft...never took Effexor and have noticed a considerable improvement in confidence and overall well-being. I apprececiate the forum this site provides.

Anonymous said...

63 y/o woman w/MD, ADD, GAD, been on just about everything over the past 35 years. Excellent pdoc of 10 years unfortunately suddenly died. Bad timing in many ways. I'll spare the details, but it was pretty bad.

Eventually crawled out of my hole long enough to find another pdoc after my meds started to run out. Was "taken off" of Cymbalta 150 mg (way too fast - do not do this) to be switched to Pristiq 50 mg.

I agree that Pristiq is a patent extender, but still could be helpful. Have had to keep Cymbalta at 60mg, largely because of pain, which it did remarkable job at eliminating. Before Cymbalta, I'd had workups for arthritis, fibromyalgia etc. I do believe now that there is some link between depression and pain,

Pristiq 50 mg has not been very effective. No motivation, basically not taking care of anything except sheer necessities, sleep and nap too much. Before abandoning it altogether, starting 100 mg/day. Am expecting it will take 4-5 weeks to see results

Agree with everyone who has posted that 1) everyone is "a case of one;" 2) they hate being dependent upon a fistful of drugs to barely make it; 3) have known people to whom Rx's have given back their lives; 4) would not have been able to hold down a job at all without meds; 5) have had decades of every kind therapy, much of which I had to pay for myself, some of which was interesting, and apparently none of which did anything for my depression.

Best wishes to all here -- do keep trying and don't give up.

Glad I found this blog -- I do not feel so alone, plus this blog does not have the wild-and-crazy postings I find elsewhere.

Anonymous said...

I switched to Pristiq from Effexor a year or so ago, and it has made a significant difference. For five years I was plagued with anxiety over nothing in particular: A sense of terrible dread, strongest on waking and through the morning, ebbing in the evening if at all; sweats; loss of appetite and other intestinal difficulties. Wonder, though if it's the Pristiq or the special, prescription-only form of vitamin B (L-methylfolate) prescribed along with it that has made the difference. Think it must be one or the other or both; no other meds worked this well for this long. Also: I have gained a lot of weight in the last year; is it my age (52), or the drugs?

Anonymous said...

I have been on Prisiq since Feb. of 09. I have to say it has actually changed my life. After being on Paxil first, which I hated for the side effects. Then Celexa, which completely took away my sex drive. Then the wonderful Effexor. I think Effexor put me further into a downward spiral. I gained 30 lbs., lost whatever tiny bit of sex drive I had left. My marriage fell apart because of. Luckily, my husband has actually been understanding, stood by me and let me work things out in my head. He went to the doctor with me and described things that I probably wasn't noticing, since he was an outsider experiencing my symptoms. She took me off the Effexor and put me on Pristiq. At first I just felt clearer, like I could see my life better, the depression was better. I had more energy. The switch wasn't bad either, and boy was I scared to do it. With Effexor, if I missed a doese by an hour I would feel it. I would be sick, I would get nausuous, a headache, feel horrible. But the transition was easy. But I would say it took about two months before I actually felt like my old self again. I feel normal.
My problem now . . .I think I want to have a baby and I think I want to get off of them but am scared I will go back to the depression and anxiety. Plus I have to still lose the 30 lbs. I gained from the Effexor. . .

verynervous said...

So, I just returned from my doc. She has placed me on Pristiq for nothing more than an anxiety problem. I'm not depressed or suicidal, just merely a very anxious individual. After reading some of these comments, I'm really terrified to start this drug. I guess we'll see...

Jozy said...

I am on Pristiq for anxiety and OCD, not depression and I feel like I am getting my life back!

Daaaaaaaaaaave said...

Well, I was smoking pot for 30 years to control my depression, and it did that very very well, with few side effects beyond the munchies and extreme anxiety when I didn't have money to replenish my stash.

I quit smoking last November around my 46th birthday. I started therapy and the therapist suggested that I take an anti-depressant to bolster the behavioral therapy. Went on Wellbutrin at the advice of a friend and the ok of my md.

Wellbutrin had some good effects on my ability to WANT to care about things, which I had lost since quitting the weed. However it caused sleep disturbances, as did the low dose of trazadone my doc later prescribed to help me with those sleep disturbances.

I quit Wellbutrin cold turkey six weeks ago, after about three months of taking it. I did not have convulsions, projectile vomiting, dizziness, suicide, death, or any of the other supposed side-effects of quitting an anti-depressants.

I have been sleeping much better, feeling more rested when I wake up, but a hopeless, "I don't give a shit about anything" malaise has been creeping in. As well, my blood pressure has gone up, probably because I don't watch my diet any more and am eating those wonderful Sausage McMuffins I avoided while on Wellbutrin.

So I went over all this with my therapist this morning, and she again recommended that I go back on an anti-depressant, but didn't push it - just suggested it would help until my habits were sealed into self-care.

So I went to the doctor afterwards, and he agreed. "If the leg is still broken, it still needs a cast on."

I said "can you give me something I can fill generically?" He gave me a spiel about how it would be good to have stock in the generic drug companies because they basically leech off of all the hard work that the "normal" drug companies put in to getting a drug to market. I found that a strange reaction from a doctor, but what the hell, I never finished college.

So he gave me a seven day sample of Pristiq, and now I'm reading your blog that says that there's only a 2% efficacy over sugar pills.

So my question is, should I just get a box of sugar cubes and put food coloring in them to give myself the feeling that I'm taking something, rather than taking this Pristiq?

Well, I got the things for free for a week, so I'll take them, but now I'm not expecting much.

I watch House a lot, so I think that without a lumbar puncture and a brain biopsy, you really can't accomplish much in the medical world. I hope that Pristiq does something for me because I'm tired of feeling like a hopeless loser.

Anonymous said...

Started taking Pristiq last week switching from Effexor. Man do I have my life back. Drug side effects affect each of us differently, however, I whole heartedly agree with the brain ZAPs! Most importantly right now, I am actually happy without trying to be happy. Does that make sense? Just as others, I am praying that the drug will align with my system. I gained weight with Effexor and, well, not too but I am grateful for the nausea. I've lost weight. Glad to be free of the thoughts of inadequacy and swings.

Anonymous said...

Wow.. is the comment above from someone at Wyeth? I take 300mg of Effexor XR. It's the one drug that works and has worked for over 6 years. I would have to agree that pristiq is truely just a way for Wyeth to extend the cash cow.

Anastasia Beaverhausen said...

I am fifty-two years old who has suffered with chronic depression since my teens, My one major piece of advice is to ONLY take antidepressants prescribed by a PSYCHIATRIST. Your GP or FP is not qualified to prescribe. They cause more problems than they solve, but chronic depressants are a wonderful source of income because they are frequent return customers because of the stress related illnesses that accompany improperly treated depression. If you have heart disease you go to a Cardiologist and an Oncologist if you have cancer. Depression is an illness best treated by a Psychiatrist. In the long-run it is cheaper because there is less trial and error and return GP and FP office visits.

Anonymous said...

If you had any problems taking Effexor XR, DO NOT TAKE PRISTIQ! I took effexor (150) 3 years ago out of desperation and from the first night, did not sleep. The begginning of the nightmare. I continued to take it for 6 more months before asking to be weaned off. I thought I was going to die and haven't touched an antidepressant since. After being literally dysfunctional for almost 6 months, I decided to ask my doctor for another try at something "different". I am an agoraphobic with severe anxiety and panic attacks.I was like the people in the depression commercials, but those are PAID ACTORS. Pristiq was another nightmare. I was already down to 100 pounds and went down to 95.The nausea was awful. My anxiety level was off the charts and my brain and nerve endings felt like they were misfiring without relief. Even worse was the "feeling" of the drug kicking back in. I went from sleeping 3-4 hours to 2 (I need 8 !!! to function), and couldn't relax enough to even take a nap.When I did doze at night my dreams were "too much". 2 diferent days I actually thought the depression was better but felt, for lack of better words, removed from myself. My doctor said to start taking another xanax.
After a month, when I called to beg him to get me off this medication, he was out of town and the nurse said to JUST STOP taking it. AND I was out of xanax and could not get even get enough medication to cover me until he came back. Their solution, go to the emergency room. Easier said than done. How totally irresponsible on the nurses and doctors' part. SHAME ON THEM!!!! Thank fully my primay physician helped until my other doctor's return. Very unusual for him.
I know ONE woman who had taken effexor without serious side effects, and getting off it with without problems. But most of the people that I know taking effexor became suicidal with terrible withdralwl symptoms similar to mine.An entire effexor nightmare from beginning to end for me. After effexor I promised myself that I would NEVER take another anti-depressant ever again. This is just to let you know how bad off I was to consider taking another one after 3 years. And I get wonderful Pristiq. I thought I couldn't think straight before Pristiq, that was almost a picnic before I took this drug. I think it should be taken off the market. If my 2 teens had not been home I may have committed suicide, which I have thought of often but NEVER follwed through. I cannot be alone in how these drugs have affected me. SSRI's have not worked for me either. The only ones I have not tried are prozac and lexapro. Elevil (which made me forget my life) and imipramine are the only tricyclics I have tried with no results.
Is there anything else out there to help beat this monster besides the ones that make me worse? I no longer have faith in psychiatrists or their pharmecutical(sp?) rep given drugs.I have no faith much less blind faith in these ssri's (they haven't worked and they were sex killers that didn't help a thing between my husband and I) or the "combos".
There is more to life than feeling desperate for help.

Stuart said...

Ive been on Effexors XR for 12 years now mostly at the 75 mg dose but did go up to the 150 but found I was getting a serotonin overload four hours after taking the 150 mg so what I did was asked my doctor to give me two lots of 75 mg per day ,one morning and one evening and that worked a treat ..Ive since wined myself back to the 75mg as I wasn't working sexually..LOL Ive just been switched from the 75 MG Efexxor xr's to Pristiq,50mg Ive been on them two weeks now I don't feel any different as yet apart from finding the other day I had a little bit of a temper and feeling agitated, that scared me a little as I haven't felt that for years...But like the pros say "it can take up to a month" But one thing Ive noticed even though the transition was a straight swap over ,,I'm getting those zapps about every two days ..What I have to do is take approx 10mg of the good old effexor beads and they go away ,,generally its in late afternoon..
I want to know if there's anyone else noticing this or anything else occurring that they havent had when they were on Effexors,,If so Let us know ,its important ..

Stuart said...

I wish people wouldn't be anonymous as it makes it very difficult to answer you directly PLease dont be scared to use a user name ,,it helps us all in the long run....
One person has stated their having trouble sleeping after being placed on Pristiq ..Ive been having the exact same problems ,,Ive been on them two weeks and I find I'm tied at night ,go to get into bed and Im wide awake or I wake up after onlty 3 hours sleep feeling a little ticked off but none the less I dont feel tied ..

I thought it was to do with my mobile phone being beside my bed aswell as the 5.8 GHZ cordless home phone producing EMF waves and interrupting my sleep but I want to know ,,are their more out there suffering from a lack of sleep since swapping from Effexors to Prsitiq..

Let us all know ,,please ...

Anonymous said...

"Wyeth will highlight the fact that Pristiq is not metabolized by the P-450 system"

That is a good thing for me since I am a CYP2D6 slow metabolizer.

Only 6.25mg of venlafaxine resulted in me having sustained tachycardia (>= 90bpm) all night with difficulty sleeping. The next day I developed a severe headache and hypertension.

With fluoxetine I could only tolerate 0.5 - 1mg (elixir) and it worked very well for my depression until I developed an itchy rash on my arms and legs and upper GI bleeding that landed me in the hospital 2 months later.

We need more antidepressants that aren't metabolized by the P450 enzyme system.

~ Paul

Anonymous said...

I have been on Pristiq for 2 months. I weaned off of 75mg Effexor during my first 2 weeks. As a result of the switch my blood pressure is down, sex drive is up, and with stronger erections.

I have been eating quite a bit but I think it is a result of taking Tramadol concurrently, which I just read is contraindicated. I'm guessing my serotonin is too high as a result, so hopefully my appetite will decrease once I stop the Tramadol.

Also, I have significantly less "down days" on Pristiq. As a matter of fact, those days are becoming a distant memory. My blood pressure is down, my sex drive and sexual performance are better, I'm happy, and my anxiety is gone.

I am very pleased with Pristiq and can see a significant improvement in side effects and the final outcome.

Anonymous said...

I have been taking pristiq for 3 weeks now. I have been having light headedness, blurred vision, and problems with my periods. I have had my period now for 3 weeks ever since I started taking the pill jit started the evening I started my pill. The doctor said it would eventually stop once my body got adjusted to the meds but how long will that take. Also I am already about 60 lbs overweight an I am concerned with that tha is part of my depression I don't want to gain any more weight and I was wondering if people are really losing weight or are they gaining weight with pristiq. Yes I know that everybody is different but overall are they gaining or losing?

ioana said...

I started taking effexor about 1 1/2 yrs ago and was doing ok, but if I ever accidentally skipped a dose i would get the most horrible brain zaps and nausea and dizziness. I was on a low dose at first (37.5), then was moved up to 75 which caused me to eventually have no libido whatsoever and it needed to be brought back down since it was almost destroying my home life. My fiance was very understanding but the lack of sex was driving a wedge between us.
the last time i went to see my psychiatrist he decided to change me to pristiq and told me to just start taking it without tapering me off the effexor first or even really telling me much about the medication. I know pristiq is a metabolite of effexor so i thought the change shouldn't be such a big shock to my system. i started with 50 mg which i understand is the common dose. within 2 weeks of taking pristiq my libido got to even lower levels, i would even say that it became negative, like sex was actually disgusting to me. i felt numb in my genital area to the point that if i even got aroused i couldn't tell, i felt nothing, absolutely NOTHING! so i called my doctor and he said to taper the pristiq down to one 50mg pill every other day. when that was making me sick as well he told me to take 25mg every other day. ever since then i have been a nauseaous mess, i ended up seeing my primary care physician who seemed mystified by my symptoms. I have brain zaps whether i take the meds or not, i am dizzy, can't concentrate and feel like i have an ulcer. i sleep horribly, i wake up with symptoms of diarrhea and have trouble performing at work. i feel hungry and full at the same time, and i usually eat because i feel like i have a hole in my stomach that needs to be filled. i am going to have an endoscopy and get tested to see if i have an ulcer in the meantime just in case.
i am angry to say the least. i've been reading others' comments online and see how many other people have experienced things like this and it doesn't seem like their docs (psychiatrists, i mean) give a crap about them either. they just pump us full of drugs that they are pushing and leave us to fend for ourselves with whatever side effects or withdrawal symptoms we may have. i've been feeling like a zombie for over a month and don't know if i should just stop cold turkey because i am really scared of whatever withdrawal symptoms i may have then but at the same time i want to stop taking this medication. My psych keeps telling me to continue with what i'm doing but i don't know how much more i can take.

Kelli714 said...

I started taking Pristiq 4 days ago (100mg a day) and I am feeling great. Much better mood (actually happy now)more energy and improved sex drive. Doc just took me off a Wellbutrin/Lexapro combo because they simply stopped working. So far NO side effects but I am aware it is a little soon. Have been on many different meds in the past (including effexor) but after a while they simply stop working. Will keep you informed on how it is going.

Anonymous said...

I was treated with Pristiq from October 2008 to July 2009. During the first three months, my symptoms seemed to subside and I did not feel depressed. Then slowly but surely I started to gain a tremendous amount of weight - about 30 pounds. I was depressed and fat. Thereafter came shortness of breath and an ill feeling. I was advised by my doctor to immediately stop taking the medication. The withdrawal symptoms were worse than the depression--insomnia, restlessness, anxiety, etc. I am now running my feet off trying to lose the 30 pounds (that will make anyone depressed). I would not recommend any anti-depressants. Better to exercise and eliminate the things and people that are making you depressed. Amen.

Anonymous said...

I only noticed one comment about jittery legs, but thought I'd offer my experience. My doc put me on pristiq about 2 months ago, and is weaning me off lexapro and welbutrin. I am completely off the lexapro now. I have suffered with restless leg syndrome for about 5 years now and all of the sudden it has become worse. It begins late afternoon now instead of in the evening. I take requip but do not like to take it during the day because of the severe drowsiness it causes. My sleep doc says that yes, this is one of the side effects, it's driving me (and my legs) crazy. the other side effect that I've experiences is not getting a full nights sleep, waking up at 3 in the morning and not getting back to sleep. In the past this has been an anxiety symptom for me, but I am wondering if it could be the pristiq?? the depression side seems to be about the same, no wonder drug as far as I can tell.........

sanj said...

"Better to exercise and eliminate the things and people that are making you depressed. Amen."

I feel I must respond after reading the above post. I take anti depressants to eliminate my depression. I love my life, I love my family, I love my job. I suffer with an illness that gives me overwhelming feelings of sadness and inadequacy.There is no one that makes me feel this way except me. People who think just move on are so ignorant. If my anti depressants continue to work for me I will happily take them for the rest of my life.

Anonymous said...

For several years I was being treated for symptoms of situational depression. Over this period of time I was put on Zoloft (100mg), Cymbalta, and Venlaxanfine (25mg bid). I never felt normal using any of these meds and at the beginning of July I experienced a major depressive episode. It took me 3 weeks before I decided to seek help. Luckily, I was able to get an appointment with a psychiatrist who took the time to listen to me and get a thorough understanding of what I was experiencing. I began treatment with Pristiq on July 20, 2009 in combination with Mirtazapine and have noticed a complete reversal of my depression and an increase in physical vitality. I am 65 years old and the renewal of energy has gotten me out of bed and put me into motion in a positive manner. I am not a health care professional so I can't say with any certainty that Pristiq is accountable for the change in my mental and physical status, but at the present moment I am glad to be using it and just hope that the positive progress continues

Anonymous said...

I have been fighting bad depression for years. Effexor was a problem. I was put on Pristiq two weeks ago. For the first time in my life I am laughing at television. I finish tasks. I went on a date. I feel emotions. I gained ten pounds, but became aware of why and changed it. The only downer is sexual. As far as I am concerned, at this point, this drug is a miracle.

Anonymous said...

I had been taking Effexor XR, Wellbutrin XR, and Klonipin for at least 5 years; and after gastric bypass surgery, had to be changed to the "regular acting" dosages (2x day) because the absorption rates for me had changed due to my surgery. No big deal, just one in the morning and one at night. I was able to take all in generic form with no problems, until about a month ago. My insurance company (who insists on mail delivery for long-term medications) changed the companies they were using for my generic scripts. At first I thought, generic ~~ schmeneric... should be the same thing, right??? Wrong answer. I started to crash and burn soon after I started the generic effexor from this new company. I talked to my doctor about this, and he said that different manufacturers will use different "binders", etc., and can also work within a certain range (spec?) of the active ingredient, and that could be affecting me. We decided to start with one at a time, Effexor, and he FAXed orders for "BRAND" and gave me a small script that I could fill locally. Well, days went by, and the local pharmacy was unable to order it; then out of the blue, Aetna calls me to tell me that Wyeth does not manufacture Effexor "Brand" any more. Now I am at home (FMLA) trying to change over to Pristiq. I went to the Pristiq web page, and saw these statements "Do Not Take With Effexor", "Do Not Take If You Are Allergic to Effexor"... which raised my suspicions about a patent extension. So far, I have been okay on Pristiq, I guess, no brain zaps or nausea, etc. I do have significant trouble sleeping at night, and feel like I am not in my own body at times... Will this go away? I am just finishing week 2 of my samples.

One more thing...I just received my latest generic of Klonipin, and it is also from a new manufacturer.... "QUALITEST" That is comforting (sarcasm). Especially for a medication I take for anxiety. Christina from Texas

Anonymous said...

First thing to note is that Dr. Carlat was a speaker for Wyeth Pharmaceuticals, and was let go for various reasons. So, anything he says regarding any product Wyeth makes should be taken with this in mind from a bitter speaker let go, and with a grain of salt, to so speak.

All five reasons he gives definitely show his resentment for Wyeth, and not scientifically-related.

First, Pristiq came out over two years before Effexor XR's patent is up; not something companies do at all, if you look at previous similar situations between citalopram (Celexa) and escitalopram (Lexapro), or Risperal and its metabolite Invega, all that came out immediately at the end of the patent, versus two years earlier. COming out two years before a patent ends doesn't make sense, especially when their drug, Effexor XR, is the #1 prescribed antidepressant worldwide. It doesn't make sense to bring out a competitor UNLESS there is a clear benefit over the other, as in this case with Pristiq over Effexor XR.

Secondly, there ARE clear benefits of developing a drug as a metabolite, versus one that goes through the liver. I agree that Effexor XR doesn't have many potential drug-to-drug interactions, but because so many patients have different variabilities in their liver metabolism, it only makes sense that if you develop a drug that doesn't go through the liver for metabolism that this would allow you to take away the extreme variations in dosing levels for patients. I have seen my patients do well on 75mg of Effexor XR, while others need extermely high doses (well over the 225mg recommended in the PI). I can only contribute this to the fact that some patients can be slow metabolizers of a drug or high. Not to mention that the average patient these days are on multiple medications, and the potential for these drugs to compete for the same liver enzyme, and thus have a drug-to-drug interaction, is REAL.
Lastly, what Dr. Carlat says about the studies to approve Pristiq isn't true at all. If you look at the 9 studies Wyeth submitted to the FDA for Pristiq's approval, then you would see that Pristiq clearly separated from Placebo, and showed clear benefits to the patients who were depressed. The results shown are very similar to ALL of the studies seen with the approval of the other drugs now on the market (Cymbalta, Lexapro, Effexor XR, and generics).

I see several benefits of Pristiq over its parent compound, Effexor XR. First the dosing is very simple for all of my patients. Most of my patients start and remain on their 50mg dose. I have had little reason to titrate to their 100mg dose.

Secondly, the side effect profile shown in their studies is similar to what I have found clinically. I have seen VERY little nausea, headache, etc.. as compared to patients who started Effexor XR. I have also seen less sexual dysfunction, and most importantly, I have seen VERY few patients have problems either when they missed their dose (HUGE problem with EffexorXR), or stopped Pristiq altogether.
I think the drug works as well as Effexor XR, but is so much simpler to dose, less side effects overall, and even its cost is sO much less.

After I read his blog, it clearly proves to me how a physician is often biased or influenced by a drug company, either positively (if they are benefiting from the company financially, professionally, or whatever), or negatively (in the case of Carlat who obviously has bitter feelings towards Wyeth, and thus shows it in his review). NO respectful physician would make such obviously unjustified comments about a drug that he obviously knows very little about it, unless it benefits him in some way.

Daniel Carlat, M.D. said...

Anonymous—I have a few responses to your comments. To begin with, Wyeth didn’t “let me go,” rather, I quit their speaker’s bureau because it was clear that they were paying me to say good things about Effexor rather than to tell the truth. You imply that I am somehow “bitter” toward Wyeth because they fired me, which is far from the truth.

Second, your statement that “coming out two years before a patent ends doesn't make sense, especially when their drug, Effexor XR, is the #1 prescribed antidepressant worldwide” is untrue. In fact, the standard strategy used by drug companies to “convert” physicians from a drug losing patent protection to a “new” drug of dubious advantage is to introduce the new drug at least 2 years before patent expiration. This is the case currently with Nuvigil being introduced well before the patent expiration of Provigil, and was the case for Lexapro/Celexa. The reason is that if the company introduces the new drug just as an old patent is expiring, physicians will have already switched their patients to the generic version, and the company loses the opportunity to convince doctors that their new formulation is much better. Often, this early introduction strategy is accompanied by increasing the price of the old drug and decreasing the price of the new drug, as a way of incentivizing the switch. The end result is that doctors will have switched all their Effexor patients to Pristiq long before Effexor goes off patent, which helps to maintain the company’s income stream.

Regarding Pristiq’s metabolic advantage, this is likely to be an advantage for a miniscule percentage of patients who come to the average psychiatrists’ office, so it is an unconvincing advertising pitch.

Regarding studies showing a more robust advantage of Pristiq over placebo, I’d love to review them. Please send me the references/links to the 9 studies you mentioned.

Finally, congratulations with having such great clinical success with all the patients you have put on Pristiq. If the drug is really as good as your experience indicates, that will filter into the medical literature in the form of letters, case series, clinical trials, etc…. But simply hearing a glowing endorsement from an anonymous source who does not disclose their industry affiliations does not give anyone a great deal of confidence.

Anonymous said...

I have many colleagues that are speakers for various Pharmaceutical companies. I have asked them about conflicts of interest in what they say on behalf of the drug company versus how they may actually practice medicine.

NONE of these colleagues have told me that the drug company asked or even implied that they ever suggest to their audience that they use the promoted drug in patients they themselves would not prescribe. I can't speak for you personally on why you felt you were being pressured to "lie" for these drug companies, but others I have spoken with only promote the drugs to patients they themselves have had positive clinical results.

I have heard of people who cross the line and promote a drug for everything, but i think that is their personal choice, possibly out of a desire to be used more as a speaker. But, I do know that companies do not encourage, approve, or even tolerate such action. These physicians only destroy not only the credibility of the drug and its company, but damage their own reputations as well. I totally disagree with your stereotyping all physicians this way, indicating that all of their actions are from pressure, when that is definitely NOT the truth.

Anonymous said...

I'm a 36 yo male and been depressed since I was a young child. At 22, I had a major depressive episode and started taking Paxil and the sexual side effects were pretty severe. I went off and had another episode so went back on. Went off again at 28 and well, I had another severe episode which ended my job and landed me in the hospital for a month where I was put on Effexor 150mg. It took a good six weeks to start working and another four to really help. I have since tried to wean off twice more with disastrous effect. Yes, I've finally learned that I need to take an antidepressant indefinately. I just hope that lesson hasn't cost me my sanity.

The Effexor has worked and I consider it to have been a life saver when I've been on it, but this June, my pdoc tried me on 50mg Pristiq with the typical 'less side fx', 'easier dosing' pitch and free samples. After 8 weeks of utter misery and no relief I tried 100mg. After two more weeks of feeling utterly hopeless and dejected, I did some research. After reading posts like this one about the lack of dose response, I demanded that my pdoc put me back on Effexor XR. I've been on it, now at 225mg for just over three weeks and I've been less depressed with at least hope of getting fully back to the real world in a few more weeks.

I have been frustrated as hell with Pristiq which was supposed to have the same therapeutic effect as Effexor XR, but may have instead extended and thus worsened my depression. I spent two and a half months in sheer agony trying Pristiq before realizing what an utter scam is being pulled. A sure sign that Wyeth has put out a less effective drug is the lack of side by side efficacy trial data. Even if it has identical efficacy, Wyeth would want that data out there if the side effect profile is better. To cover itself, Wyeth's reps are telling pdocs that if Effexor XR is working well, there's no real need to switch to Pristiq. That doesn't make sense if it has the same therapeutic effect with less side effects. When my pdoc asked the rep if there have been cases where Effexor has worked where Pristiq has failed, he didn't get an answer. Hmmm...

I believe that I have suffered grievously due to Wyeth's pushing of this "new" drug. Damn it! The wool has been pulled from my eyes about what drug companies will do in the name of profit.

Anonymous said...

Hello comrads. Taking anti-depressants since '92. I've been a fan of Pristiq since Nov '08. Due to job loss this past Feb. finances have been tight, no medical insurance so I had to rely on samples. Wyeth is no longer giving out samples so I just signed up for their "New Day" program where you get 50% off out of pocket co-pay. Pritiq costs $143 at Stop & Shop in CT so that leaves me to pay $70+. Collecting top unemployment wages and can't even make my mortgage.

I ran out of my samples this past Friday and shortly before then I could feel a difference in my mood coming on. Was it because I had to call for more samples on top of my bad financial situation, then only to find I can no longer get the samples? This weekend, while the drug was still in my system, I was an emotional wreck. Why? And now ... I am terrified of what is to come.

Wyeth ... your wonder drug did me wonders. Please don't give up on me now.

Anonymous said...

I have been taking 150mg Effexor for about 2 yrs now. My MD just switched me over to Pristiq- telling me to just substitute it...

My first dose of Pristiq was Monday night- Tuesday I felt very foggy and tired all day.... Tuesday night- MASSIVE pounding headache, I could watch my chest POUNDING through my shirt- I thought I was going to have an aneurysm.

Today I have been having terrible dizzy spells on top of still feeling foggy and it takes a few seconds to equalibrate if I move too quickly...

I just clued into the fact that it is probably the withdrawal of the Effexor rather than the addition of the Pristiq causing all this.... Does anyone have ANY advice after a similar situation??? PLEASE

~ N said...

You know, drugs like these save lives every day. Saying to forget about it is idiotic. If it saves one life, then it was worth not forgetting about it.

For people who have been on every drug, like myself, any new drug offers hope. Would I like something more innovative? Yes, I would, but until then, I'll take what I can get, kind of like every one else who is extremely sick.

Anonymous said...

I was on 150mg of Effexor for 5 years and then the dr. decided to change me to pristiq...What a mistake. I never felt worse than I have for the last two months...anxiety like no other, deep depression and pissed off at everything...switched back to effexor today at leaste I will go back to being functional......

Anonymous said...

I've been on 75mg Efffexor ER for 2 years now. Like N mentioned, each drug has pros and cons, which differ for each person. I never needed any type of help before our car accident, but now I have no problem accepting the nasty consequesnces of 'brain zaps' nausea and headache if I delay my dose by mistake, cause I know that after a few days I'll be back to a functional state. It's amazing what the human mind is capable of rationalizing, with the proper reward!! I'm staying with effexor, but I'd suggest everyone try the Pristiq with an open mind, just in case it works better for them, as long as your health insurance or finanaces allow. Be careful to wean OFF any previous med first!!

David said...

After 3 years with Effexor XR, I wanted to get rid of the zombie-like effect it was having. I spent a very unpleasant 6 weeks tapering and stopping. After a couple of months, the old anxieties began to reappear. I read about Pristiq, and my doctor agreed we should give it a try. I am fortunate that this particular drug pushed back the anxieties without a single side effect - even when missing a day. Two months with continuing benefit.

Anonymous said...

I have been on Pristiq for a little over a year. I have grown to hate this medication for if I miss a couple of doses I crash immediately- mostly crying, and the brain zaps are miserable. I have found I can no longer afford this medication. I do not want to go back to effexor either. Does anyone know how to transition to Wellbutrin? Other antidepressants had sexual side effects I did not want to tolerate (neither did my husband) but I can no longer stay the expensive course with Pristiq. I have exactly 1 week supply left and then out. I'm not sure my MD is going to know how to prescribe Wellbutrin to equal the Pristiq.

Anonymous said...

This is really a difficult subject to try to advise on, because I do believe after reading most of these posts that everyone reacts differently to the drug and it's side effects.

I've been on Effexor XR for a couple years to help with the hot flashes from a hysterectomy. They did seem to lessen the flashes, but what I didn't know was how addicted my body was getting to this drug.

I tried switching from Effex to Pristiq at my dr's. suggestion....hmmmm, not so easy. I didn't want the weight gain that I was struggling with but I found that after trying for a couple weeks to be off the Effex, I had to go back on. I had terrible headaches, like my head was in a vice. Dizzy, I felt like when I turned my head quickly, my brain would stay where it was and just the head moved....I had a "tinning" type feeling in my head felt like everything in it was made of tin and I could hear/feel it making noise......? Iknow, odd, very odd.

I felt awful, just unfunctional....
so I would go back on the Effex.

Then I decided to take it into my own hands. Now, I don't recommend anyone do this at home....

I took my one 75mg capsule that I take at night and opened it. The first day I removed 10 little beads and closed it back up. Did that for a full week. The next week I removed 15 beads....then 25 for a week ....and so on. It took me about a month and I felt pretty bad feelings, none at all..and now I started the Pristiq, 37mg, once a day...and then I will wean myself off those in about a month and I think I will be okay. This worked so much better for me than anything else.

Lily said...

No comments about the price of Pristiq. Is it reasonable? I use a discount card called RxDrugCard.

Rose said...

I just tried switching from Effexor to Pristiq. I have had a significant downslide on Pristiq and am going back to Effexor for now. However, every drug is different for each person, and I hope it helps most people who receive it.

psychotrophicallydazed said...

Pat all of yourselves on the back for being able to find your way here and figure out how to post. All the comments read here could have one hiding under the covers behind locked doors. Lot of intelligent people here like myself....dazed and confused,not to mentioned overwhelmed.

Anonymous said...

2 patients same age and background took pristiq for 2 yrs and both diagnosed with pancretic cancer. neither fall into the high risk category for the cancer. One of the patient's gave it to her young daughter and she is now having pancreatic inflammation. This needs to be looked into. One of the patients has died and the other has stage 4 pancreatic cancer. The daughter is undergoing treatment.

Anonymous said...

I took efexor xr for some time & went over to Pristiq - I ended up with rem sleep disorder. I could not get to sleep without dreaming & I ended up on 2 hrs a night. The brain zaps drove me insane & the only way that I managed to get off this hell pill was through Durogesic patches as they blocked the zaps very well - still getting zaps 6 months afterwards. Effexor xr was better - hopefully though I can stay with the durogesic patches as they are helping better than anything with my depression - with none of the side effects. I use oxy contin for breakout pain - I will be very worried if they want me to go back to anti depressants at all.

Anonymous said...

Before a diabetic is prescribed insulin, don't they first have their insulin levels checked? Why aren't seretonin levels checked before these meds are prescribed? How can doctors prescribe them so quickly and easily when they have no idea what your seretonin level even is? Most docs talk to you for 45 minutes and then they give you free pills that actully alter your brain chemistry. Is seretonin in any other parts of the body besides the brain? Are there any efforts in the medical community to develop a way to measure seretonin? SHOULDN'T THERE BE? Yikes.

Anonymous said...

after living with bi-polar for about 23 years, i would like to say that there's no "right" or "wrong" medicine out there for people to take. everybody's system is different and therefore the meds react differently too. you can't give up trying. you have to be willing to try new medicine if in fact you arent' feeling optimally. it's very important to take your medicine as directed and not to abandon it just because other people have had horrible reactions. i cannot tolerate lithium. i even had it in the liquid form when i was hospitalized. the doctors could not believe how sensitive my body was. and it still is. but we have to have hope in the sense that there are newer drugs with fewer side effects. i don't think that the drug companies are all bad. sure, they want to make money, but who doesn't nowadays? if something is going to help someone, then there is a need for the drug. a diabetic needs insulin, and a bi-polar needs the meds that help him/her manage their disability. i am on pristiq now. i don't see that much of a difference from lexapro, but it's only been a week. we can't throw the baby out with the bath water. also remember that the medicine isn't a cure-it's a treatment. there is no cure for depression or bi-polar, at least not yet. don't give up hope in trying new medicine!!!

Cracker Scraps said...

I see the disccussion of this "new to me" antidepressant has been ongoing for a couple of years.
I am a 55 y/o woman who crashed and burned after my father's death from CA. I have been on many different antidepressants including the most recent Effexor XR. My dose was at max along with the max. dose of Wellbutrin. You could peel me off of the celing.
I went on vacation in March and forgot my Wellbutrin,I also quit drinking alcohol at the same time. Fortunately my girlfriend who bunked with me has a degree in psychology as well as personal experience with antidepressants and antianxiety meds like xanax.
Yes, a lot of physiological changes for my body at once but my friend talked me through it and I survived a week with 9 other women on retreat. I had night terrors for three nights ending with throwing myself out of the bed the third night. Not a fun way to detox! I didn't mind that the others had a good laugh at my expense as they certainly didn't know what was going on in my brain!
Yes, that's what good friends do for you, love you however you are!
I live in a rural area of Florida and the psychiatrist that I was seeing moved on to a larger city as most physicians who are any good tend to do here.
I am an RN. I have purposly not researched my meds as to not be looking for side effects, until now.
After returning from my trip to Texas with the girls I had an appointment in place with a new psychiatrist in Orlando. Unlike the goofball ARNP I was schleped off to after my psyciatrist left town, my new MD in Orlando treats me as I expect, with dignity and respect. He switched me to Pristiq (LOL at the gal who said they must use the same people to name drugs that they use to name nail polish).
I didn't know what "brain zaps" were but my friend described them to me as serratonin withdrawl. Yes, they were disturbing and the generalized headache uncomfortable. But, sometimes you have to "ride it out" knowing that these meds are not a "quick fix"!
I've almost finished my fourth week on Pristiq. Now that the free samples are gone I am dreading seeing the bill at the pharmacy, yes, I got the "coupon". I can expect that my insurance carrier BCBS and Anthem RX will say that it is not formulary and my "bean counting" husband will have a few words to say about this!
I did not know that these drugs could affect your cholesterol, I've had a terrible time with mine as I cannot tolerate "statin" meds. It's so frustrating to make a "career" out of going from discipline to discipline for every part of your body when by and large my MD's don't know crap about "me" as a whole! (Oh get me off this soapbox!)
Since being on Pristiq I have a ravenous appetite and craving for sugar. (I realize this could be from my cecasion of ETOH and a side effect of Xanax and Ambien.)
My legs from the hips to the toes ache so badly that I can hardly walk...which MD do I turn to? So, I take some NSAID and try to manage it myself, relizing the clotting effect that they have on my blood. APAP just doesn't cut it.
I'm ready to live life, I feel so good not being on alcohol and want off of every drug that I don't absolutely have to be on.
Who will listen to me? Who will help me? Medicine is so screwed up along with the whole health care system I don't know how people who don't have some knowledge of "how the system works" survive!
Perspiration, extra weight, and even decreased libido are side effects that I don't like but can learn to deal with for a time.
While transitioning from Effexor XR to Pristiq I entertained my mother in law for a week(no small feat), did 24 hours of nursing continuing education online to renew my license (my engineer husband had to do some of the courses for me as I could not concentrate), and hostessed a weekend celebration for my 80 year old mother.

From Pink Floyd's "Comfortably Numb"..."Anybody out there?"

Lindy said...

It has taken me 3 days to read through every single comment, but it is saving my life to be here. I am a therapist who has an inherited tendency toward depression. Prozac has always worked best, but my therapist wondered about weght gain (20 lbs.) Pristiq was great, lost 24 lbs, but got brain zaps for missed dose by even 1 hr.

When I moved I had no insurance for a while, and the zaps and tinntus took over, making me feel crazy. What is helping me through this is 50mg of Zoloft per day, zaps greatly reduced. Has anyone else tried Zoloft to help wean off Pristiq? I would be in bed with zaps asnd dizziness without it.

F. Belt said...

Well, I had a couple of really severe depressive episodes the past couple of weeks and my husband forced me to go back to the doc. I have NEVER seen her so animated in any of the past six sessions I've had with her. She was over the top prescribing this 'new' alarm bells went off as I left the office. I did not take the first dose of the sample she gave me, knowing that I had to do research. Nope, I'm not a guinea pig...nope, I'm not taking this drug...yes, I'm getting back in touch with the doc and forcefully stating my concerns. Thank you all for being honest and bringing to light your concerns.

Lindy said...

Just an update on my condition. I have taken 50 mg of sertraline (Zoloft) for the past 5 days, and the ringing in my ears has quieted considerably, and no brain more brain zaps. I am quite fatigued until noon each day, but I am beginning to feel like myself again. Today I also began 20 mg of Prozac, and I will try to wean off the Zoloft and on to the Prozac, which has very few withdrawal symptoms due to its long half-life. Though this experience was quite scary, I would go back on Pristiq again if that's all that worked for me. I felt more normal on Prstiq, few side effects, just the damned short half-life causing such swift withdrawal symptoms. Let us know if anyone else tried the Zoloft or Prozac to help them wean off the Pristiq or Effexor.

Anonymous said...

Skeptics say that "Psychiatry kills" for a reason. I have messed around (meaning, taken drugs recommended by a psychiatrist) since I was 14. After gaining 30 lbs between the ages of 14 and 18, but after a while I think my body began to adjust and metabolize medications well. I lost that weight and did well in college when I was on Lexapro and Effexor. Then I switched to Pristiq because it was being pushed as the "side effect free" version of Effexor. For a little while I was fine, but not better. It just didn't really do anything. After taking Pristiq for a couple of years, I have really severe problems with drowsiness...if I don't have to wake up for anything I won't get out of bed until 1pm. It's terrible. I have no hope. I am extremely tired of this and I wish I'd never turned to drugs in the first place.

Anonymous said...

I've been on Effexor ER for two years, (tried Pristiq w/o being told to wean off the fxr first so I'd given up on it) BUT I tried what one gal had said to wean off fxr by reducing the number of dots in the capsule gradually - I'm totally on my own again, tho I still have times when I'm overwhelmed (and end up crying.) Best wishes to you all - never give up, keep trying, cuz each of us is SOOO unique and has different talents to share with this sad world!!

Anonymous said...

was on effexor. a terrible experience. "brain ache" that remains after 6 months. brain zaps.
could not sleep more then a hour or 2 a day. would collapse after 3-4 days. sleeping 5-8 hours. then cycle began again.
doctor said this would past. didn't.
withdrawal was just awful.
another doctor suggested pristiq.
didn't know relationship to effexor. scared to hell!
almost 2 weeks with pristiq & starting to feel better. maybe the slight change in composition is working.
can only hope.

Anonymous said...

I am a 36 year old male who was diagnosed with bipolar at age 29. Effexor did great for my depression, but I was very tense. I switched to Cymbalta and it worked great for several years, but this summer my energy dropped to zero. I went off everything and it was pure hell for six weeks. I started pristiq 5 days ago and feel great. I have been losing weight, dieting too, but it is much easier. I have felt much more relaxed now.

Wellbutrin caused me total panic, depression and suicidal. I went on lithium at the same time, so it was a bad combination. Lexapro did nothing for me. Lamictal has been a very good mood stabilizer. Prozac was good, but I still had anxiety and sexual side effects.

I am having no side effects with Pristiq, except drowsiness the first 2 days. Also, neurontin is awesome for my social anxiety and mood, but I develop a tolerance after a few days, so I have to use it sparingly.

I'm praying pristiq continues to work, and I will never stop taking my meds again. Good luck to everyone and do not give up. It took me years to find a good combination, and it stopped working eventually, but this stuff seems to be a good fit.
My doctor gave me plenty of samples and i'm going to get the 50% off co-pay plan, which helps a lot since I had to change my insurance which covers much less on my meds.

Finally off lunesta, and take dramamine for sleep, although my doctor told me to not do that and try melatonin. I did that but was ineffective to say the least.

Dave said...

Hi all,

I have been suffering anxiety in small forms for the past 3-6 months but never taken anything for it. About 3 weeks ago the anxiety got a lot worse and had started to effect my work on a daily basis.

Symptoms were really bad shacking/neck twitches/arm twitches and loss of concentration. I would try relax this by performing belly breaths and laying down. I have no idea what is the root cause of my anxiety but I was a fairly heavy user of pot for years, so I'm sure this didn't help my situation.

That aside, i went to my GP and had a good chat about my anxiety and she recommended pristiq and gave me 2 sample packs to last 2 weeks (50mg). She explained they are for anxiety and depression, and I do not have ANY form of depression (luckily) and expressed my concern about taking any form of anti d medication. She talked pristiq up a bit and seemed to know what its about so I thought id give it a go.

I'm now into my 2nd day of taking pristiq and can't really say iv felt any side effects/anxiety yet - but I am off work for the next 2 days which the gp recommended.

Anyway to my point, does anyone think taking anti depressants for pure anxiety / panic attacks is a wise thing to do? I don't want to have this cause me more issues then I'm currently experiencing.

Really appreciate everyones comments.

Anonymous said...

Wow I'm really thankful to everyone for sharing their experiences here. I went to my psychiatrist to treat me for anxiety and suicidal ideations. My struggles to deal with my anxiety were causing me to give myself a lot of negative self talk and this would lead me to suicidal ideations and in turn lead to some low level depression; not at all like some people suffering who can't get out of bed etc.

I'm also a recovering alcoholic with 5 years sobriety and I felt like I had taken the things I'd learned in Alcoholics Anonymous as far as I could go with them and that I needed to continue working that program and seek some additional help.

Tomorrow will be my 7th day on Pristiq and I'm really hopeful. My psychiatrist prescribed me 50mg/day with 0.5mg klonopin as a sort of rescue medicine if I feel like the Pristiq isn't going to knock the anxiety down.

I've also been taking benadryl to sleep for several years and just went off that when I began Pristiq because I wanted to sleep like a normal person.

I would say on the 3rd day I could tell something was different in a good way. I felt lifted. I've taken 5mg doses of Ritalin before (just recreationally) and this feels very very faintly like that and for most of the day. I feel like something is pushing me from inside in a good way.

I was concerned that I would feel "wired" and I've taken naps since I began Pristiq with no problem.

I don't expect everyday to be like the last few but if they're somewhere in the neighborhood then I'm really hopeful.

When I would have suicidal ideations it would usually be when I was lying down to go to sleep at night or if I was taking a nap in the afternoon and it would feel so satisfying to think about how I was going to kill myself and since I've been taking Pristiq I haven't been able to *push thru* to that satisfying feeling of having suicidal ideations. And I *try* to visualize myself committing suicide and I just don't get the pleasure out of it that I did before. And that's pretty incredible.

As far as how this medication makes me feel regarding my earlier paragraph about how I felt it pushing me from inside. It feels artificial but also acceptable at the same time. If that makes any sense.

I had a disagreement with someone in my family the other day and it was the sort of thing that would normally cause me some anxiety and I felt like this kept a lid on it and this was day 5 of being on the medication. I did feel some anxiety but this seemed to not allow the sensations to flood thru my chest the way it normally does.

My tongue does feel a little dry and I'm concerned about that because I'm a singer but I feel more functional on this than I've felt in a couple years and it just maybe a trade off and I also realize there's going to be some *burn in* period where my body adjusts.

I even asked my psychiatrist when he made this decision if he didn't have some pharmaceutical rep breathing down his neck or if he felt coerced in any way and he said that since he moved his practice away from a larger group that he feels freer in his judgments.

And I hope the future is like the last few days or better. That would be pretty cool.

Now I may be on here later complaining about brain zaps, dizziness and the like but so far today thank God it's going alright. I feel helped and hopeful.

Anonymous said...

Wow I'm really thankful to everyone for sharing their experiences here. I went to my psychiatrist to treat me for anxiety and suicidal ideations. My struggles to deal with my anxiety were causing me to give myself a lot of negative self talk and this would lead me to suicidal ideations and in turn lead to some low level depression; not at all like some people suffering who can't get out of bed etc.

I'm also a recovering alcoholic with 5 years sobriety and I felt like I had taken the things I'd learned in Alcoholics Anonymous as far as I could go with them and that I needed to continue working that program and seek some additional help.

Tomorrow will be my 7th day on Pristiq and I'm really hopeful. My psychiatrist prescribed me 50mg/day with 0.5mg klonopin as a sort of rescue medicine if I feel like the Pristiq isn't going to knock the anxiety down.

I've also been taking benadryl to sleep for several years and just went off that when I began Pristiq because I wanted to sleep like a normal person.

I would say on the 3rd day I could tell something was different in a good way. I felt lifted. I've taken 5mg doses of Ritalin before (just recreationally) and this feels very very faintly like that and for most of the day. I feel like something is pushing me from inside in a good way.

I was concerned that I would feel "wired" and I've taken naps since I began Pristiq with no problem.

I don't expect everyday to be like the last few but if they're somewhere in the neighborhood then I'm really hopeful.

When I would have suicidal ideations it would usually be when I was lying down to go to sleep at night or if I was taking a nap in the afternoon and it would feel so satisfying to think about how I was going to kill myself and since I've been taking Pristiq I haven't been able to *push thru* to that satisfying feeling of having suicidal ideations. And I *try* to visualize myself committing suicide and I just don't get the pleasure out of it that I did before. And that's pretty incredible.

I'm cont. in the next post... it will start with, "As far as how this medication..."

Anonymous said...

As far as how this medication makes me feel regarding my earlier paragraph about how I felt it pushing me from inside. It feels artificial but also acceptable at the same time. If that makes any sense.

I had a disagreement with someone in my family the other day and it was the sort of thing that would normally cause me some anxiety and I felt like this kept a lid on it and this was day 5 of being on the medication. I did feel some anxiety but this seemed to not allow the sensations to flood thru my chest the way it normally does.

My tongue does feel a little dry and I'm concerned about that because I'm a singer but I feel more functional on this than I've felt in a couple years and it just maybe a trade off and I also realize there's going to be some *burn in* period where my body adjusts.

I even asked my psychiatrist when he made this decision if he didn't have some pharmaceutical rep breathing down his neck or if he felt coerced in any way and he said that since he moved his practice away from a larger group that he feels freer in his judgments.

And I hope the future is like the last few days or better. That would be pretty cool.

Now I may be on here later complaining about brain zaps, dizziness and the like but so far today thank God it's going alright. I feel helped and hopeful.

Larry Dare said...

My doctor is changing me over to this new drug Pristiq. I have been on Effexor several years ago. The one that has worked for me on stability of mood was paxil. I had to increase from 20 to 40mg. Eventually I started having sexual side effects (anorgasmia) which after awhile became frustrating and I was about to stop taking the meds. Talked to my doctor (Psychiatrist) and he said that he has had some patients that have had some positive results with Pristiq. I am 62, in excellent physical health and normaly have a very active sex life. I am not ready to throw in the towel on this.

My view on medications with nasty side effects, is that, these drugs effect people different ways and a person who wants to get well, may very well have to try various medications to find what works. The struggle is difficult with steep mood swings that make you feel crazy, sometimes severe sexual side effects, even childish behavior.

Certainly none of these drugs are a panacia, but I do not want to ban it's use because it doesn't help everyone in the same way. I don't want to be miserable and die to soon. My only reasonable opinion has to be one of gratitude to those doctors and scientist who devote thier lives to find something that will ease others pain. The most important thing, though it has been a struggle, is that it saved my life.

Surviving said...

I've been taking this for three months now. So far, I'm satisfied. There were problems that I had to work through, but right now it's helping both my pain and depression. My experience is too much to list here. If anyone is interested, I wrote extensively about it on my blog.

Steve Australia said...

I have been on Pristiq for about 2 months now. Preiously I was on a string of stuff that didn't do anything but make me sick, fat, sexless and feeling pretty well useless.
It has been very interesting tonight reading the comments. So much so that I felt I needed to add my two bob's worth. Sorry; that's an Aussie expression that more than likely means zip to you good folk.

So I was started on 100mg of Pristiq a day and the results are these:I've put on 10 kgs or about 22 pounds and I still feel like a sexless creature.
Those are the only downers - unfortunately, they're biggies.

The up side is that I have less downtime, I am simply no longer aggressive and I feel a little better about myself than I have in years, and that's even taking into account the ED issues and the fat guts.

Honestly folks, if there is something better out there then please let me know about it.


Anonymous said...

Bloody hell! That's all I have to say after reading all this. Is there not somewhere one can go for reliable information about medications??? How is one to know which one's to try, and which ones not to? I've tried so many, which have been unsuccessful. I don't have a whole lot of faith in medications nor my psychiatrist. I've been in therapy for years, which is brilliant, but I need meds too. Yet I haven't been on an antidepressant for years now because the process of finding one is ridiculous and horrid!

Anonymous said...

That comment mentioned the word process, and it does rather explain our goal as human beings. Drug research is ongoing, so nobody truly knows the current status of all the meds - docs try to keep up, obviously, so as to keep their patient population satisfied and returning for additional counsel! Each of us has to evolve with our own family, coworkers, friends, local politics and economy - not an easy balancing act. I weaned off Effexor last summer (minus 5 mg each week), but was then having severe down times where my pain levels seemed overwhelming. Doc asked me to try it again, and I'm back to my cheerful self, and admitting that, for me, the addition of that dose does give me those extra few fractions of a second to deal more effectively with my emotional reactions to my environment. Willingness to trust the doc and notice your own reactions to various doses of diff meds may be what's needed... yes, is takes time and concentration, both hard to come by in our busy world.

quixotic said...

Like others I've come across this site looking for more information on Pristiq. I've been on 50mg now for 4 weeks. So far I have found that my moods have become more unstable. I've experience periods of what I can only describe as "mania", I'll feel extremely happy that everything is right in the world, but it feels fake. I'll find myself in fits of laughter over nothing particularly funny. On the flip side I find myself sitting here tonight feeling extremely down and hating myself and the world. I'm bordering on suicidal. I'd also been experiencing headaches, breathlessness, insomnia, ear aches. I'm not sure if those symptoms are related to the drug or my impacted wisdom teeth. Either way I haven't been feeling very good.

Previously I have taken 75mg of Effexor AR. I found after just two weeks my mood improved. The only drawback was that eventually the drug made me too apathetic, I found that things that I should care about didn't bother me. But honestly right now I think I'd prefer to feel like that than the, big fat, helpless, failure that I feel like now. I just picked up another months prescription, I'll try for a couple of more weeks but I think I'll be asking for the Effexor again.

Michelle said...

I have been taking 300mg a day of Pristiq for over 3 years now. I have never heard of anyone taking such a high dose. After a 15 year history of serious depression and anxiety I was introduced to Pristiq at the starting dose of 50mg a day. I worked very closely with my Dr and we kept increasing the dose until I felt completely well. He reassured me that the dose I am on was fine. I feel absolutely fantastic and intend on staying on this drug forever!

Granny said...

I am confused now. For Carlat: Is there a generic drug now available to replace the drug? Pristiq is $50 even with my insurance. So far I don't like it, mainly because I can not sleep. 30 days so far. How long does it take to "give it a chance" to work? Good thing I was laid off, because there is no way I could be working now.
p.s. Daaaaaaaaaaaaaaaave, I like your comments.

Kimberly said...

I have been on Pristiq for a few years and LOVE it. However I take 400mg per day and it is EXTREMELY expensive. I have no insurance and I am paying $450.00 each month for my prescription. Can I substitute Xanax for Pristiq?

Anonymous said...

It's rather upsetting that psychiatrists sometimes lack the pharmacological knowledge to know when a new drug is just a flim-flam job. For me, that's pristiq. I had told a (former) psychiatrist about a reaction I had to Effexor, yet she prescribed Pristiq anyway--and I ended up having a major reaction: itchy, swelled fingers; blood pressure shot straight up. Perhaps she simply didn't believe me when I said that I have trouble with medications. She sure did apologize after that.

Anonymous said...

I have to be honest, Pristiq 50 mg, was just like the other antidepressants that I took for the past 2 1/2 years. I am quitting taking Pristiq because it has been making me sick. I have been on it for about 6 months. My blood pressure is unstable. My cholesterol is elevated. I have unexplained swelling, weight gain, decreased libido.
Yet, I am quitting cold turkey. This has left me unstable until this crappy medication can get out of my system. Some of the withdrawal symptoms, insomnia, nausea, extreme headaches,confusion, muscle and joint aches. Sure this medication is suppose to be good for you, but I want to know who is gonna pay for my pain and suffering through this depressing and stressful time in my life. The drug company is getting rich on my doctor's recommendations. Who do I ask about getting my money back for my medication? I don't think that Pristq should be used for treatment of depression. I think that the FDA needs to reconsider this medication.

Anonymous said...

Suffered from depression for years, from when iwas was young. Getting help, asking for help was the hardest part. Second time I have been on anti-depressants. First was on a Prozac knock off a few years ago. Sorted the depression- messed up my sex drive (virtually zero).

Went on Pristiq a year ago after trying to kill myself. Was worried about the sex drive issue, but had to do something, right? Psychologist recommended Pristiq. Talked to my doctor, he agreed. Started at 50mg, Stopped the suicidal thoughts. Still was hard to get motivated. Went up to 100mg. Still totally zonked every day. Went upto 150mg and suddenly I am getting my work done, getting a lot less anxious, generally getting on with life.

Dosage is different for all of us. My doctor said in large men like me (6'3" 240 pounds) it can take a larger dose. Whatever works. I love it, saved my life. 9/10 because of the side effects.

Holly said...

I have been trying one medication after the other for the past ten years, and a year ago was put on pristiq. I cannot even come close to telling you how thankful I am for this medication. In addition to reducing my depressive episodes to almost nothing, it has lifted a huge anxiety burden that I wasn't even aware I was living with. I haven't gained weight, sex is better, and I am a better parent because of it. I will admit that the side effects were awful for me when I began taking it, by they were gone in a months time.

Doctor B said...

I disgaree passionately with Dr. Carlat.

It's no mere patent extender. It has a significantly more favorable side effect profile than Effexor. Less tiredness, weight gain, & sexual dysfunction; lowest discontinuation rates of any SSRI or SNRI (4%).

Dosing is most convenient of any antidepressant. My patients are almost all difficult cases, having failed with other providers before coming to me. Yet 75% of my Pristiq patients are on 50 mg/d & almost all the rest are on 100 mg/d (which means only 1 pill/d).

It is very efficacious. I've achieved remission with Pristiq for people who had failed trials of 5 or 6 previous antidepressants. I've converted people to Pristiq with success, even people who required a regimen of Effexor XR 450mg/d + Wellbutrin XL 450 mg/d before Pristiq came out. I've gotten people off of Tricyclics & MAOI's thanks to Pristiq.

Carlat is being more than a little bit disingenuous to say that when you increase the dose of Pristiq, you lose efficacy. That is demonstrably false. Carlat conveniently chooses to not tell his audience that the Pristiq studies with higher doses used a forced dose titration model; patients were started on doses of 400 mg & 200 mg/d, which could not be reduced by patient or doctor, thereby assuring a higher incidence of side efffects & a higher dropout rate for those on high doses; the studies used the "Last Observation Carried Forward" data analysis, which means that whenever a patient dropped out, for any reason, they were scored as having had no improvement. This of course skews the efficacay data in the negative direction. In real life, no one would dream of starting a patient on 400 or even 200 mg, so we only need to try doses that high on patients who have little or no response to lower doses, & guess what? There are patients who need 200 mg to achieve remission, albeit a very small cohort of the depressed patient population.

Pristiq does have metabolic advantages. Carlat doesn't tell you that Effexor is metabolized in the body into Pristiq by the Cytochrome P450 2D6 enzyme system, but that the level of 2D6 activity vary considerably between patients, which accounts for the wide variation in dosage & responses with Effexor. It is no accident that the Liver Transplant team at my hospital will routinely insist on Pristiq, even though it's a hassle for them to order it because it's not on the hospital formulary.

Overall, I find Dr Carlat's articles to be biased & misleading. He is obviously a man with an axe to grind.

But then, what do I know? I'm only a Clinical Associate Professor of Psychiatry at a major medical school.

nathenag said...

Me and the hubby are on Pristiq. It works better and has less side effects then Effexor.