How to Deal with Pristiq Withdrawal

By Andrew Yocum, MD
Medically reviewed checkmarkMedically reviewed
June 21, 2022

More than 2.5 million people have been prescribed Pristiq (desvenlafaxine) to treat major depressive disorder (MDD) and other conditions.

When a patient stops taking this medication after some time, they may experience withdrawal syndrome, uncomfortable symptoms that can include nausea, headache, fatigue, abnormal dreams, and more.

If you’re taking Pristiq or another antidepressant, you should never stop taking it abruptly without instructions from your doctor or healthcare provider—stopping suddenly increases the chances that you’ll experience withdrawal.

But even when you stop taking the medication slowly, there’s a chance you’ll experience these symptoms.

Dealing with withdrawal can be scary, and patients often feel like their depression or mood disorder has returned.

There are a few tips and strategies you can use to help manage and lessen the effects of Pristiq withdrawal.

In this article, I’ll talk about how Pristiq works, and its uses.

I’ll also outline some of the symptoms of Pristiq withdrawal, and explain how long you might experience them.

I’ll also offer some strategies and ideas for coping with withdrawal.

Finally, I’ll tell you when to talk to your doctor.

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What is Pristiq?

Pristiq is a brand name for desvenlafaxine, a type of prescription antidepressant medication called a serotonin-norepinephrine reuptake inhibitor, or SNRI.

It is very similar to another SNRI, Effexor

How Pristiq works

SNRIs work by increasing the amount of serotonin and norepinephrine that are available in the brain.

These two substances are neurotransmitters, a type of chemical used in the brain and body to transfer messages.

Usually, when these chemicals finish transmitting their messages, they’re reabsorbed by the brain, a process called “reuptake.”

SNRIs inhibit, or slow, this reuptake process so that more serotonin and norepinephrine are available.

Increasing the amount of these that are available can elevate our mood and reduce the effects of depression and anxiety.

Pristiq uses

Pristiq is approved by the U.S. Food and Drug Administration (FDA) to treat major depressive disorder (MDD) in adults.

It is not usually prescribed for anxiety disorders; Effexor, which is a similar medication is FDA-approved for anxiety disorders, including generalized anxiety disorder (GAD).

When someone has MDD, they have had symptoms of depression or low mood persistently for at least two weeks, with symptoms that interfere with their ability to do their daily functions.

A diagnosis of MDD includes at least some of these symptoms:

  • Depressed mood
  • Loss of interest in your usual activities
  • Significant changes in your weight or appetite
  • Loss or sleep or excessive sleep
  • Increased fatigue
  • Feeling worthless, guilty, or numb
  • A visible slow-down in movements and physical reactions, called psychomotor retardation
  • Suicidal thoughts 
  • Brain fog or slowed thinking

Pristiq may be prescribed off-label for women who are going through menopause and experiencing hot flashes, which are sudden, strong feelings of sweating or heat. 

Symptoms of Pristiq Withdrawal

Missing a dose or abruptly stopping your Pristiq prescription can lead to withdrawal.

If you accidentally miss a dose of Pristiq, take it as soon as you remember.

If you are near the time for your next scheduled dose, however, skip the missed dose.

This may accidentally double your dose of Pristiq, which is not recommended.

Never take a double dose to make up for a missed dose of Pristiq or another antidepressant, unless instructed to by your doctor.

A double dose could increase the risk of dependency or addiction to Pristiq. 

Like other antidepressants, your brain may become dependent on Pristiq.

If you decide to stop taking it, never stop taking it abruptly, as this can lead to withdrawal symptoms.

Talk with your healthcare professional about a reduction plan or tapering schedule.

This will reduce the amount of Pristiq you’re taking over time, reducing the chances for withdrawal.

Follow the tapering schedule your healthcare provider creates closely.

Even if you’re tapering, you could experience the following withdrawal symptoms when stopping Pristiq: 

Talk to your doctor about a withdrawal plan to lessen the severity of your withdrawal symptoms. 

Timeline for Pristiq Withdrawal

Pristiq has a half-life of around 11 hours. This means that 11 hours after taking a dose of the medication, half of the medication has been processed and left your body.

This is a short half-life compared to other SNRIs, which can mean that withdrawal can be more extreme with Pristiq than other antidepressants.

Some other medications, like escitalopram (Lexapro), have half-lives of up to two to three days.

A longer half-life time means the body has time to adjust to the medication. 

Stopping Pristiq abruptly can be dangerous for your body.

This is especially true if you have been taking Pristiq for a long time.

Pristiq withdrawal symptoms usually appear within 36 hours after the final dose and can last for up to 4 to 6 weeks. 

Each patient and their prescription is different.

The severity of your withdrawal will depend on your mood disorder, your daily dosage, the length of time you’ve been taking Pristiq, and how abruptly you stopped taking it. 

Tips for Coping with Pristiq Withdrawal

Do not quit Pristiq suddenly, as this can make withdrawal symptoms more likely.

Instead, talk to your doctor about a tapered dosage adjustment plan, and follow it closely to avoid serious withdrawal effects. 

Closely follow the taper dosage

A taper method means to continuously lower your daily dosage to wean you off the medication.

Follow this method closely until your body is entirely free of Pristiq.

Stopping antidepressants in this way lessens the effects of withdrawal.

Try psychotherapy

Talking to a psychiatric professional about your depression and mood disorder can help you understand and manage it. Joining a support group for antidepressant withdrawal can also help you feel less alone in this journey. 

Lifestyle changes

Lifestyle changes, such as a nutritious diet, physical exercise, and engaging in daily activities or hobbies that you enjoy, are recommended for coping with Pristiq withdrawal.

Making healthy lifestyle changes can have an overall positive effect on your mood disorder, and help patients cope with Pristiq withdrawal. 

Over-the-counter medications

Diphenhydramine (Benadryl) can help ease nausea.

Bismuth subsalicylate (Pepto-Bismol) can help with nausea, vomiting, or diarrhea. Ibuprofen (Advil, Motrin) can relieve headache pain. 

Keep in communication with your healthcare provider

Stay in touch with your doctor or healthcare provider while tapering off of Pristiq.

Keep your doctor updated on any withdrawal symptoms, so they can help lessen the effects.

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When to See a Medical Provider

See a doctor if you experience any severe withdrawal symptoms like slurred speech, blurred vision, or find your depression worsening.

You should also talk to your doctor if you miss a dose of Pristiq, or decide to stop taking the prescription.

Your doctor can help create a tapering or treatment plan, recommend another medication if needed, or help you deal with withdrawal symptoms.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?
Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

How long does withdrawal from Pristiq last?
Pristiq withdrawal starts within 72 hours of stopping the medication and can last up to four to six weeks. The timeline for withdrawal will depend on your daily prescribed dosage and how long you were taking the prescription.
How long does it take to wean off desvenlafaxine?
It’s different for every patient. Your doctor can help you design a tapering method to wean off desvenlafaxine. The tapering schedule will depend on your mood disorder, your daily dosage, and the length of time you were taking desvenlafaxine.
Is Pristiq hard to get off?
Pristiq is a powerful antidepressant, so you should not abuse your prescribed dosage. It has a short half-life of 11 hours, so withdrawal symptoms can be more severe than other SNRIs. If you decide to stop taking Pristiq, develop a coping strategy with your doctor.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Andrew Yocum, MD

Dr Andrew Yocum is a board certified emergency physician. He graduated Summa Cum Laude from Kent State University with a Bachelor of Science in Molecular Biology before attending Northeast Ohio Medical University where he would earn his Medical Doctorate (MD).