# Struggles and Support > Medication >  >  pristiq anyone?

## sweetcakes

is anyone taking pristiq? how did you find it? how long did it take to get full effect from it and on wat dose?

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## Equinox

What do you take it for? I took it for a month at 50mg, only side effect was jaw clenching/pain. I stopped it because of that issue so I can't comment on effectiveness since antidepressants usually take about a month to start working. Dosage wise I think its normal to move up to 100mg after the first month if necessary which might work better for anxiety/depression.

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## peace

I have been on Pristiq for 15 months, I noticed pins and needles in my hands for the first ten days and some headaches that subsided. I was taking 100mg I had little motivation and was more apathetic though my anxiety was lessened. It took a good month for it to start to work in which time I was suicidal. I am now on 50 mg and have more motivation less apathetic but my anxiety is back. Go figure.

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## James

I was on it for about six months. I started at 50mg, but moved up to 150mg. It was great for getting rid of my anxiety, a lot of the symptoms, but it also turned me into a zombie. I slept all night and all day. I tried going back down to 50mg, but then it did nothing for me at that dose. Everybody's different though.

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## Antidote

I was on 50mg for several weeks. Went slightly manic the first few days then remained hypomanic and chatty for the next few weeks (which I didn't mind). I had to stop it promptly though because I was unable to go to the toilet on it.  :Nerd:

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## Monotony

I was on it for a week it did not end well, Usuall I don't let my anger get the better of me.

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## metamorphosis

Pristiq:

Basics from DrugBank




> Indication
> Desvenlafaxine is indicated for the treatment of major depressive disorder in adults.
> 
> Pharmacodynamics
> Desvenlafaxine is a selective serotonin and norepinephrine reuptake inhibitor. It lacks significant activity on muscarinic-cholinergic, H1-histaminergic, or α1-adrenergic receptors _in vitro_. Desvenlafaxine does not appear to exert activity against calcium, chloride, potassium and sodium ion channels and also lacks monoamine oxidase (MAO) inhibitory activity. It was also shown to lack significant activity again the cardiac potassium channel, hERG, _in vitro_. Compared to other SNRIs, desvenlafaxine undergoes simple metabolism, has a low risk of drug-drug interactions and does not have to be extensively titrated to reach a therapeutic dose. Some of the limitations of desvenlafaxine include moderate efficacy in the treatment of major depressive disorder, similar safety and tolerability profile to other SNRIs and possible transient discontinuation symptoms upon cessation of therapy.
> 
> Mechanism of action
> Desvenlafaxine, the major active metabolite of venlafaxine, is a selective serotonin and norepinephrine reuptake inhibitor. The clinical effect of desvenlafaxine is thought to occur via potentiation of serotonin and norepinephrine in the central nervous system. Unlike venlafaxine, desvenlafaxine is thought to have a differential serotonergic and noradrenergic activity profile.
> 
> ...





 
So, desvenlafaxine is a synthetic form of the isolated major active metabolite of venlafaxine, and is a new (SNRI). Someone lost their patent on Effexor and it is generic now. Interestingly, 70% of Effexors benefit come from it being metabolized into desvenlafaxine.
It can have the same nasty discontinuation side effects like Effexor. So, if you ever come off, titrate down slowly. Often an SSRI is used during this time to help stabilize the changes in 5HT.  

This is a meta-analysis on Pristiq. It focuses on major depression. It has a lot of good info:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2947544/


Note these 8 week studies examine anxiety remission in patients with MDD:





> *Analysis of the Effect of Desvenlafaxine* *on Anxiety Symptoms Associated with* 
> *Major Depressive Disorder: Pooled* 
> *Data from 9 Short-Term, Double-blind,* 
> *Placebo-Controlled Trials
> *Karen A. Tourian, MD, Qin Jiang, MS, and Philip T. Ninan, MD
> *
> FOCUS POINTS*
> â¢ Symptoms of anxiety are commonly associated with major depressive disorder (MDD). 
> Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor approved for the 
> ...



Here is the whole pdf.
http://mbldownloads.com/0310CNS_Tourian.pdf



As far as common side effects, tolerability, etc.





> *Efficacy, safety, and tolerability of fixed-dose desvenlafaxine 50 and 100 mg/day for major depressive disorder in a placebo-controlled trial.*
> Boyer P, Montgomery S, Lepola U, Germain JM, Brisard C, Ganguly R, Padmanabhan SK, Tourian KA.
> *Source*
> University of Ottawa, Institute of Mental Health Research, Ottawa, Ontario, Canada. pboyer@rohcg.on.ca
> 
> *Abstract*
> The objective of this study was to assess the efficacy, safety, and tolerability of desvenlafaxine (administered as desvenlafaxine succinate) 50 and 100 mg/day for major depressive disorder (MDD). A multicenter, randomized, double-blind, placebo-controlled trial was conducted in Europe and South Africa. Outpatients with MDD received fixed-dose desvenlafaxine (50 or 100 mg/day) or placebo for 8 weeks. The primary efficacy variable was the 17-item Hamilton Rating Scale for Depression total score; secondary measures included Clinical Global Impressions-Improvement scores. The intent-to-treat population included 483 patients: desvenlafaxine 50 mg (n=164), desvenlafaxine 100 mg (n=15, and placebo (n=161). At the last-observation-carried-forward analysis (final evaluation) using analysis of covariance, adjusted mean changes from baseline on the Hamilton Rating Scale for Depression were significantly greater for both desvenlafaxine 50 mg (-13.2; P=0.002) and 100 mg (-13.7; P<0.001) versus placebo (-10.7). Significant differences on the Clinical Global Impressions-Improvement scores were observed for desvenlafaxine 50 mg (P=0.002) and 100 mg (P<0.001) versus placebo. Both doses of desvenlafaxine were generally well tolerated. The most common treatment-emergent adverse events were nausea, dizziness, insomnia, constipation, fatigue, anxiety, and decreased appetite. Fixed doses of desvenlafaxine 50 and 100 mg/day are safe, generally well tolerated, and effective at a clinically relevant level for the treatment of MDD.







> *An integrated analysis of the efficacy of desvenlafaxine compared with placebo in patients with major depressive disorder.*
> 
> Thase ME, Kornstein SG, Germain JM, Jiang Q, Guico-Pabia C, Ninan PT.
> *Source*
> 
> 
> Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. thase@mail.med.upenn.edu
> Abstract
> *INTRODUCTION:*
> ...



I have some samples of it but have never used them . So, I have no first hand experience.
Here are some anecdotal reports:
http://www.askapatient.com/searchres...hField=pristiq

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## metamorphosis

^
Let me also say that while a large pool of first person accounts can be very insightful and invaluable. The odds are more apt, that more people who are dissatisfied with a medication, will post on an anecdotal forum than many who are having good results with their meds. Askapatient can be very informative just by the sheer # of those posting and you will see certain side-effects and result % that appear more frequently. So, those will help paint a part of the picture concerning med. reactions.
I mean the only psychotropics that I have seen above the 4.0 mark (askapatient) are the MAOI's, Parnate and Nardil. And their side effects, possible dangers, and lifestyle changes can be monumental or unbearable for many.

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## JustinOi

Always provide type arguments when you use a generic type.  Levitra Soft  The method might be a pre-Java-5.0 method that was defined before generic and parameterized types had been available in Java.  
White House  In other words, we would not even be capable of expressing that we intend to refer to an enum value belonging to a particular instantiation of the generic enum type.  impotence  Early ejaculation (Premature ejaculation) is a kind of male erectile trouble.  Impotence - http://loppholaibet.edublogs.org/2014/04/05/impotence/  I talked to my doctor, who proposed a month of 5 mg, followed by a month of 5mg every other day and then a revisit to see how things are going. I am just entered the 5 mg every other day phase, having made it through one month of 5 mg.

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