# Desvenlafaxine (Pristiq)



## coeus (Jan 11, 2010)

Hey all,

I had therapy today. I don't think I like my therapist, in short. My GP still wouldn't prescribe me Clonazepam but he did offer 4 weeks (Starter Packs) of Pristiq. So I have now a month's worth of SSRI. Theoretically, how long would it take for it to take effect? I know it's all relative on our body compositions but based on your personal experience, how long?

I have been taking St John's Wort for quite some time - how long of a break do I need before I can start taking Pristiq?

Btw: This is a 50mg starter pack.


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## S O L A R I S (Dec 24, 2009)

I was on Venlafaxine aka Effexor. I would assume its almost similar as desvenlafaxine/pristiq. For me the effects were instant, I found alot of benefit from it.

The side effects were nausea, which wasnt bad to handle. I later developed high blood pressure from going on effexor, so I had to quit it. Im not sure if pristiq does that, but id recommend a blood pressure check once youve been on it to see whats happening.

I wish you the best of luck!! Keep us posted!


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## Jay (Mar 27, 2008)

Venlafaxine and pristiq (a molecule which your body would convert venlafaxine into if you took plain old effexor, packed into a pill), pretty much works _within_ a months time. St. Johns Wort has a half life of about 26 hours, which is the time it takes for half of the active ingredient(s) in the plant to be metabolized. This does _not_ mean that it would then take 52 hours for everything to be metabolized, pharmacokinetics are not linear like that. It would take anywhere from 5-9 days for St. Johns Wort to leave your system (it's variable because everyone is different).

hope this helps

~ Jay


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## Absentis (Jul 10, 2007)

I`m surprised you didn`t mention this to your doctor, since drug-drug interactions can be serious. You need to ask a physician or a pharmacist about how long you should wait before starting Pristq.


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## Jay (Mar 27, 2008)

Absentis said:


> I`m surprised you didn`t mention this to your doctor, since drug-drug interactions can be serious. You need to ask a physician or a pharmacist about how long you should wait before starting Pristq.


safest bet as always...


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## coeus (Jan 11, 2010)

Absentis said:


> I`m surprised you didn`t mention this to your doctor, since drug-drug interactions can be serious. You need to ask a physician or a pharmacist about how long you should wait before starting Pristq.


I totally forgot to ask him. I read somewhere that 2 weeks should be sufficient but as a precaution, I'll ask my GP to confirm.


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## Absentis (Jul 10, 2007)

coeus said:


> I totally forgot to ask him. I read somewhere that 2 weeks should be sufficient but as a precaution, I'll ask my GP to confirm.


Okay, totally understandable. I've been on the wrong side of a bad drug-drug interaction, and waking up once in a hospital convinced me that I should be careful when mixing drugs (even if they're all prescribed by a doc).

Anyway... You read correctly. You should wait two weeks before taking an SSRI/SNRI/**RI from when you've stopped taking an MAOI.

I hope desvenlafaxine helps you.


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## coeus (Jan 11, 2010)

I'm hoping it does too. Thanks again for the advice.


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## Absentis (Jul 10, 2007)

Glad I could help.









(Do you see the green and red buttons on the bottom right of each post? I know I'm lame for suggesting this, but you could boost my ego by raising my rep.)


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## coeus (Jan 11, 2010)

Haha. Egotism at its best.

The fact that you might have steered me clear from Serotonin Syndrome deserves a +1 rep and since you sound like you're well-versed in psychopharmacology.


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## staples (Apr 1, 2009)

I took Pristiq about a year ago for 3 months and it was a living hell. It's not actually advertised to treat any type of anxiety disorder. It's a more potent form of Effexor, but it did help a lot with my depression. It personally made my DR a lot worse, but it could have positive effects for you. Good luck!


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## coeus (Jan 11, 2010)

I thought I would post a little update about my progress with Pristiq. I'm presently on the forth week of my dosage and I can honestly report that it hasn't visibly helped me in any way. In fact, there were no side effects to begin with, of which is typically prevalent with starting an antidepressant. I'm one of the luckier ones I suppose.

However, I haven't had a single panic attack in the last two months - whether or not I can attribute this to the antidepressant is unclear. It's my opinion that my own take on thought-countering and self-help CBT techniques proved to be more helpful in reducing the severity of general anxiety and panic. I'm glad the panicky sensations have disappeared.

Nonetheless, I'm going to switch over to Lexapro since it's officially indicated for generalised anxiety which would be deemed more helpful in the long-run, along with CBT. I'll see how I manage on the Lexapro. No benzodiazepines for the time being - I'll only consider it if the anxiety starts to constantly skyrocket.

Hope this helps.


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## Absentis (Jul 10, 2007)

I don't recommend switching meds just because of their official indication. It sounds like it is working in your case, even if you might not think it's the one that's helping you the most. The official indications don't correlate to the relative effectiveness of a drug. The indication is just whatever diagnosis the drug company researched when getting approval from the FDA or Health Canada (I don't know the regulatory bodies outside of North America). You're lucky that you have a reduction in panic attacks and that you have minimal or no side-effects from taking the drug. That alone should convince you to stay on it, because there's no guaranteed that Lexapro will help you more that desvenlafaxine.

If that doesn't make you reconsider, know this: Lexapro was launched when the patent for Celexa ran out. The molecule in Lexapro that has the psychoactive effects is the exact same as the one in Celexa. The only difference is that Celexa has two chiral molecules, l- and d-, while Lexapro just has the l- form. (If you don't have a chemistry background, just think that the pharmaceutical manufacturer just removed something from celexa that doesn't do anything in the first place, and kept the thing that works.) This is a move so that they can continue to make plenty of money from a brand name drug that has already gone generic.

I'm in a rush so I may not have been entirely clear, so don't hesitate to ask for a clarification or whatever.


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## coeus (Jan 11, 2010)

Absentis,

I appreciate the advice. In fact, I always enjoy reading your posts containing information on pharmacological products. It's comforting to have someone who can give an impartial, objective perspective on starting/switching medications.

I'm most certain that the panic attacks were secondary to my generalised anxiety. They were never frequent and for the most part, I believe it was my own mental initiative that made them fade on their own perhaps, an physical exercise regimen too. I don't believe that the Pristiq helped at all as I've seen no noticeable benefit specifically for my anxiety. You could be right that perhaps that I'm simply under the delusion that it doesn't seem to be working.

Another reason I want to switch to Lexapro is to find an SSRI that may help alleviate this unrelenting tension headache I've had for the past two months. I've read briefly that Paxil and Lexapro may yield some relief for the dull tension headache. I've even gone to the extent of reading literature about Amitriptyline and its reported benefits for tension headaches in controlled clinical studies. I might ask my GP for Elavil (Amitriptyline) instead of Lexapro, as a trial-and-error endeavour. Initially I thought this would be compromise: treating the tension headache (Amitriptyline) and forgoing an indication on generalised anxiety (Lexapro) but based on your advice about the indications, there probably isn't any compromise or trade-off in choosing one or the other.

I'm aware that medications are not the 'solve-all' choice for everything but anything that can complement the possible reduction in my symptoms is definitely welcomed. The majority of the battle is obviously the shift in attitude/mentality but as we all know, medications can help in some cases.

What are your thoughts on my take on Lexapro (or Celexa) and Amitriptyline with regard to the tension headache, if any?

Again, appreciate the help.


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## coeus (Jan 11, 2010)

I guess I was asking too much of a question


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## Absentis (Jul 10, 2007)

My apologies for the delay. I've written part of a reply and have it saved on my desktop because I want to finish it properly. I'll edit this post and replace it with the finished reply.


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## coeus (Jan 11, 2010)

Absentis said:


> My apologies for the delay. I've written part of a reply and have it saved on my desktop because I want to finish it properly. I'll edit this post and replace it with the finished reply.


No worries, Absentis. No fuss.

Oh and just as a side-note, the reason I'm asking is because my Pristiq samples are going to soon run out. In fact, I've got 3 tablets left and am weening off them by 50% daily. In all honesty, I probably don't even need to "ween" off them since I've only been on Pristiq for about 3-4 weeks. Since I haven't noticeably felt any changes with Pristiq, I'm wondering if these samples even contain 'real' medication or if it's merely a placebo!

(NB: Sorry if you have to revise your reply!)


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## Absentis (Jul 10, 2007)

Nope. The only bit about Pristiq was something you already know. keep it in mind as a factor if things deteriorate.


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