Pristiq and Alcohol: Risks & Side Effects

What is Pristiq?

Pristiq is an antidepressant medication classified as a member of the SNRI (selective serotonin and norepinephrine reuptake inhibitor) class of medicines.¹ Pristiq’s active ingredient is desvenlafaxine. It is available in the form of extended-release tablets that are taken orally. It is also available in a generic version. Pristiq should be taken daily, regardless of whether it is taken with or without food.²

How Does Pristiq Work?

The effectiveness of Pristiq comes from its ability to boost the brain’s uptake of the neurotransmitters serotonin and norepinephrine. ³ This increased absorption can help to improve mood and reduce anxiety and depression symptoms. Pristiq has been approved by the Food and Drug Administration (FDA) in the United States to treat major depressive disorder (MDD). In addition, it can be prescribed off-label to treat anxiety disorders, menopause, panic attacks, and nerve pain.

Can You Mix Pristiq & Alcohol?

It is unsafe to use Pristiq with alcohol since alcohol can make depression symptoms worse and has a negative interaction with the medication. When combined, these two compounds can be an indicator of a more serious issue in specific situations. People who suffer from untreated depression are more likely to abuse substances like drugs or alcohol, which can lead to addiction. A person who has an alcohol abuse disorder that is not being treated may combine their prescriptions in an attempt to get “high” or to escape the emotional suffering they are experiencing.

What Happens When You Mix Alcohol & Pristiq?

Pristiq’s side effects on the neurological system, such as lightheadedness, sleepiness, and problems concentrating, can be heightened by alcohol. Additionally, cognitive and judgmental impairment may be experienced by some people. While taking Pristiq, alcohol usage should be avoided.⁴ Use Pristiq only as directed, and until you are familiar with how it affects you, refrain from engaging in activities like driving or using potentially dangerous machinery. If you have any questions or concerns, consult your physician or pharmacist.

There is a boxed warning for this medication. This is the most serious Food and Drug Administration (FDA) warning. Children and young adults (26 and younger) who use antidepressants, such as Pristiq, are more likely to have suicidal thoughts and actions. Combining alcohol and Pristiq can increase the risk of suicidal thoughts, plans, or attempts.

Side effects of Pristiq include:

• Dry mouth
• Restlessness
• Headache
• Constipation
• Tremors
• Decreased appetite
• Nausea
• Insomnia
• Increased sweating
• Nervousness
• Fatigue

Side effects of alcohol use include:

• Vomiting
• Loss of consciousness
• Impaired coordination
• Blackouts
• Alcohol poisoning
• Excessive thirst and dry mouth
• Rapid heartbeats
• Poor or decreased sleep
• Dizziness
• Fatigue
• Decreased ability to concentrate
• Headaches
• Muscle aches

Combining desvenlafaxine with alcohol is risky since both substances have the potential to amplify the harmful effects of the other, which can already be serious on their own.

This is not a comprehensive list of possible mild or serious side effects with Pristiq. You should talk with your prescriber and your pharmacist about possible side effects before starting any medication.

Pristiq & Alcohol Interactions

When Pristiq and alcohol are used together, the side effects of Pristiq, such as dizziness, impaired coordination, and drowsiness, can be amplified. When combined, the two substances can cause a loss of consciousness, coma, and even death in certain people.⁵

When both alcohol and Pristiq are used at the same time, potentially harmful interactions between the two substances can take place. If alcohol is consumed while Pristiq is still present in the body, there is a greater risk of developing health issues.

Severe side effects of mixing Pristiq and alcohol include:

• Hallucinations: When Pristiq alcohol are used together, you risk experiencing auditory and sensory hallucinations, an inability to tell what is real from what is not real.
• Worsening depression: Alcohol use can worsen symptoms of depression.
• Shaking and tremors:  The side effects of Pristiq and alcohol may increase tremors and shaking.
• Suicidal thoughts: When taking antidepressants like Pristiq, some children and young adults (age 26 and under) are more at risk for experiencing suicidal thoughts and self-harm. Pristiq and alcohol together may enhance suicidal thoughts.
• Sweating: Alcohol induces dilated blood vessels, which makes the skin feel warm and flushed and can stimulate the flow of perspiration; using alcohol and Pristiq together increases sweating. Sweating is a frequent and irritating side effect of treatment with Pristiq.
• Constipation: Alcohol usage while taking Pristiq can exacerbate symptoms of constipation, which is frequently related to antidepressants since they interfere with the normal functioning of the digestive tract and other organ systems.
• Blurred vision: Taking alcohol and Pristiq can cause an increased risk of side effects like blurred vision.
• Increased heart rate: Alcohol use while taking Pristiq may produce extremely high serotonin levels. Serotonin syndrome, a potentially fatal illness that can induce a rapid heartbeat, can be brought on by an excess of serotonin.

Alcoholism & Depression

Nearly one-third of people who suffer from serious depression also struggle with alcoholism.⁶ Alcohol is a CNS depressant. Therefore, drinking in any amount increases your risk of developing depression. Heavy drinking can damage your brain and cause major depressive disorder.

You are more inclined to act impulsively or make poor decisions when you drink too much. You might, as a result, deplete your bank account or lose your job. When that occurs, you are more likely to experience depression, especially if your genes predispose you to it.

The combination of alcohol and Pristiq may indicate a more serious issue in certain instances. People with untreated depression are likelier to abuse substances and develop addictions, such as alcohol or drugs. An untreated alcohol abuse issue might cause a person to combine their prescriptions to become “high” or escape the emotional suffering they are experiencing. Simply because you are receiving treatment for depression does not guarantee that you will no longer feel the temptation to drink.

Can You Ever Drink While Taking Pristiq?

Anyone using Pristiq is typically advised not to drink alcohol. There are numerous other ways to define moderate alcohol use, but when avoiding Pristiq side effects, you can only rely on your doctor’s advice.

Alcohol consumption can have potentially fatal interactions with Pristiq when the two medications are taken simultaneously. Alcohol consumption can also have negative effects when Pristiq is still present in the body. Because every person’s body is unique, the drug half-life may take longer in one system than in another. As a result, patients using Pristiq should abstain from all alcohol use while taking medicine.

Can Pristiq & Alcohol Kill You?

The combination of alcohol and Pristiq can be risky and even fatal if someone is casually drinking, binge drinking, heavy drinking, or has an alcohol dependence before taking it. Alcohol is classified as a depressant because it depresses nervous systems in our bodies, such as heart rate, blood pressure, and respiration.

Can I Skip a Dose of Pristiq to Drink Alcohol?

Every day, Pristiq should be taken consistently at around the same time. Avoid missing any of your doses, as doing so could reduce the effectiveness of your treatment and increase your depressive symptoms. Pristiq withdrawal symptoms could also appear if you skip a dose of the medication. Alcohol consumption may make withdrawal symptoms worse.

Risk Factors for Abusing Pristiq & Alcohol

Pristiq and alcohol abuse can start at any time for anyone. Specific risk factors for substance abuse may increase a person’s vulnerability to substance misuse, albeit this is not guaranteed.⁷ A mental health issue, using drugs or alcohol at a young age, not having adult supervision, peer pressure, using highly addictive substances, having low self-esteem, and traumatic life experiences are all common risk factors.

Symptoms of an Overdose of Pristiq & Alcohol

The most often reported side effects from taking too much Pristiq and alcohol are tachycardia, altered levels of awareness (from sleepiness to coma), mydriasis, seizures, trouble breathing, and vomiting. If someone is actively under the influence and experiencing severe side effects or overdose, they should call 9-1-1 or visit the nearest emergency room immediately. Symptoms of an overdose might be hard to address when working with a high-functioning alcoholic.

Symptoms of an overdose of Pristiq and Alcohol include:

• Vomiting
• Hallucinations
• Blurred vision
• Stiff, rigid muscles
• Difficulty in breathing
• Skin rashes
• Increased heart rate

Treating an Alcohol & Pristiq Overdose

Rest, hydration, and quitting drinking are methods for treating alcohol intoxication. Hospitalization, intravenous fluids, observation, and supportive treatment are necessary for severe instances. It is crucial to get checked immediately if you have suspicions of taking too much alcohol or Pristiq. Call 911 immediately if you or a loved one exhibits symptoms of a Pristiq or alcohol overdose.

Seeking Professional Help

Communicating with your doctor is crucial if you want assistance and support. It could be difficult to begin talking about your drug use. However, having frank and open discussions is essential to getting the greatest medical counsel and care. Your therapy may suffer if you withhold information regarding the substances you use, how much you use, and how frequently. Do not forget that any conversations you have with your doctor are private and confidential.

Your doctor can provide you with advice on the best alcohol or drug treatment options for your particular situation. They can also offer alternative treatments if you are worried about the side effects of using Pristiq with alcohol. If in need of a new psychiatrist, online psychiatry options are available. Doctors may prefer to treat alcohol use disorders and mental health conditions together due to cross-addiction risk.

Questions to Ask Your Health Team About Pristiq Use

Drinking alcohol may interfere with the effects of your Pristiq medicine, making it more challenging to treat your symptoms. Those who do not know how Pristiq may influence their body are the ones who are at the most risk of experiencing negative side effects. The greatest education method is to discuss your concerns with your healthcare professional.

Questions to ask your doctor about alcohol and Pristiq include:

• Is there a safe amount of alcohol that I can consume with Pristiq?
• If someone wants to drink, should they stop taking Pristiq for the day?
• Is there anxiety medication or depression medication that isn’t negatively affected by alcohol?
• What should I do if I decide to drink anyway and have an adverse reaction?
• What are the adverse reactions to Pristiq?
• What to avoid when taking Pristiq?
• What can happen if I drink alcohol on antidepressants?
• How does Pristiq work?
• What if I miss a dose of Pristiq?
• How long should I continue taking Pristiq?

In My Experience

Pristiq (desvenlafaxine) is an antidepressant medication member of the SNRI class of antidepressants. In my experience, these medications may help to reduce the signs and symptoms of depression. Pristiq, like other antidepressants, interacts poorly with alcoholic beverages and can cause various unwanted side effects. Treatment approaches for treating alcohol use disorder and depression are available. Potential options include alcoholism medication, therapy, and a comprehensive long-term recovery strategy.

For Further Reading

Antidepressant Discontinuation Syndrome: Symptoms & Prevention
Pristiq (Desvenlafaxine) Dosage Guide: Forms, Strengths, & How To Take It
Substance Abuse Risk Protective Factors
Pristiq for Anxiety: How It Works & Comparisons to Other Medications
Pristiq Vs Effexor: Differences, Similarities, & Which to Take
Antidepressants & Alcohol: Understanding the Risks