Pristiq (Desvenlafaxine) Withdrawal: Symptoms, Duration, & How to Cope

Stopping Pristiq too quickly can cause withdrawal symptoms like dizziness, tremors, confusion, tingling sensation, and headaches. These symptoms can last for a few days up to a few weeks and can lead to more severe side effects in some cases. Working with your doctor to slowly decrease your dose over time can greatly reduce the risk of withdrawal symptoms. It is important to understand withdrawal symptoms and have a plan to cope, before coming off of the medication.¹

What is Pristiq (Desvenlafaxine) & How Does It Work?

Pristiq (desvenlafaxine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat depression in adults. It is chemically related to another SNRI antidepressant called venlafaxine. Pristiq comes as a tablet made specifically to slowly release medication throughout the day. This allows the medication to be taken just once daily, but care should also be taken to not chew or crush the tablet. This would release a large amount of medication all at once.¹

Pristiq and other SNRI drugs work in the nervous system to increase the activity of serotonin and norepinephrine. These chemicals are responsible for activities in the body related to stress, mood, and other emotions. Studies have shown that this action can help improve symptoms of depression.¹

What Is Pristiq Withdrawal?

Pristiq withdrawal is the occurrence of unfavorable symptoms due to the discontinuation of the medication. Pristiq withdrawal can happen when any antidepressant is abruptly stopped and it is widely known as antidepressant discontinuation syndrome. This occurs in about 20% of patients that stop any antidepressant abruptly after at least 4 weeks on an antidepressant.²

While it is often referred to as withdrawal, it is not due to an addiction to Pristiq, but rather a dependence. Addiction vs dependence is an important distinction. The body becomes accustomed to the medication and experiences symptoms due to the chemical changes that happen when stopping the medication.

Factors That Influence Pristiq Withdrawal

The risk of Pristiq withdrawal depends on many factors including the dose and time having taken the medication. It is important to understand how other factors can influence withdrawal symptoms.

Factors that influence Pristiq withdrawal include:^{1, 2}

• Length of time taken: The longer you have been taking Pristiq, the more likely you will experience withdrawal symptoms. There is a significant increase in risk after taking Pristiq for more than 6 weeks.
• Dosage: Some studies have shown stopping at higher doses is more likely to lead to withdrawal symptoms.
• Other medications: Other medications taken at the same time can influence withdrawal symptoms. Some may increase the severity of symptoms, while some may lessen the symptoms.
• Social support: Having a social safety net of support both personal and professional can help when managing discontinuation symptoms.

Causes of Pristiq Withdrawal

Pristiq withdrawal symptoms most often happen from suddenly stopping the medication. It can also happen if a dose is lowered too quickly, or a dose is skipped or missed. There is also a risk for withdrawal symptoms when switching antidepressants. Usually, you will be instructed to slowly change medications if you are switching.¹

It is crucial that if you plan to stop taking the medication, you work with your doctor to come up with a plan. Some people choose to stop taking Pristiq on their own because of how antidepressants make them feel. This is understandable, but if done without medical guidance, stopping antidepressants abruptly can lead to worse symptoms.

Pristiq Withdrawal Symptoms

Pristiq withdrawal symptoms can range from mild to severe. A person’s dose of Pristiq is a large factor that determines the risk of withdrawal symptoms, with larger doses leading to increased symptoms. Symptoms may also vary from person to person based on age and other medications and on the presence of other diseases.

Many symptoms can range from mild to more serious. Knowing how to recognize a severe symptom and when to get help is very important.

Common Pristiq Withdrawal Symptoms

More common symptoms of Pristiq withdrawal usually go away on their own and are not life-threatening. They can last a few days to a few weeks. Some symptoms can be physical like nausea and flu-like symptoms while others are neurological like brain fog and anxiety.^{1, 2}

Common Pristiq withdrawal symptoms include:

• Anxiety
• Brain zaps
• Nausea
• Dizziness
• Sweating
• Trouble sleeping
• Diarrhea
• Abnormal dreams
• Changes in mood
• Headache
• Confusion
• Aggressiveness

Severe Pristiq Withdrawal Symptoms

Some symptoms of Pristiq withdrawal can be serious and life-threatening. These symptoms are much more rare but require medical attention right away. Some risk factors for severe side symptoms would be a history of seizures or a history of heart problems. A history of other mental health disorders may also increase the risk of severe physiological symptoms.^{2, 3}

Severe Pristiq withdrawal symptoms include:

• Suicidal thoughts
• Changes in blood pressure
• Seizures
• Blurred vision

Discontinuation of Pristiq After Long-Term Treatment

After long-term use of Pristiq, it is even more important to discontinue use slowly according to your doctor’s plan. Withdrawal symptoms can be much worse after long-term use, especially when taking Pristiq for more than 2 months. Another risk of discontinuing Pristiq is the reappearance of depression. Your doctor may recommend you switch antidepressants to prevent depression symptoms while tapering Pristiq.

Depending on your dose, you can taper anywhere from 1 to 3 weeks. Often your doctor will recommend decreasing the previous dose by half each week. Each person’s discontinuation plan will look different and it is important to work with your doctor as you stop taking Pristiq.^{2, 3}

Discontinuation of Pristiq While Pregnant

Utilizing antidepressants during pregnancy should always be done under the supervision of a doctor. You and your doctor will discuss the risks and benefits in detail. Stopping Pristiq during pregnancy comes with additional risks to you and the fetus. Symptoms can be worse and may cause harm to your baby if withdrawal symptoms are severe.

Pristiq Withdrawal Timeline

After discontinuing Pristiq, withdrawal symptoms can begin to appear within the first 24 hours. The half-life of the medication, or the time it takes for your body to eliminate half of the dose is about 11 hours. This means that after just one day of not taking Pristiq, the level of the drug in your body is already decreasing.¹ Once withdrawal symptoms start, they can last for as little as a few days or up to 2 weeks.²

Physical symptoms like nausea, trouble sleeping, headache, and diarrhea should resolve in a relatively short amount of time. Other symptoms like changes in mood, irritability, and relapse depression can last much longer. When symptoms last longer than two weeks, they can be considered post-acute withdrawal symptoms (PAWS).

How to Cope With Pristiq Withdrawal Symptoms

Having a thorough plan of how to cope with and manage symptoms is crucial to successfully stopping Pristiq. The goal is to have healthy coping mechanisms that will reduce symptoms and provide safe relief from negative side effects. You and your doctor should discuss plans thoroughly and address any fears you may have.

Share your plan and agreed-upon coping strategies with someone you trust. This will help you stick to them during times of stress and when symptoms are the worst.  Finally, make sure you have a plan to get help when withdrawal symptoms are too much or become dangerous.

7 strategies to help relieve symptoms of Pristiq withdrawal include:

1. Prioritizing sleep: There are many positive impacts of sleep on mental health. During a period of additional stress on your body, sleep is very important. Providing your body with the right amount of sleep can be very helpful during a period of withdrawal.
2. Exercising regularly: There are many mental health benefits of exercise, which can help reduce feelings of anxiety and stress during withdrawal. Sticking to a regular plan can provide stability and support during an uneasy time.
3. Speaking with a therapist: It is always helpful to have professional support during change. Speaking with a therapist during Pristiq withdrawal can be grounding and provide comfort.
4. Taking medications: Some symptoms of Pristiq withdrawal may be reduced with medications. Talk with your doctor about being prepared with medications for nausea, headache, trouble sleeping, and flu-like symptoms.
5. Avoiding substance use: While it can be tempting to utilize alcohol or other substances, these can make symptoms worse. It is important to avoid these for your own safety.
6. Following self-care routines: Following self-care routines closely during Pristiq withdrawal can help a person feel grounded and ease anxiety.
7. Online support groups: Sharing experiences with others helps to understand symptoms and provide support during the rough times of Pristiq withdrawal. Having the encouragement of others in online support groups can be empowering.