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Effexor vs. Pristiq

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Anxiety and depression are the two most commonly diagnosed and treated psychological conditions

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Anxiety and depression are the two most commonly diagnosed and treated psychological conditions. These two disorders often coexist with one another, and there are a number of medications that are useful in treating both anxiety and depression. 

Specifically, there are two classes of medications that are considered first-line treatment for anxiety and depression, called Selective Serotonin Reuptake Inhibitors (SSRIs) & Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs). Within each class of medications, there are several different drugs that all have their own unique properties and effects on the body. 

In this article, we will compare two of the most commonly prescribed SNRI medications, Effexor and Pristiq, so that you can be better informed before discussing treatment options with your healthcare provider. 

If you are struggling with anxiety or depression and find that your mental health is impacting your everyday life, don’t let your symptoms go untreated. At Klarity, we connect you with a licensed healthcare provider in your state from the comfort of your own home. 

Schedule an appointment today and be seen within 48 hours to get started with the convenient and affordable mental health care you deserve. 

What are SNRIs?

As the name implies, Serotonin and Norepinephrine Reuptake inhibitors (SNRIs) work by increasing levels of serotonin and norepinephrine within the brain by blocking their reuptake after neural transmission. SNRI medications help to increase the levels of key neurotransmitters in the brain, which play an important role in numerous bodily functions, such as mood, sleep, and appetite, to name a few. 

Serotonin and norepinephrine are two important neurotransmitters found within the brain and throughout the body. These chemical messengers help send signals of communication between different areas of the brain, and those who suffer from anxiety or depression tend to have lower levels of these neurotransmitters, leading to physical and psychological symptoms. 

SNRIs are commonly used in the treatment of anxiety and depression by helping to restore this neurotransmitter imbalance. There are a number of different SNRI medications, and each has its own different properties and effects on the body, making each drug unique. 

It is important to note that everyone reacts to each medication differently, so although one SNRI medication did not work for you, another drug within the SNRI class may work and be beneficial for managing your symptoms. 

SNRIs Can Treat Symptoms of Anxiety and Depression

Anxiety and depression can present themselves in many different forms, and these two conditions are commonly seen together. Your symptoms may range from mild in nature to severely debilitating and prevent you from living a healthy life. 

When talking with your healthcare provider, be sure to explain all the symptoms you are currently having to make sure that they arrive at an accurate diagnosis so your symptoms can be properly managed. 

Some common symptoms of anxiety include: 

  • Constant thoughts of worry or fear unproportional to the situation
  • Feelings of panic 
  • Catastrophizing 
  • Feelings of impending doom 
  • Irritability 
  • Difficulty concentrating 
  • Insomnia 
  • Physical symptoms, including increased muscle tension, racing heartbeat, sweating, hot flashes, abdominal pain, headache, or tremor

Some common symptoms of depression include: 

  • Constant low or depressed mood 
  • Fatigue or decreased energy 
  • Loss of interest in pleasurable activities or hobbies 
  • Excessive crying 
  • Changes in appetite, causing weight loss or gain 
  • Feelings of worthlessness, guilt, hopelessness, or helplessness
  • Difficulty concentrating
  • Sleep disturbances, including sleeping too much or too little 
  • Suicidal thoughts or thoughts of self-harm 

What Is Effexor?

Effexor is the name brand of the drug venlafaxine and belongs to a larger class of medications called Serotonin and Norepinephrine Reuptake Inhibitor’s (SNRIs). It is commonly prescribed for the treatment of anxiety and depression.

Common Doses and Forms of Effexor

Effexor or venlafaxine is available in both immediate-release and extended-release formulations in tablets and capsules. The dose is typically started at the lowest dose and then titrated up on a weekly basis until at the lowest effective dose for treating your symptoms. 

Effexor immediate-release tablets are available in the following dosage: 

  • 25 mg 
  • 37.5 mg 
  • 50 mg 
  • 75 mg 
  • 100 mg 

Effexor extended-release 24-hour capsules are available in the following dosage: 

  • 37.5 mg 
  • 75 mg 
  • 150 mg 

Effexor extended-release 24-hour tablets are available in the following dosage:

  • 37.g mg 
  • 75 mg 
  • 150 mg 
  • 112.5 mg
  • 225 mg 

Conditions Effexor Treats

Effexor is FDA-approved for the treatment of generalized anxiety disorder, major depressive disorder, panic disorder, and social anxiety disorder. 

Off-Label Uses For Effexor

The term “off-label” is used to describe any use for a medication that has not been approved by the FDA. This does not mean that the medication is not effective in the treatment for a given condition but that it has simply not gone through the FDA-approval process. 

For a medication to receive FDA approval for a specific condition, there is a lengthy process that must be followed. This process often requires a great deal of time, funding, and resources, which often presents as a barrier for drug companies to get FDA approval for each use. 

Some off-label uses for Effexor include: 

  • Narcolepsy 
  • Diabetic neuropathic pain 
  • Obsessive-compulsive disorder (OCD)
  • Premenstrual dysphoric disorder (PMDD) 
  • Migraine prevention 
  • Vasomotor symptoms associated with menopause, such as hot flashes 
  • Fibromyalgia 
  • Complex pain syndrome  

Effexor Costs

The cost of Effexor or generic venlafaxine varies greatly depending on your insurance coverage, dosage, and which pharmacy you use. The average cash price for a 30-day supply of Effexor is around $677, but this cost can be significantly reduced to around $4-25 with the use of generic formulas and coupon codes. 

Effexor is typically covered by most health insurance plans, and coupon codes can be found at the majority of large pharmacies. 

Effexor Side Effects

When starting a new medication, it is important to weigh the potential risks and benefits of the given drug. Some of these risks include the possibility of developing side effects after starting Effexor. 

Side effects typically appear within the first few weeks of initiating the medication but are also known to decrease or resolve completely after continuous use of the medication. 

If you are experiencing bothersome side effects that are persistent and interfere with your everyday life, talk to your healthcare provider about discontinuing the drug or finding an alternative. 

Common side effects of Effexor include: 

  • Headache 
  • Dizziness 
  • Drowsiness or increased tiredness 
  • Sleep disturbances, including insomnia or strange dreams 
  • Changes in appetite, resulting in weight loss or gain 
  • Dry mouth 
  • Tremors 
  • Racing heart rate 
  • GI upset, including abdominal pain, nausea, vomiting, diarrhea or constipation
  • Tremors 
  • Sexual dysfunction, including lack of desire or libido, and inability to achieve orgasm 

If you begin to experience the following serious side effects, contact your healthcare provider immediately: 

  • Changes in vision, including blurred vision
  • Abnormal bleeding 
  • Seizures 
  • Difficulty breathing or chest tightness
  • Hyponatremia or low blood sodium

Effexor Drug Interactions

There are a number of medications to avoid while taking Effexor due to potential interactions. It is important to disclose all medications you are currently taking with your healthcare provider, including all over-the-counter medications and supplements. 

Some common drugs that interact with Effexor include: 

  • NSAIDs
  • Blood thinner medications, such as Warfarin or even aspirin 
  • MAOI medications – should be discontinued two weeks prior to starting an SNRI
  • Opioid pain medications
  • Supplements such as St. John’s Wort 
  • Recreational drugs that increase serotonin, such as MDMA or ecstasy

What Is Pristiq?

Pristiq or desvenlafaxine is another SNRI medication that is commonly used in the treatment of anxiety and depression. 

Common Doses and Forms Of Pristiq 

Pristiq is available in extended-release 24-hour tablets only. Similar to Effexor, the medication is typically started at a low dose and then titrated up on a weekly basis until at the lowest effective dose. 

Pristiq is available in the following dosage forms:

  • 25 mg 
  • 50 mg 
  • 100 mg 

Conditions Pristiq Treats

The only FDA-approved indication for the use of Pristiq is for major depressive disorder (MDD). Although this is the only FDA-approved use, there are a few different “off-label” uses for Pristiq that are listed below. 

Off-Label Uses For Pristiq

As described above, the term “off-label” does not mean that the medication is not effective in the treatment for a given condition but that it has simply not gone through the FDA-approval process, which is typically lengthy and costly. 

Some common off-label uses for Pristiq include: 

  • Generalized anxiety disorder (GAD) 
  • Panic attacks 
  • Social anxiety disorder 
  • Obsessive-compulsive disorder (OCD) 
  • Vasomotor symptoms associated with menopause, such as hot flashes 

Pristiq Costs

As with Effexor, the cost of Pristiq or desvenlafaxine can vary depending on insurance coverage, dosing, and which pharmacy you use. Without insurance, a typical 30-day supply of Pristiq is around $516, which can be significantly reduced to between $13-110 with the use of coupon codes and generic formularies. 

Pristiq is typically covered by most health insurance plans, and coupon codes are readily available at the majority of large pharmacies. 

Pristiq Side Effects

As with any medication, there is the potential for developing side effects after starting a new medication. Similar to other SNRI medications, these side effects may begin to appear within the first few weeks of starting a new medication and tend to improve or resolve with continuous use. 

If you experience bothersome adverse effects that impact your everyday life or serious adverse effects, it is important that you contact your healthcare provider immediately or seek emergency medical care. 

Some of the common side effects associated with Pristiq include: 

  • Dry mouth 
  • Nausea and vomiting 
  • Diarrhea or constipation
  • Fatigue or increased tiredness
  • Dizziness 
  • Reduced appetite 
  • Sleep disturbances, including insomnia and increased need for sleep
  • Increased anxiety, irritability, or restlessness
  • Sexual dysfunction, including reduced libido or sex drive and inability to achieve orgasm 

Serious adverse effects that require immediate medical attention include: 

  • Worsening depression or anxiety 
  • Suicidal thoughts or thoughts of self-harm 
  • Severe insomnia 
  • Severe irritability or aggression 
  • Signs of serotonin syndrome, including racing heartbeat, sweating, flushing, tremor, muscle stiffness, hallucinations, seizures, or coma 
  • Chest pain 
  • Easy bruising or bleeding 
  • Changes in vision, including blurred vision, seeing halos around lights

Pristiq Drug Interactions

It is important to disclose all medications you are currently taking with your healthcare provider, including all over-the-counter medications and supplements. Below is a list of drugs that cause known interactions with Pristiq and should be avoided. 

Common drug interactions with Pristiq: 

  • MAOSs – should be discontinued two weeks prior to starting an SNRI medication 
  • Other SSRIs and SNRIs
  • TCA antidepressants 
  • Lithium 
  • Opioid pain medications
  • NSAIDs 
  • Blood thinner medications, including Warfarin and even aspirin  
  • Certain diuretics 
  • Stimulant medications, such as ADHD medication Adderall and diet supplements like Adipex

SNRI Warnings

Although SNRIs are considered to be relatively safe medications to take, there are a few warnings that should be considered before starting an SNRI medication for the treatment of anxiety and depression. Below we have listed a few of the major warnings associated with SNRIs, including Effexor and Pristiq. 

If you have any of the following preexisting conditions, SNRI medications may not be the best medication for you. 

  • Hypertension or high blood pressure 
  • Significant cardiovascular disease
  • Bipolar disorder 
  • Seizure disorder 
  • Certain lung diseases, such as interstitial lung disease 
  • Hyponatremia or low blood sodium levels, including SIADH
  • Glaucoma 
  • Chronic kidney disease 
  • Liver disease  

Black Box Warning 

As with most antidepressant medications, there is a risk of developing suicidal thoughts or thoughts of self-harm shortly after starting a new medication. Studies have found that this only occurred in a small number of patients and was more common in young adults under the age of 24. 

This is a rare side effect of starting an SNRI but should be discussed with your healthcare provider before starting a new medication. It is important to monitor yourself for signs of increased suicidal thoughts or thoughts of self-harm when starting an SNRI. 

If you’re experiencing suicidal thoughts or thoughts of self-harm, contact your healthcare provider immediately or seek out medical attention at the nearest emergency room. The Suicide and Crisis Lifeline can be reached at 988 and is available 24/7. 

Serotonin Syndrome 

Serotonin syndrome is a rare but serious condition that may occur while taking an SNRI medication and is the result of high levels of serotonin built up within the body. This is typically caused when someone is taking more than one medication that causes an increase in serotonin. 

Although this syndrome is fairly uncommon, it is important to seek out immediate medical attention because this condition can be fatal in rare circumstances. 

Some common symptoms to look out for include:

  • Fast or racing heart rate 
  • High blood pressure 
  • Severe nausea, vomiting, or diarrhea 
  • Fever 
  • Dilated pupils 
  • Severe dizziness and loss of coordination 
  • Twitching or muscle rigidity  
  • Agitation, restlessness, and inability to sleep
  • Confusion or loss of consciousness
  • Hallucinations 

Withdrawal or Discontinuation Syndrome

As always, you should always take your medication as prescribed. If you are experiencing bothersome side effects or are thinking of discontinuing your SNRI medication, it is important to discuss this with your healthcare provider, as you are likely to experience withdrawal or a discontinuation syndrome when abruptly discontinuing or significantly decreasing your dose. 

Your healthcare provider will help you titrate down your current dose of SNRI safely, so you are less likely to experience adverse effects of withdrawal coming off of your medication. 

Some common symptoms of withdrawal or discontinuation syndrome include: 

  • Increased symptoms of anxiety and depression 
  • Dizziness 
  • Paresthesias or sensations of numbness or tingling throughout your body 
  • Nausea or vomiting 
  • Increased irritability 
  • Headaches 
  • Sleep difficulties, including nightmares 

Caution With Use in Elderly Population 

SNRI medication should be used with caution in patients over the age of 65 due to the increased risk of adverse effects, including dangerous changes in blood pressure and low blood sodium levels or hyponatremia. 

Some signs and symptoms of hyponatremia include headaches, confusion or delirium and may even result in loss of consciousness. Elderly patients are typically started at a lower dose of the medication and closely monitored when starting an SNRI medication. 

Get Anxiety and Depression Treatment With Klarity

Living with symptoms of anxiety or depression is challenging enough. Finding the best medication for you shouldn’t be. With so many different drugs on the market, the process of finding the right treatment plan can be overwhelming, to say the least. 

Let Klarity help. At Klarity, we connect you to a licensed healthcare provider in your state who will help you navigate this process and will come up with your individualized treatment plan. 

We offer quality, affordable care for your mental health without the hassles associated with the traditional psych clinic visit. No insurance or subscriptions necessary. Anxiety and depression treatment are low as $25/month. 

Schedule an appointment today and be seen within 48 hours of making your appointment. 

Frequently Asked Questions About Effexor and Pristiq

When comparing two drugs that are from the same class of medications, we understand things can get confusing, especially when the medications have a similar name, such as venlafaxine (Effexor) and desvenlafaxine (Pristiq). 

Below, we have listed the most commonly asked questions when comparing Effexor vs. Pristiq: 

Does Effexor Make You Gain Weight? Does Pristiq?

While there is a potential for weight gain due to appetite changes when starting any SNRI medication, the risk is quite low. In fact, it is more common to experience decreased appetite and weight loss when taking either Effexor or Pristiq. 

Is Effexor or Pristiq Better for Anxiety?

While both medications can help with anxiety symptoms, Effexor is FDA-approved for the treatment of anxiety and has been clinically proven to be effective. 

Can I Replace Effexor with Pristiq?

Yes, you can easily transition from one medication to another, but this should be done under the close supervision of your prescribing healthcare provider. They will help to taper you off one medication and transition to another, as your dose may change. 

Is Effexor Energizing or Sedating? What About Pristiq?

Both Effexor and Pristiq is known to be energizing medications. This is due to the effects of increasing norepinephrine within the body. 

Does Effexor Cause Brain Fog? Does Pristiq?

Neither Effexor nor Pristiq are known to cause brain fog. However, It is important to remember that everyone reacts differently to each medication. SSRI medications are typically known to be associated with brain fog. 

Can I Drink Alcohol On Effexor? On Pristiq?

Alcohol should be avoided while taking any SNRI medication, including Effexor or Pristiq. Drinking alcohol while taking either medication can cause an increased risk of experiencing adverse effects of the medication, such as nausea, increased anxiety, dizziness, and an increased risk of bleeding. 

Can I Drink Caffeine When I’m on Effexor? How About Pristiq?

It is considered to be generally safe to drink caffeinated beverages while taking SNRI medications. However, it is important to remember that caffeine is a drug in itself and can cause its own side effects if taken in high quantities. 

What Is Better For Depression—Effexor or Pristiq?

Effexor and Pristiq have been shown to be highly effective in the treatment of depression. They remain to be equal with regard to effectiveness, but some studies have shown that Pristiq is better tolerated, with fewer side effects than Effexor.  

Start today, and discuss your symptoms with a specialist who can help.

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