Key takeaways

  • Desvenlafaxine succinate is a generic antidepressant that’s also available as the brand-name drug Pristiq. It only comes as an extended-release (ER) tablet that you swallow.
  • Desvenlafaxine is used to treat major depressive disorder (also known as depression) in adults.
  • Desvenlafaxine’s side effects include insomnia, excessive sleepiness, anxiety, decreased sex drive, and more. Many side effects are expected to go away on their own over time, but some can be long term.

Desvenlafaxine is used to treat depression in adults. With depression, you may experience persistent sadness and a loss of interest in activities. It can affect your mood, behavior, sleep, and other physical functions.

Desvenlafaxine is only approved for use in adults. It’s not approved to treat depression in children (ages 17 and younger).

How it works

Desvenlafaxine belongs to a group of drugs called antidepressants. The specific type of drug is called a serotonin-norepinephrine reuptake inhibitor (SNRI).

Serotonin and norepinephrine are natural chemicals in the brain that help maintain mental balance. Desvenlafaxine may work by stopping the process that breaks down these chemicals. This process is called reuptake. Blocking reuptake increases the amount of these chemicals in your brain and may help to improve symptoms of depression.

Like most drugs, desvenlafaxine may cause mild to serious side effects. The following lists contain some of desvenlafaxine’s side effects, but they don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of desvenlafaxine. They can also suggest ways to help reduce side effects.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking desvenlafaxine and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Here’s a list of some of the mild side effects that desvenlafaxine can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read desvenlafaxine’s prescribing information.

Mild side effects of desvenlafaxine can include:

  • excessive sleepiness
  • insomnia
  • dizziness
  • blurry vision
  • digestive side effects, such as nausea, vomiting, or constipation
  • dry mouth
  • decreased appetite
  • sexual health effects, such as decreased sex drive or erectile dysfunction

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Allergic reaction

For some people, desvenlafaxine can cause an allergic reaction. But this side effect wasn’t common in the drug’s clinical studies.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking desvenlafaxine.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to desvenlafaxine, they may have you switch to a different treatment.

The desvenlafaxine dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re taking desvenlafaxine to treat
  • other medications you may take
  • other medical conditions you may have

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Form and strengths

Desvenlafaxine is available as an oral tablet in three strengths: 25 mg, 50 mg, and 100 mg.

Recommended dosages

The typical recommended dosage of desvenlafaxine for depression is 50 mg per day.

If you have certain health conditions, like a kidney or liver problem, your doctor may increase or decrease your dose.

About taking desvenlafaxine

The following are some common questions about taking desvenlafaxine.

  • Can desvenlafaxine be chewed, crushed, or split? No, you should not chew, crush, or split desvenlafaxine tablets. You should swallow them whole. If you have trouble doing so, you can get tips on how to swallow pills, or ask your doctor or pharmacist for advice.
  • Should I take desvenlafaxine with food? Desvenlafaxine can be taken with or without food.
  • Is there a best time of day to take desvenlafaxine? Desvenlafaxine can be taken at any time of day, but it’s best to take it around the same time each day. This helps keep a steady level of the drug in your body, which helps desvenlafaxine work effectively.
  • What if I miss a dose of desvenlafaxine? If you miss a dose of desvenlafaxine, take it as soon as you remember. But if it’s almost time to take your next dose, skip the missed dose and take the next dose at its usual time. You should not take two doses at once to make up for a missed dose. Doing so could increase your risk of side effects.
  • Will I need to use desvenlafaxine long term? Yes, desvenlafaxine is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
  • How long does desvenlafaxine take to work? After starting treatment, it takes about 4 to 5 days for desvenlafaxine to reach steady levels in your system. However, it may take longer for you to feel like the drug is working.

Overdose

Do not take more venlafaxine than your doctor prescribes, as this can lead to harmful effects, such as serotonin syndrome. This is a severe and possibly life threatening side effect that’s characterized by excessive serotonin levels in the body.

Symptoms of serotonin syndrome include:

  • agitation
  • hallucinations (seeing or hearing things that aren’t real)
  • seizures
  • nausea

What to do in case of overdose

Call your doctor if you think you’ve taken too much desvenlafaxine. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Desvenlafaxine can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Before taking desvenlafaxine, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, or supplements you use. Sharing this information can help you avoid potential interactions.

For more information, see this Pristiq interactions article.

Interactions with medications and supplements

The following list contains some drugs and supplements that may interact with desvenlafaxine. Taking any of these with desvenlafaxine may increase your risk of certain side effects, such as serotonin syndrome or excessive bleeding.

Desvenlafaxine may interact with:

  • other antidepressants, including fluoxetine (Prozac), duloxetine (Cymbalta),
  • diuretics (water pills), such as hydrochlorothiazide or furosemide
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin
  • anticoagulants such as warfarin (Jantoven), apixaban (Eliquis), or rivaroxaban (Xarelto)
  • St. John’s wort

The list above does not include every medication or supplement that desvenlafaxine may interact with.

Before you start treatment with desvenlafaxine, be sure to tell your prescriber about every medication or supplement you take. They’ll let you know whether desvenlafaxine has interactions with your existing medications.

Desvenlafaxine and alcohol

Doctors typically recommend that you avoid drinking alcohol during treatment with desvenlafaxine. This is because alcohol and desvenlafaxine both affect the central nervous system (CNS). And both can cause similar effects in the body, including:

  • excessive sleepiness
  • sexual health effects, such as decreased sex drive or erectile dysfunction
  • risk of suicidal thoughts and behaviors

Drinking alcohol while taking desvenlafaxine may increase the risk or severity of these side effects.

If you drink alcohol, be sure to let your doctor know before starting treatment with desvenlafaxine. They’ll let you know how much alcohol, if any, is safe to drink with this drug.

Whether you have health insurance or not, cost may be a factor when you’re considering desvenlafaxine. What you’ll pay for desvenlafaxine may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Comparing pharmacies: The price of desvenlafaxine may vary depending on which pharmacy you use, so it can help to compare prices across pharmacies to find the lowest cost.
  • Drug coupons: You may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits, but the discounted price may be lower than what you would pay through insurance.
  • Financial assistance: Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:

The following is important information to consider and discuss with your doctor or pharmacist before taking desvenlafaxine.

If you can become pregnant or are breastfeeding it’s important to consider whether desvenlafaxine is a safe choice for you.

You can refer to this Pristiq reproductive health article for more information. (Pristiq is the brand-name version of desvenlafaxine.)

If you have additional questions, talk with your doctor.

This section describes the warnings and precautions for desvenlafaxine.

FDA warning: Risk of suicidal thoughts and behaviors

Desvenlafaxine has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Like other antidepressants, desvenlafaxine can increase the risk of suicidal thoughts and behaviors in adults and children ages 24 years and younger. (Note: Desvenlafaxine is not approved to treat depression in children. It’s only approved for use in adults ages 18 years and older.)

This side effect may be more common at the beginning of treatment and after dosage adjustments. In addition, you may have a higher risk of this side effect if you suddenly stop taking desvenlafaxine.

Suddenly stopping an antidepressant can lead to a side effect known as discontinuation syndrome. With discontinuation syndrome, you may experience symptoms such as:

  • suicidal thoughts and behaviors
  • mood changes, including aggression
  • anxiety or irritability
  • seizure or tremor

During treatment with desvenlafaxine, it’s important to tell your doctor if you notice any symptoms of worsening depression. It’s also important to talk with your doctor before making any dosage adjustments, including stopping treatment.

If you and your doctor agree that you should stop taking desvenlafaxine, they’ll likely taper your dosage slowly over time. This will help reduce the risk of discontinuation syndrome.

Other precautions

Before taking desvenlafaxine, discuss your health history with your doctor. Desvenlafaxine may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

Note: For more information about the potential negative effects of desvenlafaxine, see the “Desvenlafaxine side effects” section.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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