Q. Can you offer me any ideas of how I can ease my withdrawal from Pristiq? My brain is cloudy, I am having brain zaps and I am agitated.

I should have never tried it out. Please help!

A. You must let your physician know what is going on. DO NOT stop this antidepressant suddenly. The withdrawal symptoms can be devastating.

Here are some stories to consider:

“I was prescribed Pristiq (desvenlafaxine) four years ago [this drug is somewhat similar to Effexor (venlafaxine) and Cymbalta (duloxetine) in that it works the same way] when Lexapro lost its effectiveness. Pristiq seemed to have no obvious side effects unless I forgot to take it in the morning. By afternoon, I would be experiencing brain zaps and hearing my eyes move. I would see “trails” when moving my eyes. This would go away within hours of taking the missed dose. I then tried to stop the drug myself, because I didn’t want to be on something that has that effect.

“I tried weaning off myself by taking a full dose (100 mg) then 75 mg the next day and alternating for 2 weeks then go down to 75/75. I went crazy after two weeks and had to go back to the original dose. Not only did I have severe suicidal thoughts every 5 minutes, but uncontrolled crying, extreme sluggishness, night sweats (when I could sleep), weight gain, irritability and mood swings. Physically, my blood pressure (which has ALWAYS been 110/78) jumped to 149/101.

“After two weeks of getting back on the drug, all symptoms (including high blood pressure) normalized. I am now under a doctor’s care to switch back to Lexapro (which she says will work again since I have given the drug a rest). She is having me take a full dose of Pristiq one day and then full dose of Lexapro the next day for a week. Then in 2nd week, Pristiq 1 day, then 2 days of Lexapro. She supplemented with Abilify daily. So far, the withdrawal symptoms have been manageable and I am in my 2nd week. I have added weekly acupuncture for the mood swings and am hopeful that I will have my life back.”
A. H.

“I was put on Pristiq almost a year ago. I got tired of taking this drug and I slowly started weaning myself off of the pills for about a month. As I’m typing this message my brain is shivering and zapping like nobody’s business. When I tried to explain it to my doctor he acted like he didn’t know what I was talking about. In the meantime, I suffer like crazy.”


“I am coming off Pristiq right now. Was on 100 mg a day and my doctor pulled me off it cold turkey. I’ve only taken it for about 2 months, but I feel like I’m going crazy. I have the brain zaps so bad I can barely walk around my house. I’m terrified to drive. This is worse than anything I’ve ever been through, and that includes quitting smoking.”


“I have been on a variety of antidepressants over the past few years for depression and anxiety. My latest prescription is Pristiq 50 mg once a day. I have been on it for 6 months. At first, I did see a difference in my depression and anxiety, but things began to change in the 7th month. I started having side effects from Pristiq. I haven’t had a brain freeze yet, but I have had other symptoms.

“I have had insomnia, headaches, GI upset, elevated cholesterol, blood pressure changes, joint/muscle pain, abnormal swelling all over, fatigue, agitation and ears ringing. From what I have read this is a hard medication to get off. I didn’t realize that this medication was making me sick until I went online and started to look up my symptoms. I really don’t know if I want to continue to take antidepressants if they are going to make me more physically sick.”


No one should ever discontinue antidepressant medication without medical supervision. As described above in vivid detail, the withdrawal symptoms can be terrible. We are especially concerned now that we see Cymbalta (duloxetine) advertised for arthritis symptoms. We wonder whether physicians are warning patients that getting off such drugs can be challenging (to say the least).

Here are some side effects to be aware of with Pristiq and Cymbalta:


• Nausea, stomach pain, constipation, diarrhea, decreased appetite, vomiting
• Dizziness, fatigue, sleepiness
• Dry mouth
• Insomnia, anxiety, jitteriness, irritability, tremor
, weird dreams
• Sweating, hot flashes
• Blurred vision
, glaucoma
• Headache
, ringing in ears
• Sexual dysfunction, lowered libido, erection difficulties, lack of orgasm
, abnormal ejaculation
• Liver damage
• Serious skin reactions, rash, hives (requires immediate MD assistance!)
• Glaucoma
• Irregular heart rhythms
• Bleeding problems
• Blood pressure problems
• Interaction with other drugs (leading to serotonin syndrome among other reactions)
• Pneumonia
• Seizures
• Depressed mood, suicidal thoughts and behavior, suicide

Some people never experience such side effects and achieve substantial benefit from medications like desvenlafaxine, duloxetine and venlafaxine. But others find the problems with such drugs overwhelming. The sexual side effects alone can be disconcerting. They are also quite common. You can imagine that dizziness, dry mouth, lack of orgasm and excessive sweating might be enough to drive a person to want to stop such medication. But as you will see below, that can trigger a whole other set of problems.

Doctors have taken to calling this “discontinuation syndrome.” These clinical words do not do justice to what it is like to stop antidepressants like Cymbalta, Effexor (venlafaxine), Paxil (paroxetine), Pristiq (desvenlafaxine) or Zoloft (sertraline) suddenly.


• Brain “zaps” (electric shock-like senstations in the brain)
• Dizziness, light-headedness, vertigo, feeling faint
• Headaches
• Anxiety, irritability, hostility
• Nausea, diarrhea, digestive upset
• Tremor, hands shaking, nerve tingles, strange sensations
• Fatigue, tiredness, lack of energy
• Visual disturbances

So, what is a person to do once started on the antidepressant merry-go-round? Sadly, doctors do not have clear guidelines about how to help patients stop such drugs. There is no clear-cut formula that will work for everyone. Patience is essential, though. This is NOT a do-it-yourself project. You will need help from a knowledgeable health professional. And you will need to take time. For some, a few weeks may be adequate to gradually phase off the drug. For others, it may take many months of very slow dosage reduction.

We offer our Guide to Dealing with Depression. It provides some additional insights into both side effects and withdrawal. It also discusses some other ways of coping with depression. Whatever you do, you will need great support from a health professional who understands the complexity of such medications.

You are also invited to share your experience with these drugs below.

Join Over 52,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. Claire

    I’m going crazy….
    I have been weaning off 100mg of Pristiq for the past few months and have now had nothing for 4 days. I am actually losing my mind. I am rage-filled. And driving to work this morning I wanted to drive my car into a tree. My heart beats in my ears in weird bursts. I’m terrified that maybe I am crazy and that’s why I should stay on it… Or is it really the withdrawal symptoms? I am having very reckless thoughts that would destroy my marriage…. I want to buy a ticket to the other side of the world and never come back. Will this go away? If so how long?

    My Dr says I have to ride it out. But what if I actually lose my mind…?

  2. Esther
    Victoria texas

    I had been on Pristiq for over 5 years. I was taking it for hot flashes. It worked for me right away. Once I went out of town for a week and two days went by and I had this horrible headache that I couldn’t even think. The pain was so bad, my vision was blurry, I got very irritable. Looking through my meds, I noticed I had left this one at home. I managed to drive home, which was a 2 hr drive. I took it and I was better. Another time the pharmacy got my prescription mixed up and I went 3 days without it. I was bedridden because the headache, nausea, diarrhea and stomach pains were excruciating. I finally got my prescription and within hours I was okay. I decided that I wanted to get off of it and I DID! I was on 100 mgs and week one I took 1/2 a pill then the 2nd week I cut the pills in 1/4 ……..for the next week I had headaches but nothing an over the counter advil can’t take care. I’m doing so good without it. Good luck to anyone else trying to get off of it.

    • alice
      ridge ny

      I am so afraid to stop. Prestiq worked for me but I am ready to stop. I’ve tried before and felt nervous, dizzy, and had really bad headaches. I went back on. I have to try- it’s been 4 years. I will speak to my doctor, thanks.

What Do You Think?

Share your thoughts with others, but be mindful of protecting your own and others' privacy. Not all comments will be posted. Advice from web visitors is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. In posting a comment, you agree to our commenting policy and website terms and conditions.