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.”–Oscar

“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.”–Laurel

“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.”–Julie


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.

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  1. Sara

    Has anyone else had the lovely side effect of being itchy from the top of your head to the soles of your feet and everywhere in between? I stopped Pristiq fully about five days ago after weaning off for a week and now I am chilled all the time, have a very hard time sleeping, but it’s this itching that is blowing my mind. I haven’t found mention of it in any other site but it’s awful. Nothing helps and I am scratching my body raw. Am I alone in experiencing this? I have not had a single brain zap but my vision is weird now – like my eyes want to keep crossing on me – and I have lost my appetite completely. If you are also experiencing the severe itching response to stopping the drug, please let me know I am not alone and losing my mind over this.

  2. Deborah
    Spring Hill, TN

    I went to my doctor to explain the side effects I am having while taking the medication prescribed to me for depression. I was made to look as if I was ignorant and had no idea as to what I was talking about. My doctor prescribed a strong dose stating this should help. He was wrong. I was ignorant but it because of the side effects I was feeling and having a hard time explaining but for listening to my physician. When I finally stated I want off all the medications prescribed my doctor stated which one do I want to quit and when did I want to come back? I was shocked at the way my doctor was acting but I told him I guess I would start with pristiq 50mg because it was the most recent prescribed. I asked how do I stop? It was explained to me that I am on the lowest dosage and stopping should not be a problem. I’ve been off the medication for four days now and feel as if I am going to go crazy. Someone on this site stated brain zaps which helped me explain and articulate what I am feeling now. I feel anxious , suck to my stomach, dizzy, I can’t focus my eyes very well, I keep crying , I can’t sleep, and many more side effects a list too long to write. How are physicians allowed to prescribe medications and not know what the side effects might be? How are they allowed to prescribe a drug with such strong side effects? I am a 52 year old woman who doesn’t drink and thought I didn’t so drugs … Until now, I am in miserere . I don’t know what to do. I am on Monday morning going to call the FDA and report the Adverse reactions I am having with this medication. I hope all the other people on this site go the same. I am so scared because after I get done withdrawing from this medication I have to start the process of getting off the Buproprion I am taking! This is not fair that another human being ( physician) can do this to another human being!

  3. Ryan

    I have been taking the meds for a little over a year and a half. I was suffering horribly from anxiety and depression. The meds worked wonderfully for me, but it’s time to move on as I don’t think it’s wise for ANYBODY to depend on meds for their entire life.

    I have run out of pills and it’s only been two days and it’s been hell, thus far. I am going to my doctor in 3 days and I am going to ask for his help weaning off. I would highly recommend against anyone stopping cold turkey as I have tried. The headaches, dizziness, nausea, brain zaps, blurred vision, have been unbearable. Hopefully weaning off them will be easier. Good luck to all trying to get off this stuff, it’s not easy.

    • Deborah

      Ryan , I am going through the exact same thing as you are going through. I will keep you in my thoughts. But would like to also recommend your medication side effects be reported to the FDA

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