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. loong
    sydney, NEW SOUTH WALES

    My wife passed away and I was in grief. My GP and a psychologist were treating me and the psychologist felt that I should have medication and was referred to a psychiatrist. I was prescribed 50 mg Pristiq in July 2017. I told the Psychiatrist I was unable to sleep and felt a loss of energy and in August, it went to 100mg Pristiq and 15mg Avanza. I became more and more tired and felt a total lack of energy and was having strange dreams and by the end of October, was taking 200mg Pristiq and 45mg Avanza despite me telling the psy that I was disorientated, having weird dreams and feeling totally drained and fatigued.

    At no time were I told of any side effects as I had told the psy that Zoloft and I do not get along when he first suggested that as a course of treatment. I was now having strange dreams, shivering at night and cold sweat was becoming a normal occurrence. I saw the psy every month and in late January, it became extremely bad and in my February 2018 meeting with him, after another horrendous night, I told him it was the Pristiq making me worse. He was resistant to the idea and said that the drugs would need some time to be efficacious. After a few more days of ‘hell’, I saw him again and he recommended a steeping down to 150mg and then as it goes. I did not tell him that I wanted it to stop and about ten days ago, I stopped Pristiq altogether , scaled Avanza back to 15mg. I was still having cold sweat, developed flu like symptoms but continued with my cold turkey approach. I feel less tired, and although the flu-like symptoms still persist, I feel more energized.
    I really think over prescription is a problem. In July 2017, I was able to walk my dogs but after August, was so tired that dog walking became impossible. Pristiq side effects must be made known to the patient, including its withdrawal effects. I would like to see a larger group of us supporting each other. I don’t know how my grief became transformed into a depression management problem and with horrible side effects. For those of you still struggling out there, be strong , stay strong and the psy is not always rights. Cheers and regards

  2. Amanda
    Sacramento CA

    Does anyone have experience with altering their desvenlafaxine tablets? Does anyone know what to expect about how long the brain zaps, sensory, crying and anxiety withdrawal symptoms will last when weaning off?

    My last dose was 50 mg once a day, and am now having withdrawal symptoms. I read online that if I cut the 50 mg pill in half or have a compounding pharmacy pulverize the tablets and make smaller doses for me, the pill’s structure and integrity are changed, and will likely cause discontinuation syndrome symptoms. Well I’m already having those symptoms in droves after three days after my last dose. I couldn’t go to work today, and am worried about how long I’ll be so incapacitated.

    With doc’s supervision, I reduced my dose by 50 mg every two weeks with absolutely no side effects until three days after the last 50 mg dose.

  3. Sheri

    I’m weaning off pristiq under my dr care. I was on 100 mg and she introduced Prozac 10 mg. It is not a pleasant experience it’s been weeks. I had a week of nauseau, vomiting, dizziness, and the headache persisted. She added 10 more mg of Prozac to stop headaches and that helped. I have stiff neck, crying everyday, feel out of it. So agitated I needed to up my klonopin. I have anxiety and OCD health anxiety. You can only imagine what I’m thinking as all these things happen. I’m now on 50 mg of pristiq and 20 Prozac. Changing psychiatrists. This is horrible. I feel out of it. No motivation. I will say exercise has been key in helping. This is a nightmare! I am hoping my new psychiatrist who is renown will get me off once and for all and back to Prozac. Good luck to all. It’s quite the journey we all have to take and no one quite understands.

  4. Glenda

    I’ve been taking 200mg a day for what seems like years. I’m emotionally numb, except for sadness, feeling useless, and hating myself. I know not to stop cold turkey on the meds and have heard it’s horrid, and with my high dose am nervous. I have been on antidepressants for nearly 40 years. I have no quality of life and am struggling just to leave the house. Also weight gain has been a real downer, the biggest ever in my life (59 years). Any help or experiences would be greatly appreciated. Your posts are interesting and the best I’ve seen, best of luck to you all.

  5. LD

    I am going through withdrawals of Pristiq, as I write this. I have been on depression medication since my daughter was 9 mos. old. She is now 19. I started with Prozac and progressed through 5 or 6 different medications through the years. I am presently taking 100mg of Pristiq, which I stopped abruptly 4 days ago. I was at work and felt ill in the morning, 6 days ago. I went to emerg, and found out that I had pneumonia, yet again. I had a hospital stay this past August, for 3 days, for severe pneumonia. I am now feeling the brain zaps, I’ve had an INSANE migraine, the muscles in the back of my neck are extremely tight, I’ve had insomnia like crazy, the uncontrollable crying, etc.

    I have been reading a lot of comments left by others, and actually looked up more information on this drug. I suddenly realized that this drug may well have been the cause of my pneumonia, which I had a first bout of, about 13 years ago. I feel so stupid now, not taking the time to actually find out the “ins and outs” of antidepressants. I just told the doctors what I was feeling, they prescribed a drug and dosage, I took it in hopes that it would help, and that was the end of it.

    If you take nothing else away from all of these personal comments, please take this one SIMPLE suggestion. When you are prescribed an antidepressant, PLEASE do your research, and read the paperwork that comes with your prescription from the pharmacy! Also, pay close attention as to how the drug is affecting your body, because it could be a detriment to your health, if you don’t. I will continue to put up with the brain zaps, and the rest of the withdrawal symptoms that I am going through right now, because I want my life back. For so many years, I have missed so much of my life because of “walking around like a zombie”, “not feeling emotional when I know I should”.

    I am not saying that this is a good or bad drug, I just know how it is affecting my own life, and I am, quite frankly, tired of it. I will inform my doctor, of course, but this is a personal quest that I am on, and I hope to have success so that I don’t have to rely on antidepressants any longer. This may not have been a good idea for me to do, but having pneumonia, I just felt that I have enough medications in my body, and with the sickness, have not been “in my right mind.”

    Thank you to all of you who have shared your thoughts, etc. It helped me to know that I am not alone in what I am feeling, and it was also informative, as before today, I didn’t know about the “brain zaps”. Take care, and be well.

  6. Rachel

    I’ve been on pristiq, twice. Once for anxiety; once as an add-on to control seizures (I have a brain cavernoma in the area that affects anxiety). I will never use this medication again.

    My first time getting off of pristiq was after about 3 years of use at 50 mg. I chose to cut the meds, and experienced severe (undiagnosed) focal partial seizures/brain zaps for about 3 weeks. My experience may be unique in that I do have a seizure disorder. Pristiq causes seizures, and did with me, during the withdrawal phase. (I also had seizures once in awhile while on the meds, but the seizures were not yet diagnosed).

    My second time getting off of pristiq (25 mg) was after being on it for 3 months. Recent treatment for seizures may include adding an anti-depressant/mood stabilizer to minimize the seizures. I am also unique in that my seizures may be caused by my brain cavernoma (known to bleed and cause seizures; it has done both in my case). With one seizure medication (zonisamide), pristiq didn’t mix well…with another seizure medication (oxcarbazepine), it did fine. However, now that I am tapering off of the pristiq (I switched to venlafaxine 37.5 mg) I am experiencing withdrawal and a return of the seizure symptoms (so I am again not sure if my seizure meds are working or if it is the withdrawal from pristiq/venlafaxine). I chose to stop the pristiq because it wasn’t helpful, and I was concerned about getting off it (I hadn’t realized all forms of pristiq are xr, which means you can’t get off of it safely/without experiencing some kind of withdrawal symptoms). I hate it, I hate it, I HATE IT!!!

    Regardless of the cause or correlation, I will never use pristiq/venlafaxine again. The withdrawal exacerbates my seizure symptoms and it is horrible. During withdrawal, I have experienced vertigo(not the same as dizziness), nausea, brain zaps (seizures in my case)…even though I have tapered slowly. I wish I had never agreed to use pristiq again. Erroneously, I thought pristiq was not extended release, but all forms of it are. You cannot get off of it without withdrawal or needing to switch to another medication that you can safely cut…but you’re likely going to experience withdrawal. It completely sucks!

    FYI – prior to tapering off of my 2nd use of pristiq, I contacted the manufacturer to get tapering instructions. They had NONE. It was not helpful and now they try to contact me to “get more information about my adverse side effects,” since i mentioned that I had cut the pills in the past and experienced increased seizure activity. I already reported it, but don’t want to offer any more information. It feels like an invasion of my privacy, rather than a legitimate gathering of information for helpful use.

  7. Raziel

    Currently coming off 50 MGs been on for two years. I’d like to add my perspective, currently experiencing some discomfort.

    I say to the Brain: My Brain, My Brain, My Beautiful Brain, my source of comfort and familiarity you run my body so precisely at every moment I’m forever grateful.

    However in days passed we wondered off the path of positive thought and we imagined dogmatic realities and envisioned danger around every corner, the curse of the imagination took hold and depressed our natural zest and curiosity for life, and we needed some physical assistance to create the serotonin you so cherish.

    Today we know better, we no longer fall in to the trap of the evil inclination the imagination who makes us assume the worst at every turn, we can tell what’s real and here and now, from what’s not real and only exists in our mind, and we are therefore ready to take back control of our serotonin production.

    There is a however a necessary period of adjustment, and you, my strong capable Brain, will be at the forefront of it. We can do this together my beloved Brain, let’s not resist the change taking place within us, let’s welcome it, this is the door to our healthy future if we keep faith in one another we can beet this for sure. I will make everything in my life secondary to you my Brain in these few days where you need all my attention. I will rest if you want me to rest, work if you want me to work, be social or alone as you please, we will accept this transition together because we know it’s best for us in the long run and we will enjoy the rest of eternity in freedom together.

    • Cathy

      Such a wonderful help, thank you for sharing this. Day 2 stopping cold turkey 100mg, after 1yr. Im finding the withdrawal symptoms interesting rather than horrible. Actually very similar to the initial side effects when I began taking pristiq. I can hear my neck when it turns (bizzare), feel disassociated from the world, kind of vertigo, calm, very vivid interesting dreams, a little tense.

      I came off these tablets only as I was experiencing jaw tightness and teeth clenching ever since starting them (that was horrible), otherwise they have really helped me to become ‘chill’, they stopped my overthinking, anxiety and feeling ‘crazy’. They gave me the opportunity to get my diet healthy, life balanced, I now meditate to relax and hope these changes are enough to continue my progress.

      I know the advice is not to stop suddenly however I want to get the withdrawals over and done with. I do not suffer depression so am not concerned about suicidal thoughts appearing etc, I am reading articles so I am informed about what to expect and of course am monitoring myself very carefully with a pristiq handy in my pocket just in case things become ‘crazy’. If this happens I will be off to the dr to get a 50ml prescription to wean off more gradually. For now though feeling positive and looking after myself.

      • Cathy

        Day 6, I am pretty much through the withdrawal symptoms I think. Cold turkey from 100mg for a year. Raziel’s comments were so helpful and I used his approach. The withdrawals did increase the worst being constant nausea, vertigo / dizziness and internal noises such as hearing my head turn. I took care of myself, flooded my body with good things, veges, fruit, rest when required. I found taking fexotab antihistamine and panadol really helped with the nausea and flu like symptoms and I took vitamins, magnesium and berocca. I had a coffee in the mornings and one beer each day in the weekend which seemed to help relax me. Went to sleep listening to guided meditations and I woke with 3am insomnia so listened again and went back to sleep.

        I assured my body and brain it knew how to get through this and that I would listen. That my body was clear of the meds. It was so good to read forums such as this and to know what to expect and when things came up such as backache – I knew it was just a symptom. I’ve been working and having no major issues after the medication got our of my system. My whites of my eyes are becoming white again, I have had fits of giggles and felt emotional, teary but happy teary. Nice to be feeling again. The one thing I was scared of was irrational anger outbursts people had mentioned but, fingers crossed, it hasn’t happened.

        I feel empowered and positive, no mood swings just feel good. I usually eat low carb but had a birthday and treated myself to chocolates, licorice, chinese and sent nurturing thoughts to myself. Not the time to worry about weight. Its nurture time – although i have learnt putting good things into my body supports my overall positive health and even moods. Anyway I think I’m through this – don’t see me ever going on meds again. I love being free! I will definitely look at natural alternatives in the future if my anxiety, depression symptoms return. Stay strong everyone! You can do it! Sending hugs. Will update if it changes.

        • CP


          Thanks for your post, its encouraging. We are now into December, I am wondering how you are feeling. I have done extensive research on Pristiq. I have been on the drug for over 3 years, originally for seasonal affective disorder and generalized anxiety. It did wonders for both, however, about a month ago, I started to feel overwhelmingly energized, which appears to have been a form of “adrenal fatigue” and so I have made the decision to quit.

          The only empirical evidence I could find showed a minimized of side effects with one week of 25 mg then nothing. However, when I tried this approach…..I did 7 days of 25 mg….it did not work. Today I took nothing (0 mg).

          Today, I feel light-headed, dizzy, and a little spacey (almost out-of-body). It is sure hard to function. Whats amazing is how challenging this is. I am hopeful it will get better in a week or so as this is the second try at weaning off, the first I couldn’t take the discontinuation syndrome any more.

          I will keep everyone posted.

        • Jessie

          Thank you Kathy. I have been on 100 mg for 6 mo. and I am quitting cold turkey as well. Day 5 and I feel like I can manage this. We’ll see. Thank you fro sharing, it is giving me hope I can do this on my own.

      • Michele

        How did you go with withdrawal?

        I’ve been taking pristique for years for anxiety which I controlled since 8 years old with occasional use of valium. Drs don’t like to prescribe valium so I started pristique. But I feel it is slowly making me depressive and want to come off it. I tried a few years ago to wean off but the show effects are awful.


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