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


PEOPLE’S PHARMACY RESPONSE:

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:

CYMBALTA (DULOXETINE) & PRISTIQ (DESVENLAFAXINE) SIDE EFFECTS:

  • 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.

SUDDEN WITHDRAWAL SYMPTOMS:

  • 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 130,000 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. shar
    victoria australia
    Reply

    I told my doctor that I wanted to come off Pristiq. He told me that taking 10 mls of Paxal would help.

    I stopped Pristiq last thursday and started on paxal on Saturday….. I highly recommend that if you want to start pristiq DO NOT ….I started getting panic attacks after the sudden death of my husband ….then 3 mths later the tragic death of my baby grandson…..i am also a carer for a chronically ill daughter so have a lot of stress I found that weight was just creeping on me regardless of the ammount of exercise or the ammount of food i ate…… then their were the aches and muscle pains and in my joints.

    I had scans and MRIs that showed nothing, then there was the dullness it was like I was on a 7 second delay as my daughter is very sick I need to have my wits about me, since stopping and start taking Paxil the withdrawal symptoms have dominated my day and night bran Zaps upset tummies sleeplessness today is day 6 the brain zaps have receded and I even felt confidant enough to drive the car…. also the muscle and joint pains stopped within 2 days. Good luck everyone dont forget to ask God for help.

  2. Aidan
    Newcastle, Australia
    Reply

    I would like to know if anyone has used pot or has any thoughts on using pot to alleviate the withdrawal from Pristiq?

    I was prescribed pristiq 50mg two years ago for depression and stress. A year later I went up to 100mg. And since then I feel worse than when I was on the smaller dose. I’m getting more frequent brain zaps even less than 24hrs since taking a dose. I’m really irritated and constantly snapping at my wife and two younger kids. I’m 31, male, reasonably fit though I don’t exercise and vegetarian. I should not and don’t want to be on this anymore.

    But back to the question. Medicinal marjauna is not available in nsw Australia so I would need to catch up with an old friend, but I would like to know opinions on using it. I think I want to start splitting the tablets each fortnight until I get to zero so maybe pot could help with sleeping and brain zaps??

  3. Barbara
    Pennsylvania
    Reply

    Has anyone else experienced hives when they tapered off Prestiq?

    Miserable

  4. Lorraine
    okanagan BC
    Reply

    I was prescribed a prescription for Pristiq today and now that I have read peoples posts, I am not going to take it! thank you for sharing your experiences – you have helped me and others by being honest and taking the time to write down your experiences.

  5. Megan
    Melbourne
    Reply

    My doctor just put me on 50mg per day …. I am suffering really bad mood swings and severe depression … after reading about the brain zaps ect I am really scared to continue with this …. but i feel i have no choice because of my chemical inbalance

  6. Kaine
    NSW
    Reply

    These comments have been a very helpful and encouraging read. I’ve been gradually weaning myself off Pristiq with lower doses over the last couple of months, and I’m 3 days into no Pristiq. I thought it was time to move off it, my personal circumstances have improved and I’ve been exercising pretty consistently for the last 6 months.

    However even with the warnings, I wasn’t really prepared for how I would feel after coming off it completely – even going from a low dose to no dose, the side effects feel much much stronger than when I was just lowering the dosage. I have very strong feelings of vertigo and I don’t trust my balance – which is my main concern at the moment as I don’t feel safe exercising. I find it currently difficult to get comfortable lying down initially and when I sleep I have nightmares that are vivid and generally terrifying.

    I thought I would be okay to go to work whilst coming off Pristiq, but I’m not convinced now that I can do it. I’m not sure what I’d do if I did stay home though, because I don’t currently feel very good lying down. Being aware of the side effects and the knowledge that they do go away eventually is a comfort though – I’m very keen to kick this Pristiq habit.

  7. Amanda
    Cal
    Reply

    My doctor stopped Pristiq and gave me Zoloft without any titrating down of the Pristiq or titrating up of the Zoloft that was on last Monday this is a week later. I have felt like I’m having a nervous breakdown. Crying, feeling hopeless. Will this subside?

  8. Annie
    Sydney, Australia
    Reply

    Did some research on compounding of medications and phoned a nearby compounding pharmacy this morning. The pharmacist said that they will do Pristiq in smaller doses – 40, 30, 25 mg right down to 5mg !! It does cost more for this service: AUD$50 for two weeks supply of 25 mg, for example, but that is great news for people wanting to titrate down from this drug. I would encourage others to check out what is available in their area in terms of getting a custom compounded dose so that the process of getting off Pristiq is not so horrible !! Peace n’love to all.

  9. HiHopes62
    Georgia
    Reply

    I have been on Pristiq 100mg for almost 5 yrs I think. Suddenly my insurance decided to not cover my prescription. I have tried other meds, but had allergic reactions. So needless to say, while waiting on all the appeal paperwork to go through, I ran out and have gone cold turky for 5 days. I have awful sweating, jitters, slight vision distoortions and slight dizziness. Each day gets better. The best thing is that the brain fog is gone, I have more energy and can “feel” again! I realize it will take me some time to get this out of my system. Hope it will get better..

  10. roxanne
    australia
    Reply

    i have stopped taking prestiq for nearly a week . I only weaned off for a week before stopping completely. withdrawal symptoms are maddening. as it’s nearly a week I don’t want to start again. is this sensible. regards Roxanne

    • Andrew
      Nsw
      Reply

      Good on you.
      I was on Effexor for over 10 years with the dosage slowly increasing over time to have any effectiveness then a shrink put me on Pristiq and the same thing is happening now having to increase dosage to have any effect. In the process my life has deteriorated resulting in the loss of my job and destruction of family life.

      I know that the only time I can reduce my dosage is when I can maintain a good exercise program to force my body to produce its own chemistry. Otherwise I am in a fog and struggle to get going. I hope I can kick this dreadful drug but in the mean time I have been trying to find out if there is a class action here in Australia.

    • lona
      OH
      Reply

      Roxanne, How are you doing now? I am about 1.5 weeks in after going cold turkey because I ran out and didn’t want to pay for prescription again due to cost with deductible renewing. I am curious how your journey has been in recent days. Thanks for sharing.

  11. Ann
    Reply

    Just to add to my previous post. I went down from 200mgs of Pristiq to 0 in a week. It was ok until I hit the 0 mark and then the emotions went crazy.

    My legs keep cramping badly during the night, I don’t want to sleep because I’m haunted by nightmares every night. I had severe itchiness which let to me bleeding from scratching so much. My tinnitus is worse than usual, the brain zaps are going but I’ve been told it could take months for the symptoms and brain fog to go away.

    Also found out lucky me, I’ve been misdiagnosed for 20 plus years. I’m bi-polar so every time they pumped more anti-d’s into me it make me manic then crash and burn leading to a higher dose of anti-d’s and the cycle continued.

  12. Katie
    Reply

    I don’t typically write on these forums but I recently discontinued taking Pristiq and during the first few days free of the medication, I was desperately searching for a hopeful post, which I hardly came by! I was sure that I would spend the next few weeks as miserable as I felt at the time! I was feeling really discouraged and contemplated going back, but was determined to push through, and I did!!

    I was on Pristiq 100mg for almost 2 years and decided that the tough time in my life when I started taking it had passed and it was now time to stop. It was a hard decision that I put off foe months solely because I didn’t want to go through the withdrawals. I began splitting my 100mg into quarters, i know you’re not “supposed” to do this, but I did and didn’t have any issues. I took 3/4 pill (75mg) for 2 weeks then, 1/2 (50mg) for two weeks, then 1/4 for 3 weeks and decided I was ready to stop completely so I did. The first 2-3 days were a piece of cake.

    Only a few brain zaps and dizziness but nothing I couldn’t manage. Day 4-5 were the days I felt the worst! I was dizzy, moody, headache, really sick to my stomach, horrible night sweats and bad dreams, needless to say I hardly slept that week! Lack of sleep may have had a huge part in why I felt so crappy! Days 4 and 5 were the days I searched for hope it wouldn’t last long and never found anything saying it wouldn’t last long. Most of what I found were horror stories!

    That is who I am writing this now. To give hope to anyone needing it! On day 6, it felt like I woke up in a whole different world!! I felt amazing and it was then that I began to realize the foggy cloud Pristiq had held over me for nearly 2 years!! I’m glad the medication was there when I needed it, because there was a time that I REALLY did, but my advice would be not to take it any longer than you NEED to. I’m on day 12 and still feel great! Just remember to tapper of, don’t rush it and remember you won’t feel the withdraws forever!! You can do it! Just hang I there!

    • Andrew
      Reply

      Yes I was the same. Misdiagnosed but even then I think I could have been better off if I changed my life style rather than going on the spiral I have been down. I have suffered massive muscular cramps from being on Effexor and as a result tore the ligaments in my feet and spent a fortune on physio and massage therapy to overcome it.

    • Rhonda
      Australia
      Reply

      Hi thanks for posting and I am amazed at the side effects this drug has. I’ve been wanting to get off it for awhile now as I had worked out it was the drug making me feel suicidual (it’s supposed to help, not encourage). So I’m reducing it each week by days eg miss one day then two until it’s reduced to nil. Reading all the other posts now explains the nightmare sweats tinnitus jitters foggyness I’ve been having. However I don’t understand brain zaps could someone explain this please and thank you for the posts it’s really helped me…

  13. Ann
    NSW
    Reply

    I’ve been on 200 mgs of Pristiq for around 6 years. I was previously on Zoloft and after 10 years it just stopped working. The doctors then tried multiple others before I ended up on Pristiq.

    I know this day was coming and boy has it hit these last 4 days. It seems Pristiq has stopped working, I’m literally going crazy with my thoughts, anxiety, fear, depression. Leg cramps, nausea, brain zaps and I haven’t even started the withdrawal. I’m going into hospital for that and to change back to Zoloft and be reassessed.

    I’m so scared, last time I was in and out of hospital for 6 months of a year and then it still took time to find the correct med. Why are they allowed to give us these meds without any warning of the withdrawal effects? It wasn’t the psych I’m seeing now who put me on this awful drug.

    • Jackie
      Canada
      Reply

      Thank you, Ann. Your post has given me some hope. I was on on 50 mg of PRISTIQ for 1 1/2 years which was prescribed for depression due to a terrible time in my life. Prior to that I had taken Celexa for a period of time. At the same time I was under the care of a neurologist for some undiagnosed movement disorder. Every test I have had in connection with this has come back negative.

      I have now realized that Pristiq exacerbated the symptoms terribly. From difficulty walking and balance I actually had some falls, also had lack of coordination, muscle and joint stiffness, eventually slurred speech and bladder incontinence. I am determined to stick it out, as after cutting down the first week to 50 mg. every other day my speech improved. When I finally stopped the drug completely on day three I had no incontinence issues which was absolutely amazing to me, like a miracle. I also slept through the night without having to get up three or four times to P.

      However the withdrawl symptoms of nausea and dizziness are terrible, and I’m hoping they will not last long I am sharing this because these neurological movement disorder symptoms are listed as rare, and I’m sure that other people have maybe experienced them. I am only 58 and thought my future was a nursing home. I now have some hope. I am convinced that my neurological symptoms were a result of Celexa over the years and eventually PRISTIQ. There is actually a website for medication induced movement disorders. I just have to get by the withdrawal. Luckily for me my depression was certainly situational over the years and has been helped by making long overdue changes to my life situation, meditation, diet, and exercise.

  14. Mary
    Hunter Valley nsw.
    Reply

    Hi I have been on 100mg for a year now and was experiencing side effects so I decided to go to the Doctor to help me get off them,
    He told me to take 50 mg ,that was ok ,now I wanted to come off them all together. He wasn’t happy ,he told me to come off cold turkey or cut them in Half, then I said no,you can’t do that!!

    So, now I’m doing it with the help from my daughter who is a qualified nurse.

    I was taking one 50mg every other day. Wow. I couldn’t trust myself to drive, my head was buzzing, after a couple of weeks, I took one tablet every other two days, (We can’t get the 25mg here in Australia).

    I’m suffering like hell, the depression is back, I have no interest in doing or going anywhere, palpitations, tinnitus is bad, and emotional, sobbing for nothing, crying on the phone, very emotional.

    I’m trying to overcome this awful depressed state and my husband who is a retired scientist, suggest I cut one in half which gives me a two 25mg tablets, that will cover the two days without at a lower dose.

    How you ask?

    Is by emptying a capsule like Panadol casing and insert half the tablet inside it,

    I would like to know why we can’t get the 25 mg here in Australia.
    I am 76 years old and I want to get off them. I have been taking Mega B for about 10 years ,had a knee replacement 4 years ago with no problems. Broke my wrist in a fall no problem getting over it.these Pristiq should not be prescribed to anyone without first been told the terrible withdrawal symptoms.

    • Rhonda
      Reply

      Hi Mary
      Did the super B help? As I’m in the process of reducing my tablets, these would be the worst antidepressants I’ve ever taken. I don’t feel gps have a understanding of this drug as mine suggested cutting it in half too and this is a no no. Anyhow it’s great to read others posts as I had no idea how bad this drug was

  15. Cara
    Reply

    I got off Pristiq 50 Novemeber 1st after my visit to Doctor and tapering down. I stopped cold turkey after I left his office. I got some Super B complex and 5-HTB and Dramamine.

    Two days later, I am feeling much better. I take Dramamine for dizziness and brain zaps. Non-drowsy, and got the other two for weight loss and Moods. I will give a update after 7 days, but day two I am better than day one. I still have weird vivid dreams and wake up sweating and dizzy.

    But once I take these, I feel better at work. I was scared to death to come off this stuff because it was bad for me. But I am trying to do everything naturally this time. After gaining 15 pounds too, never in my life I ever gained weight that fast.

    • Jody
      Wa
      Reply

      Please do you have a up date for me :(

  16. Cara
    Georgia
    Reply

    I am on this drug for past six months and it is awful I am suffering high blood pressure, weight gain, brain zaps if I am even late on a hour or so, dizziness, irritable, night sweats, and I am trying to wean off too and going to my doctor tomorrow. I feel so drained as well. I take this in placement of hormones because I had a partial hysterectomy and was on Cymbolta before. I gained 15 pounds that fast too. I am normally tiny. I can’t wait to be off this stuff for good.

What Do You Think?

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted.