The Difference between VENLAFAXINE (EFFEXOR) and DESVENLAFAXINE (PRISTIQ) | A Psychiatrist Explains
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- čas přidán 12. 03. 2022
- Venlafaxine (EFFEXOR) is a serotonin and noradrenaline reuptake inhibitor (SNRI) that is indicated for major depressive disorder (MDD), generalized anxiety disorder, social anxiety disorder, and panic disorder with or without agoraphobia.
Desvenlafaxine (PRISTIQ) meanwhile is a synthetic succinate version of venlafaxine’s major active metabolite, although its approval is limited to MDD.
#venlafaxine #desvenlafaxine #effexor #pristiq #antidepressants
Dr Sanil Rege explains the difference between the two.
1. Venlafaxine sequentially inhibits Serotonin transporter (SERT) and Noradrenaline Transporter (NAT).
2. Venlafaxine has a 30-fold higher affinity for the reuptake of serotonin over noradrenaline whilst desvenlafaxine has a 10-fold affinity
3. Venlafaxine at its minimal effective dose in depression (75 mg/d), venlafaxine acts as a selective 5-HT reuptake inhibitor. In contrast, when administered at higher doses (225 and 375 mg/d), it acts as a dual 5-HT and NE reuptake inhibitor exhibiting dose-dependent pharmacology in relation to efficacy and tolerability.
4. The sequential inhibition of serotonin and NA is reflected in its side effect profile-that initial side effects are predominantly related to serotonin (e.g., headaches, nausea, fatigue, sexual dysfunction). In contrast, subsequent side effects with higher dosing are related to serotonin and norepinephrine (e.g., activation effects, dry mouth, night sweats).
5. Desvenlafaxine, on the other hand, blocks the serotonin and norepinephrine reuptake at starting doses.
Both Venlafaxine and desvenlafaxine have applications in a range of disorders beyond depression and anxiety.
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Finally thank you so much!! I been looking for an explanation. I have tried both and could not figure out why Effexor works better when Pristiq is what Effexor breaks down to. God bless you for doing this!! Totally going to save this for my psychopharmacology class!!
Thank you for your feedback and glad to know it was useful
Thank you sir. You may not be getting views you deserve. But sir you are helping us. Huge respect.
Thank you for your feedback. 🙏🏼
Great advice , so good at explaining 👏
From Mauritius. You are doing a great job! Keep up the good work to help doctors worldwide!
Thank you for your feedback 🙏🏼
Excellent and clear explanation. Desvenlafaxine was a revelation for my treatment-resistant depression. Now I understand why it didn't work with venlafaxine (especially at lower doses).
Thank you for your feedback and sharing your personal experience 🙏🏼
This is very fascinating. I was on Cymbalta for several months and it did nothing for my GAD. The doctor switched me over to Effexor XR and I’m on 225mg. It has saved my life. I can function and it has made me feel like myself again. So thankful for these medications. Thank you for this video
Thank you for your feedback and also sharing your personal experience. Much appreciated as these experiences can help others.
I think it was cymbalta that made me hallucinate at a low dose.... It's apparently one of the very very rare side effects of SSRIs and is a sign of a dangerous syndrome where there's too much of the serotonin? in your brain... It was not fun... Needless to say I quit taking that immediately
@@Homemaker-eg2he hello homemaker 👋 how would ypu describe the hallucination? Reason why Im asking is because i found myself in a similar situation recently, right when i woke up. It lasted about 10-15min. It felt like things were kind of wobbly. At one point when i looked at my flowery wallpaper it seemed as if the flowers were not completely still. I had pressure in my ears and i was feeling a bit hot.
Im not 100% sure if this was caused by prozac (which i’ve been on for the last 3months) or because i take supplements like, ltheanine, ashwagandha and sometimes noopept along with the prozac.
Btw: Im on prozac for OCD/depression. So far no success..
@@yeahright6021 my daughter had left for school and I was sitting on the end of my bed with the baby reading him a book he was probably around 1 at the time and I don't know I heard a noise or something and I looked up and there was this guy walking through my kitchen we made eye contact they were brown he was wearing a flowery like Hawaiian shirt and pants ... He walked into the hallway eye contact the whole time then he turned past my doorway and walked into my daughter's room I immediately jumped up put the kiddo in the middle of the bed and was after this guy there was no exit nowhere for this person to go I checked her whole room which wasn't hard she had a closet and a dresser and a bed that we did t have a bedframe for the the mattress and boxspring were on the floor the windows were blocked by stuff on the front porch and they were old and squeaky and tight if they opened at all he was just gone..... I went back grabbed the baby and called my husband and starting looking up the medication I was on.... I think it was cymbalta at the time and one of the very rare side effects was hallucinations brought on by serotonin reuptake syndrome or something like that which is caused by a buildup of too much of the medication like if the dose is too high those classifications of drugs I can't take I have horrendous side effects with every one of them I have to take the other class the ssni I think not the ssri.... I've seen things my whole life but that was the most vivid terrifying thing I've ever seen while not staying up for days at a time.... Which I did in my youth a lot and past a certain point I always hallucinated usually it was bugs I would see bugs big massive ones crawling on the computer screen or whatever book series I was stuck on I knew they weren't real so they didn't bother me but the demon one that was the second scariest and third scariest would have been waking up to the ghost demon thing besides my bed then seeing three of them over my mom's side and find out she's having a dream where people are trying to get us specifically me by killing her brutally and I woke her up just as they were commencing with her murder..... I don't think I felt hot or anything when I saw the guy I remember being extremely panicked and scared and ready to fight.... The things I normally see come in flashes or jump scares or peripherally and are like night and day compared to that single experience I can tell the difference between if I'm seeing something like ghosts or fake stuff it seems more superimposed and discombobulated
@@Homemaker-eg2he Homemaker, i really appreciate you taking the time to answer me! And i apologize for the delayed response on my end 🙏 wow that sounds awefully scary, Im not sure if i would be able to handle something like that, atleast not where my mental state is atm. I’ve had similar things happen to me as kid but nothing that vividly. Well except for one time and it involved sleeping paralysis.. but it has happened so many times now that i no longer find it too scary . I commend you for your strength! It cant have been easy! Hopefully you are not experincing the same things today 🙏 Then Im guessing i wasn’t hallucinating, i was just experiencing some sort of symptoms that Im not too sure of. It could also be something thst has to do with my eyes because recently being on this med, my vision has been impacted negatively. But i cant explain feeling hot and having a pressure in my ears. Oh well, probably nothing to worry about 😬😅😊 It is easy for me to say that there’s nothing to worry about, but i can’t say that whole heartedly not knowing what you’re experiencing. But What i can tell you and hope for you to find peace in is know that its not real. Don’t listen to the tricks of the mind and follow your heart 💛
If there are any prescribing medical professionals reading this PLEASE don’t think of Effexor if you can avoid it: the normal taper off is BRUTAL! Very hard to get off! The Brain Zaps suck! Love you guys ❤❤
its true. effexor has the worst come off. pristiq does not cause it has longer half time reduction.
Almost whole year of brain zaps. Thank God for 5 htp.
Yes. Even just one day without desvenlafaxine causes horrific withdrawal symptoms (at least for myself). The intense dizziness, nausea, psychological breakdowns, fear and panic, etc. are unbearable. HOWEVER, I must note that desvenlafaxine has helped tremendously with anxiety. It DOES make me feel stable, and overall happier.
I guess people are different I had no significant problems with the taper off. If I forgott to take it for a day it was anoying with headaches and nasea but not horrific. I hope you found a better treatment wether its another drug or therapy.
@@lesliedrake8217Did you have nightmares as a side effect?
Thank you! Interesting to learn about as I just started pristiq. And I never knew what emotional blunting was a side affect and possibly what my last anti depressent did to me
Wish you well with your treatment
This was awesome! Especially for patients. Thank you for explaining this.
Pleasure!
@@PsychiatrySimplified how does Cymbalta work different than Pristiq for depression and anxiety?
This was a fascinating explanation!
Thanks . I’ll plan one.
thank you for the clear explanation and the subtitles! I'm on venlafaxine and the side effects of higher doses that you described are very accurate. it's a life saving drug and I'm willing to trade it off because I can manage my life again.
Thanks for the feedback. Glad you find the medication helpful. Wish you well.
How many days u recover then u eat this medicine
Dr Rege - could you do a video about the relationship between dopamine and norepinephrine?
From what I understand venlafaxine needs greater dosage to show increase in norepinephrine whereas devenlafaxine requires lower dosage.
Yes correct . psychscenehub.com/psychinsights/venlafaxine-and-desvenlafaxine-pharmacology/
Thank you for the great information, doctors don’t take time share because of hourly patient quotas. Pls consider intro music that would cater to an educated listener. The music is fun but reminds me of my party hard days as college kid.
Thanks . We have changed the music in subsequent videos . 🙏🏻
Well shoot. I thought it was my body getting used to the medication and that's why my Anxiety would come back a few months after increasing dosages. Very well explained video. Thank you.
Thank you 🙏🏼
I agree with the person comments just before me thank you for helping me ❤
So nice to watch this your informative video clip since I am on"Venlaxaine,37.5 SR"once daily and assume good results in my anxiety with depressive illness disorder taking for last 6 months and feel nothing like that to increase the dosage, thank you sir for your further informative clip regarding this subject...
السلام عليكم اخي الكريم هل انت في السعوديه
Greetings from Arkansas. I stumbled upon your video. Very informative. I just was prescribed venlafaxine for chronic fatigue that has lasted off and on almost 2 yrs now. I'm hoping that it works. I'm having trouble urinating right now from the side effect. I trust that goes away. Thanks for the video. God bless
I've been prescribed both thankfully not at the same time. Effexor was less horrific but both were not a nice experience. Good luck to those taking it in the future.
Sorry to hear. Hope things are better for you:
I hate it how long was withdrawal
@@tiffanykivett4221 effexor no withdrawal really, it just wasn't much fun while I was taking it. I'm in benzodiazipine withdrawal and nothing is as torturing as that. Taper slowly for all meds would be my advice and always ask to go slower at first.
@@melanie98d my withdrawal from pristiq is awful. I'm finally down to 25mg every other day and by about 5pm the 2nd day I'm having drunk feelings. Everything spins and if I move quickly it is a hot mess. Lucky for me it is getting better and easier to tolerate
@@tiffanykivett4221 Good to hear it's getting a bit easier. I wasn't on Pristiq long enough for withdrawal, it made my mood go very dark very fast and was taken off pretty quickly.
I got pins and needles with effexor. They are switching me to cymbalta. Im being prescribed for vestibular migraines
Took effexor for years but still battled anxiety. Finally changed to Pristiq a few years ago and less anxiety. Both are horrible to detox so will take til death
Pristiq was a much cleaner med for me, it didnt kill my libido and have the horrible withdrawal effexor did
Started on 37.5 mg for 5 weeks, now on 75,5 for the past 4 weeks and not feeling any better, I also take 30mg mirtazapien at night, been taking that for 10 weeks, will have to up the dose of venlafaxine... was on Prozac for three months before taking this with no effect either!
thank you for the video! I am taking these pills so it's cool to know more
Thank you very much for your informative video. I had been prescribed desvenlafaxine by my psychiatrist back in 2020 and it had worked for me. But whenever I felt like I am alright and I had stopped taking the medications, depression would come back in full swing, and I would re consult my doctor and get the prescription renewed. Now, as a second opinion I consulted another psychiatrist, and I have prescribed Sertraline + Risperidone, citing desvenlafaxine has side effects. (I had escitalopram, which did not work for me very well). I am confused if I should change to Sertraline or not ! (Or would a 3rd consultation would be appropriate ?)
Also, I wanted to know if there are long term effects of the medications and can we have them for 5-6 years, without worrying ?
Its always good to discuss medications and their rationale with your psychiatrist as they would have prescribed it for a reason which they can explain. All medication prescribing is a risk-benefit analysis- depression or other psychiatric disorders have significant bio-psychosocial impact. Medications when safely and appropriately prescribed, do not have long-term issues of harm. Risperidone for example can be associated with increased prolactin which should be monitored as this can have long term effects which your doctor can explain ( this is when prolactin is elevated over long term due to prescribing) . Wish you well. Ps not medical advice.
@@PsychiatrySimplified is this medicine safe during pregnancy
Dr. Rege, would you mind making a video comparing amphetamine with methylphenidate?
Sure will add to the list
30x affinity? Holy shit! That explains why I was so manic after that small step up.
Hi doctor. I have fibromyalgia and sfpn. Depression and anxiety try on effexor because last meds caused akathisia and low dopmine symptoms. Do you think small dose of Venlafaxine won't do this? Can you replay.
It's difficult to predict the response for an individual however low dose venlafaxine can provide benefits but can still be associated with akathisia if activation and hyper arousal is present ( sleep disturbances, racing thoughts etc) . In some at know doses it can reduce the anxiety without akathisia while for other others can head to activation. Ultimately your doctor will be in the best position to answer this and close monitoring after a trial is always appropriate. Wish you well.
should one continue the medicine if side effects include paranoia and beliefs that people are taking picture of us, aren't talking to us because they think we're ghosts, etc? Also sprouts of irritability and aggression. it's day 13 of the medicine for my friend.
This can be a severe side effect or underlying illness as the symptoms sound like psychosis - please see the doctor who prescribed it. We can't advise on the next steps. I wish your friend well.
If you are taking a SNRI you need to talk to your doctor about every side effect that you may experience. If I had known about all the side effects I would never in a million years have taken effexor. I did not need it it was the doctor's idea not mine.
when do you know to come off teva desvenlafaxine
Does desvenlafaxine increase norepinephrine in areas of the brain that differ from the areas where venlafaxine increases norepinephrine, and vice versa? So that they all complement each other in treating depression? Thank you for the beautiful video ،Because if I take venlafaxine, I take both
Hello Doctor. Ive been on Pristiq on 50 mg it was great for my depression but did nothing on anxiety. No luck with SSRIS neither. Could Effexor help both anxiety and depression? Thanks
Venlafaxine is evidence based in depression and anxiety - Pristiq is a metabolite of venlafaxine. Usually if anxiety is not treated - this may be because what is described as anxiety is actually hyperarousal - indicated by sleep disturbances , racing thoughts, nightmares etc. Also mixed features should be ruled out. Check out the video we have done on this topic (mixed features)
I took venlafaxine at the advice of my ENT. In 2 hours my Vertigo was 80% gone after having The vestibular migraine for 9 months.
At 2am the next morning I woke up with a blinding headache. I took my BP and it was 196/121. Yeah off to the ER I went. If I have to decide between Vertigo and a Stroke,,,,Easy choice.
You post this on almost all the videos about effexor that I've seen.
Still have the VMs?
@@TDR85 They don't know what it is. Next stop a Chiropractic Neurologist for a 3hr exam $600 out of pocket.
@@BalkanDeputy Hope you find some releif man
Thanks doctor. I have a question: how common is Desvenlafaxine 50mg causes emotional blunting? Is it comparable to SSRIs or Efexor for example? Or less?
Less likely in general due to SERT:NAT RATIO 10:1 conored to venlafacine 30:1 and ssri even higher. Increasing dise increases nat blockade and theoretically reduces blinding but some individuals may still experience this.
@@PsychiatrySimplified Thank you so much doctor
Why don't think they just find out what is causing the issues.
I m frightened to stay on this as it says memory lossand I already have this... plus migraine headaches every single day
Please discuss this with your doctor. They may be side effects - that can be managed. PS not medical advice
I've tried both and nothing compares to the vivid dreams I experience on Pristiq (and I wish I knew why.) Super relaxing medication.
Activating effect on REM sleep. We’ll know effect .
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Plz help doc suggest this medicine but im scared what happen should i take
Being on Pristiq for 4 months now (which is kind of working), after 3 years of trying without success few other antidepressants or a combination of them, I'm starting to believe that the chemical imbalance theory is not so accurate. if it was, there was no need for people to try few medications until finding the right one. If they will find it, because that's another problem to discuss.
With all due respect for your channel, you think it's possible to make a video about the new findings about chemical imbalance not being linked to cause of depression? Thanks. Mike
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Ive been on at least 5 different prescritptions now and my medication specialist says that if the desvenlafaxine doesnt work then ill need to do a gene testing to see how i metabolize and absorb the different meds so we can find the correct dosage and type needed. You may want to look or ask about gene testing and see if thats something you may need to do.
@@ashes2342 thanks for the information. Didn't know that this gene testing even exists. Definitely something to discuss with my doctor
And discuss with your banker cause it's not cheap @@OrangeMicMusic
Have just been switched from Effexor XR to Pristiq. Thanks for the great explanation and can feel a good difference moving from Effexor to pristiq. Feel like anxiety right from a low dose
Everyone is different but this definitely wasn’t for me.
Major heart palpitations, chest pain, cough, headache, visual disturbances the list goes on.
I did feel the positive effects but the negative effects were horrendous. 5 days of gradually increasing severity of reaction.
Felt good almost instantly on stopping it.
You have to find what works but I would look at this as a last resort.
If anyone is reading this and just starting the journey of finding what works:
- Find something with a long half life
- Check if it comes in a soluble solution (or can be easily divided and not time release) to facilitate micro-dosing and hyperbolic tapering
- Discuss SSRI’s before a SRNI’s
- Discuss Mirtazapine before an SRNI’s
- Look at what it’s FDA approved for (just as a guide)
- Do your own research
- Listen to your body and instincts
- Always follow your doctors advice
- Find a doctor with experience with antidepressants
Venlafaxine or desvenlafaxine? Both can be activating.
If venlafaxine stopped working at 150 and I’m still depressed a year later, would a higher dose work?
Depends on the specific Sx targeted. A question for the prescriber. Venlafaxine becomes a Noradrenergic potentiator at higher doses - so depending on Sx - if NA potentiation is needed, then higher doses may work. PS not advice
Wt do you think combo of pristiq and Wellbutrin?? My doctor suggested me 1 week ago
Yes it is a combination that is used in treatment resistant depression - essentially the combination is aimed to increase NA and DA - which can target symptoms such as anhedonia, amotivation, fatigue and low mood. Hypertension can be a side effect. Your doctor will be able to tell you the reasons it's recommended. It is effective when used appropriately. Ps not advice
Thank you very much sir for such a valuable information
My doctor mentioned the possibility of similar. I haven’t tried Pristiq or Wellbutrin, yet.
Has Pristiq been banned in Europe and that there was a 60 plus million payout via class action in the US?.
It’s not banned , it wasn’t approved based on trial data but I see is available in Spain and Germany.
Started seeing vivid memories of my truama I've quick cold turkey, at least I seen the little girl in me I thought I could never peace with , she's at rest now as my medication I trashed
Ketamine works well for Depression and Anxiety and fast
My doctor prescribed men venlafaxine bit I hate taking meds I'm kind of afraid to take it is it safe to take iv got anxiety bad.
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Iam taking Nexvenala OD 50 once a day so it is ok? SSRI level is increased how can we know? Is there side effects
This is a question for your doctor. Desvenlafaxine is used in the treatment of depression and anxiety
Thanks for the video. You mentioned that in order to achieve NET inhibition with Effexor, one would need to get in the 225mg range. And this got me thinking…
If someone began taking Effexor at 37.5mg, and gradually increased their dose to 225mg, would their serotonin levels increase six fold before NET kicked in? Do increases in antidepressant medications literally raise the levels of neurotransmitter(s) they target by an amount equal to the respective dose increase? Eg, if one doubles their dose of Effexor from 37.5mg to 75mg, are they doubling the amount of serotonin that will be inhibited (theoretically)?
Sorry for the lengthy question!
It’s not so much the exact number increase that we know at an individual level - what we know is they until 225 mg most of the activity will be SERT inhibition this increase in Serotonin extracellular levels. After that NAT binding occurs . But there isn’t a ratio relationship such as double the dose double the extracellular level. This correlation is not exact and that’s why it is the clinical symptoms that matter .
@@PsychiatrySimplified Thanks, Doc! That makes a lot of sense. It’s wild that pharmaceutical companies are allowed to classify their drugs as SNRIs when such a high dose is required for it to act as such. Definitely could mislead the less astute prescribers into thinking they’re helping their patients with a more “activating” antidepressant.
True SNRI is clomipramine ( Classified as a TCA ) SERT : NAT is 2:1
I was on 150mg per day desvenlofaxine (pristiq) for 7 years to treat depression and GAD, i really didn't experience any serious side effects except maybe a slight lowering of my libido. The medication definitely helped to stabilise my moods and emotions and I was generally a happier more relaxed person while taking them. That was in Australia, nearly 2 years ago i moved to Bali and tapered off the pristiq with no serious side effects except for brain zaps for a couple of months which are annoying but never particularly bothered me. Lately I've found that my GAD and depression has come back quite badly again, desvenlofaxine isn't available here in Indonesia but venlofaxine is, I'm planning to go see my doctor here to get a prescription this week I'm very much hoping the relief i get will be at least similar to the relief i got from desvenlofaxine. Fingers crossed.
Wish you well .
@@PsychiatrySimplified Thank you. As a professional would you expect to see similar (positive) result using effexor as compared to the positive results i used to get from pristiq? What daily dose of effexor would be approximately equivalent to taking 100mg per day pristiq?
Effexor-- is norepinephrine activated at 150 mg dose?
If at all - it’s not significant. 225 mg and above is where NAT Inhibition starts becoming prominent.
I have been experiencing insomnia for 4 weeks on effexor. Will that side effect improve overtime?
It's unlikely to settle if it's worsened over a period of 4 weeks. Please discuss this with your doctor. It's important that insomnia is addressed. If antidepressnat induced mixed States should always be taken into account.
@@PsychiatrySimplified strangely this side effect only started in week 4. The doctor prescribed me mirtazapine to combat the insomnia
My physchiatrist seemed to get a bit perturbed at me last time we talked cuz I've gone thru a dozen meds & nothing works...she said let's try Effexor....then, I think she'll just give up on me
Hope that doesn’t happen and things work out for you . In general treatment is about targeting symptoms and identifying the target symptoms with psychopharmacology .
Tell your psychiatrist to give you a gene site test. A simple test will tell them what meds work on you based on the test. I had one done and my psychiatrist was offended but I started taking meds that worked for me.
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Is it safe to take continue low dose of venlafaxine for more than one year?
Safety depends on the indication and dose. This is a question best asked to your doctor as safety is individualised. Venlafaxine has been in general been used for several decades now - it does have tolerability issues in some individuals.
@psychiatry simplified. Does Cymbalta work better than Pristiq?
Both have equivalent sert :NAT inhibition. But duloxetine tends to do better for pain.
Get the gene sight swab test. One is on my green. Other is on my red list. Bad
Can it effect the liver if taken for years ? Venlafaxine
Venlafaxine can be associated with liver injury, as can other antidepressants. This side effect, however, has been listed as rare. One can discuss this with the prescribing doctor to carry out liver tests if concerns arise
If pristiq didn't work (even at higher dosages), is it worth trying effexor? The added serotonin/ratio could possibly make a difference I guess?
All depends on what one is trying to target. An analogy is ( not trying to be patronising but wanting to simplify it) - if squats didn't work should i shift to leg presses. Could make a difference.
One can see it depends on ultimate aims.
@@PsychiatrySimplified Venlafaxine is the antidepressant that gives me the most side effects, I've used several. It improved my depression, my PMS but I still feel drowsy, yawning, hands and eyelids shaking and a little ringing in my ears. I was taking 150mg in the morning and 75mg at night, I spoke to the doctor and he said I can take it all in the morning. I don't know if it's because it also acts on noradrenaline. I've been on this dose for 2 months, I hope these side effects improve.
Sir Can i Combine mirtazapine 15mg+ desvenlafaxine 25mg+ Cariprazine 3 mg to treat psychosis, ocd, schizophrenia, neuropathic pain?
Kindly reply sir.
You are getting huge respect from India ❤
There are lot of followers from india
We can't provide advice as your doctor is in the best position to tell you the specific indications for the medications. However the medications can theoretically be combined. Ps not advice. Wish you well
@@PsychiatrySimplified
Respected Sir
Here in village there is no such qualified doctor in remote village.that's why I am facing lots of problems.
I studied on my own and started cariprazine. It is giving me good results for psychosis. And now mirtazapine, desvenlafaxine startment. I had . I am taking treatment under the guidance of a MBBS doctor. we need guidance from well qualified psychiatrist like you. I have some financial issues also🥺.
Sir I tried all antidepressants but I didn't get relief and intolerance problem.
sir theoretically Is this good option with less side effects desvenlafaxine and mirtazapine combination with cariprazine.
Will there be serious side effects possible. If yes then what are they?
@@entertainmenteducavlogs9717 I have done a video on mirtazapine that may help. Wish you well.
It appears that the precursors to these SSRIs and SNRIs were derived based on testing on Concentration Camp people in WW 2 and also the Soldiers and Pilots of WW 2.
Where did you get this information?
Drs never test seratonin before prescribing. They all have black box warnings. Feeling awful.
We cannot test for serotonin. We have no bio markers that can tell us about neurotransmitters - moreover neurotransmitter levels are not directly correlated with symptoms - we don’t know enough at the molecular level/ what we do know is that when prescribed appropriately they can treat symptoms effectively. Side effects can also be minimised through choice; matching and other clinical aspects of Rx.
My doctor prescribed me pristiq and propranolol. Are the two counteracting each other?
I am going to get off pristiq because I hear the withdrawal is way worse than the others. I am also going to switch doctors because this one seems to share a lot of misinformation.
They do not counteract each other. Please speak to the doctor before making any changes.
Pristiq is a metabolite of effexor and therefore interacts dangerously w/ fewer meds. The prop was probably prescribed to keep your blood pressure down for the time being because, as the vid says, pristiq may raise your blood pressure due to NART. Your doc seems legit, it all makes sense at least.
@@fiveish77 I have insomnia and she kept giving anti depressants that had anti histamine properties. It would work for a few days. Then tolerance.
Each new drug did the same thing or none of them worked after the first one.
I told her about the tolerance but she said they were just working on S and N
So which one do you think would have the best results? For anxiety
Both are effective for anxiety. The decision should be made based on tolerability and side effects if the only choice is between the two.
@@PsychiatrySimplified I just started Effexor xr 150 once daily and 1mg Kolonopin twice daily. how long you think I would be prescribed kolonopin for?
@@jayton580 ive been on the same combo. Completely changed my life. Still struggle but the it gets better!!
@@stonedmetal666 now I’m on 300mg is this gonna be good for GAD SAD and depression?
@@PsychiatrySimplified so with 300mg daily be effective for GAD and SAD?
Please make a BZD & withdrawal video.
Good suggestion. Will do
Why do doctors recommend this for VM and PPPD?
Because both the conditions involve amygdala activation as part of the salience network. Venlafaxine at low doses can reduce amygdala activation but also has mild opioid properties .
Venlafaxine helped me with my anorexia but the side effects were horrendous.... I stopped it cold turkey when I got pregnant and that was even worse.... I can't do SSRIs they react negatively to me and I liked the venlafaxine once It leved out but I tried going back on it and the side effect hit immediately and I'm like no freaking way so I'm wondering if pristiq would work better for me... My issues aren't actually diagnosed by a psychiatrist so I e just been tryi g to treat what issues I can with normal drs as I ha e issues with counselors and such they are all liars.... They say one thing and do another.... My depression is seriously out of control and I've gotta get it handled.... I need to be able to function for my family ....
Sorry to hear. Reading your comment - I would recommend seeing a psychiatrist for an evaluation. There are many ‘types’ of depressions medication choices are dependent on the symptoms being targeted. Wish you well.
Are u ok now
@@mehakjan6996 yeah I'm actually on the updated version of the venlafaxine it's called pristiq but my sleeping medicine over does the serotonin which causes me to have days of severe dizziness shakiness and I've been seeing things that my brain doesn't realize isn't actually there it's worse some days then others but overall it's helping I think
@@Homemaker-eg2he plz u can help me i am pregnant I have depression plz confirm this medicine is safe for pregnancy
@@Homemaker-eg2he and how many days u see a change in ur mind then u take medicine
So in simple terms...Pristiq is better than Effexor. Am i right?
Not necessarily. Depends on what is being targeted
So before you decide to take any SNRI ask the doctor exactly how it works and if it is TOXIC. If the doctor does not know how it really works I would not take any SNRI.
It really is that simple. Just say Doctor what is in effexor and is it safe. Simple logic. Then ask the Doctor their opinion on B Complex vitamins readily available on Amazon or at a Pharmacy.
SIR, i want to Taper down my DESVENLAFAXINE 50MG.please help me... love from india🖤
Hi, It's difficult to provide advice about tapering as this should be a risk benefit analysis done by your doctor. Please discuss this with them. Wish you well.
Kitne time se le rahe ho Aap
My doctor wants me to try pristiq for anxiety and it seems more dangerous than benzos
When prescribed appropriately desvenalfaxine ( Pristiq) is evidence based for anxiety.
From experience it's safer than benzos
Benzo withdrawal can kill you
@@ernstthalmann4306 Yes, benzo withdrawal can kill you... but SSRI and SNRI withdrawal can make you wish the withdrawal would kill you.
At least with benzos it's a known danger. SSRIs and SNRIs horrify me.
What’s the difference between Duloxetine and Pristiq?
Both SNRI - SERT :NAT 10:1 ratio. Duloxetine does tend to have better pain target due to mild NMDA antagonism. Pristiq is metabolite of venlafaxine and hence withdrawals tend to be worse
@@PsychiatrySimplified thank you. I have trouble with back pain so Cymbalta/Duloxetine has been an option. But also ADD symptoms, so may go with Wellbutrin to see how I do. I do get insomnia pretty bad, so I’ve been occasionally taking Trazodone or 5 mg (half pill) Ativan.
How can I get off pristiq without the horrible side effects I can barely move without horrible side effects.
It's difficult to answer that on YT as the doctor will need to take your personal aspects into account and come up with a tapering plan if it is indicated. Wish you well.
I'm on a tapered plan and jist going down to 25mg I feel drunk and spinning all the time.
@@tiffanykivett4221 sorry to hear. Discuss this with the doctor. In some it can be time limited ; in some may indicate slower taper ( conpounding etc) .
why do they want me to take this for nerve pain
There is evidence for this agent in neuropathic pain. There are also other options . A risk benefit analysis with your doctor to choose the right agent would help
I started Venlafaxine 1 and a half weeks ago, I feel terrible sleep, I keep yawning all the time, feeling tired, headache, hand tremors
This is a side effect and is indicative of 1. Hyperarousal ( Rem sleep arousal nightmares, vivid dreams etc ) 2. Mixed state ( racing thoughts, irritability, mood swings) 3. ADHD phenotype - indicated by yawning ( reduces ventral striatal DA) . 4. All 3 of the above. Best to discuss this with your prescriber.
Pristiq worked so much better for me. Just my experience. I had horrible side effects on Effexor
@@fraudexposed5486 Venlafaxine is the antidepressant that gives me the most side effects, I've used several. It improved my depression, my PMS but I still feel drowsy, yawning, hands and eyelids shaking and a little ringing in my ears. I was taking 150mg in the morning and 75mg at night, I spoke to the doctor and he said I can take it all in the morning. I don't know if it's because it also acts on noradrenaline. I've been on this dose for 2 months, I hope these side effects improve.
whats the best time to take it morning or night?
Venlafaxine and Desvenlafaxine both - AM. As taking at night can disrupt sleep
@@PsychiatrySimplifiedbut sir i read somewhere that norepinephrine reuptake inhibitors comes with drowsiness or lethargy feeling, and i saw in india psychiatrist generally prescribe it at pm.
I tried the medication for 10 days. 37.5 mg/day x five days then 75md/day. It gave me panic attacks and hypertension. The first day off this nasty drug I felt immediate relief. Maybe if works for some people but for me it was horrible giving me a week of hellish anxiety.
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You tried what medication?
@@johncarlson8125 venlafaxine
@@matshagstrom9839did you go any higher from 75mg
I had depression in July 2019 and after that since March 2020 I have 24 hours severe headache and my brain not working I can't understand and think anything and memory loss and concentration problem I have severe pain in my head since last 3 years any medicine don't working duloxtione fluxotine peroxtine mirtazpine sertaline olanzpine ecitalopram my mri is normal I want to die I can't survive with this pain
How are you feeling now? Have you consulted any psychiatrist?
I'm feeling the exact same as you. I don't want to live anymore. I've tried all these meds. Just got started on desvenlafaxine. If that doesn't help I feel I'm a goner...
@@droidnick Oración, y lectura bíblica 🙌🏻
@@droidnick how are you now, did the med works
your solution in one medicine is called xanax or alprox . take 0.5mg day and night
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If you are taking an SNRI you should get a glucose sensor and start monitoring you glucose level. As far as a antidote it is a little complicated. Doubtful a hospitalcan help in this matter I had to experiment a little with stuff a home from the pharmacy not things readily available at a hospital. Have not been near effexor for 13 years. It can be done the sooner the better. But of course always check with your doctor especially the ONE that gave you the SNRI to begin with.
false.
@@hylianlegends really i have not taken effexor for 13 years. so i believe other people can maybe stop. However I do not know what kind of stuff I took at home . It really did involve herbs and other stuff maybe small amounts of wine. Can't remember. Oh the high blood sugar and liver enzyme increase are known to a few doctors.
@@hylianlegends The KEY is finding a doctor that knows exactly what effexor is made from and then an antidote can be made however some small amount of nerve damage can already have happened however it may be reversible it may take time.
Thank you 🙏 WorldTaperingDay
Why this shit isn't schedule 1 is beyond me.
They essentially cause you to commit crimes or commit... Psychedelic therapy and ketamine therapy would be best way to go.
Losing the sex drive is the worst part😢
Sorry to hear. Yes it’s a major side effect of venlafaxine and to a degree Desvenlafaxine
@@PsychiatrySimplifiedI started Venlafaxine 1 and a half weeks ago, I feel terrible sleep, I keep yawning all the time, feeling tired, headache, hand tremors
You will never be able to get off Pristiq. Don’t take it
I got off it easily
Venlafaxine raised my pressure, 120/170, would desvenlafaxine helps reduce it?
Both have a risk of increasing BP. Desvenlfaxine > risk due to its greater Noradrenaline potentiation right from 50 mg. One can counteract it - so synergy means one can continue with desvenlafaxine if it works and then counteract it. This of course is a decision for the prescriber after a risk benefit analysis. Ps not advice
@@PsychiatrySimplified I know it is not a medical advice and I will of course talk with my doctor but your answer still helped me, so thank you. =)
Im glad it did. Wish you well
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