How To Get Off Pristiq or Reduce Pristiq

Now I’m not a doctor, in fact, I don’t even play one on TV, but I wanted to share a little about me and how I’m handling getting off of, or at least reducing, Pristiq.

Please also read: When to Get Off Antidepressants with Bipolar Disorder

and: How to Get Off Antidepressants Effexor/Pristiq (Venlafaxine/Desvenlafaxine)

Antidepressant Pristiq – Easy On, Not-So-Easy Off

I’ve been talking the antidepressant Pristiq (desvenlafaxine) for months and it doesn’t seem to be doing much, but honestly, the withdrawal from Pristiq is so bad I didn’t want to attempt getting off of it. As you might know, Pristiq is a metabolite of Effexor and Effexor, another antidepressant, is also a nightmare to get off of. If I would miss a Pristiq dose by even a few hours I would become suicidally depressed. Really. No joke.

Buying a Drug Because of an AdNo Taper Strategy for Pristiq

So getting off of Pristiq wasn’t on my short list of fun things to do. There is no taper strategy for Pristiq as it only comes in 50 mg and 100 mg tablets and you cannot cut them.

How I’m Trying to Get Off Pristiq

But I seem to be successfully reducing the dose of Pristiq with minimal impact and withdrawal.

I am not endorsing this withdrawal/reduction method nor am I suggesting you follow in my footsteps. I’m providing this for informational purposes only. Discuss all medication changes with your doctor.

Here’s how I’m reducing Pristiq:

  1. I started taking half the Pristiq (I was on 2 – 50mg pills) later and later in the day, one hour at a time. This takes a long time, but the withdrawal was so bad I was prepared to take as long as necessary to try to reduce/get off safely.
  2. I started taking some Welbutrin which is another antidepressant that works on norepinephrine (Pristiq is a serotonin norepinephrine reuptake inhibitor, SNRI, Welbutrin is a norepinephrine dopamine reuptake inhibitor, NDRI).
  3. Eventually, I was taking one tablet in the morning and one at night, so I just stopped taking the one at night. This meant the worst of the withdrawal would happen at night, when I was asleep. The withdrawal was negligible.
  4. Now I’m taking the second pill later and later in the day until, hopefully, I can eventually get off that one too.

Now, no doctor suggested this to me, I simply used my knowledge of psychopharmacology to do it. This means, it is in no way recommended. You should talk to your doctor. But I wanted to share, for anyone who has lived the hell I did trying to get off of this medication before.

Good luck.


How to Get Off Antidepressants Effexor/Pristiq (Venlafaxine/Desvenlafaxine) gives doctor recommended guidelines.

  1. I’ve been on prOstia 50 mg for at a least 4 years but during the past year only take it every 2 or 3 days for the most part I feel fine but sometimes I get dizzy I didn’t put it together with taking my pills like I do

  2. My husband and I have been taking Pristiq for a few months now. He became very sleepy. To make a long story short, hospital doctor told me to cut and pill in half. It is working wonderfuly. He is awake. Will keep on this regiment for a 2nd week and then give him 1/4. I have notice that I had many dreams and bad thoughts so I am doing the same.

  3. Hello – found your blog very useful, particularly this post since I am trying to get get off of Pristiq. I started it back in 2009 and want to be off of it. I was taking it with welbutrin and was able to quit that cold turkey last week but can’t just quit the pristiq daily. i take 50 mg a day. Have an appt. with my doctor on Tuesday to address this, but curious to know if the bridging technique would work with welbutrin??????? I’ve taken prozac and it works but welbutrin works better for me.

    And as for your technique, since Pristiq is all that I am taking, should i attempt with the welbutrin once again and start your method? i know you are not a doctor but wanting your “what would you do” say in this??

    • Hi Jennifer,

      I would wonder why you were getting off the Welbutrin if it works?

      That being said, if I was in your situation I would stay on the Welbutrin (or restart it) as you know it works and then start the Prozac bridging technique. Then get off the Prozac and then the Welbutrin if that’s what you’re looking to do.

      That’s my non-medical opinion. I believe that has the best chance at causing you the least grief.

      – Natasha Tracy

      • I know you can use Prozac, but I actually used Lexapro.

        The reason I used Lexapro is because I found someone on the internet who was successful with bridging off of Pristiq and the drug they used was Lexapro.

        I made a youtube channel to track my progress, I linked it in my post.

        I can give you an explanation of how I bridged, because It wasn’t the way you mostly read about.

        Basically I went on 10mg of Lexapro, and took it for a month along with my normal dose of Pristiq, Once I was at the end of the month, I dropped the Pristiq, with no taper, and continued to to take just the Lexapro at 10mg.
        I was amazed. I had hardly ANY withdrawal symptoms. The first day I had loose stools, and other than that, I had a tad bit off brain fog. The withdrawal effects were so minimal, and I would know because I cold turkey’d from Pristiq twice before. The most I made it was a week before having to go back on the meds.

        I am still on the Lexapro, This Thursday is my 3 weeks off of Pristiq

        • whoops, I accidentally posted too soon.

          This Thursday is my 3 weeks off of Pristiq, and on Friday I begin my taper from Lexapro, cutting my dose every 3 weeks.

          I hope this is of help to you or anyone else out there.


          If you have any more questions, please ask.

  4. Ive stopped taking pristiq for 3 days and im feeling so sick head spins etc. how long do withdrawl symptons take to wear off?

    • Hi Debra,

      I’m sorry there is no easy answer to that question. Everyone is different. If you’re having a lot of trouble with withdrawal symptoms I recommend you contact your doctor.

      Sorry I can’t be more helpful.

      – Natasha Tracy


    • Hi Betty,

      What you’re experiencing is withdrawal symptoms and is normal for some people. I would never tell you not to follow doctor’s advice as they know you and your individual situation and can make the best call. If a doctor feels you’re finding the withdrawal too difficult, they will generally recommend you go back on the med and they will find another way to take you off.

      Without a doubt, you should make an appointment to discuss it with him.

      Yes, these effects will diminish over time. I can’t tell you how long it will take, however. If I had to guess I’d say you are over the worst of it, but I couldn’t say that for a fact.

      You have to decide what is best for you. Can you wait for your current withdrawal symptom to go away, or do you need relief immediately?

      If you find you can’t stand the withdrawal and have to go back on Pristiq, there is now a technique they use that involves Prozac that makes it easier for people to get off Pristiq. You doctor can explain that to you, I’m sure.

      Good luck.

      – Natasha Tracy

  6. Hi Carol,

    Well, I'm glad you talked to your doctor and made a plan. Hopefully this works for you.

    Watch coming off of the Pristiq, as I've mentioned, it can be pretty nasty. If I were you I'd put plans in place, like friends and family, just in case things go wrong. But maybe you'll be lucky and it'll be easy for you. You never know.

    Meds don't actually "rewire" anything. Meds manipulate neurotransmitters which effects how often a synapse fires. It's a bit complicated but it's sort of like throwing pebbles in a glass of water – the water level goes up but the amount of water stays the same. When you remove the rocks, you're back to where you started. (This is according to everything we know about meds and the brain thus far.)

    I wish you the best of luck with this plan. Just try to follow it and don't be afraid to call your doctor if you need to.

    – N

  7. Ok, I saw the psychiatrist on Tuesday and this is the plan…when i come back from vacation on the 24th I am to quit taking Pristiq. I will take Prozac as needed to help with w/drawal and I will take another antiseizure med, zonisamide, which the dr. says will help me w/w/drawal, but he intends for me to stay on it…supposed to help with anxiety/depression..also prescribed for binge eating and studies are being done to see how this drug can help people w/alcohol abuse problems…lamactil stimulated me too much but he said the zonisamide will not necessarily behave in the same way…my mother says I should go some place to detox… i can also continue on .5 clonezepam per day and ambien as needed, we have agreed not more than twice a week except on vacation…

    If this does not work i will go back on a low dose of seroquel about 150mg and then take a statin…I think with all of the meds you eventually reach a tolerance with them…absolutely NO to any increase in benzo's…he believes they are too dangerous in the long run. And of course as "downers" can lead to depression.
    this is the first time a dr. has helped w/ the w/drawal so i'm hoping for the best and will see him the 2nd week of November…but I had symptoms from 10 mg of Prozac before…and i opened the capsules and poured some on food to get about 5 mg…constant nausea…no more antidepressants I can say that for sure.
    I think once you are on any of these meds for any length of time they rewire your brain…when i am off meds even for months I am so nervous and panic stricken and depressed I do not enjoy my life…

  8. Carol,

    You bring up a very good point about benzos. You see, it went like this:

    – barbituates were famously addictive drugs that housewives and partiers liked to take in the 60's and 70's.
    – These drugs were given out far too easily and got a bad rap. Probably rightfully so.
    – people who killed themselves often used barbituates, at least as part of the cocktail
    – benzos came in and they have similar effects to barbituates but are "lighter" (they act on fewer neurotransmitters)
    – due to the backlash from the barbituates, benzos got a bad name too

    That's my theory anyway. I have never seen a study that proves that benzos are addictive (of course, benzos due vary). (Also, the possibility of addiction is greater in those with other addictions.) Of course addiction is a slippery term and can be tough to prove.

    People become _reliant_ on benzos but as you've mentioned, it's not the same thing.

    If your anxiety was successfully controlled on a benzo I would make a strong case for trying it again, and if the doctor says no, then ask to see some research. There's really no reason why you should be in pain just because your doctor isn't up on the latest literature.

    You are exactly correct – some people can't live without their antidepressants and some people can't live without their benzos. I would be very pointed in asking the doctor what the difference is.

    (FYI, part of the definition of addiction is that it must be harming your life or the lives of others in some way. If this was not the case for you, I would challenge the doctor on that also.)

    Actually, I could go on this topic for ages, so I'll just stop, but yes, be proactive with your doctor. If something works then it works damnit! (Most of us don't even get that lucky.)

    – Natasha Tracy

  9. thanks N….yes, I'm almost positive it is the Pristiq raising my bp and triglycerides..if you look at the literature it is a side effect…and in between the seroquel and Pristiq my blood work was normal.
    i see the dr. on tues…when i was in my 20's I was on valium for anxiety…on it for 10 years with no problems…i was taken off of it because it was "addictive". that is so funny to me because when I was weaned off of it there was NOTHING like the joy of "discontinuation sydrome" which is NOT addiction. I'll take addiction any day of the week. there was a time I was depressed right before I retired from teaching…that's when i took the Paxil which did absolutely nothing for me but make me fat. I am going to come right out and ask him to put me on more clonezepam or valium at a higher dose until I am withdrawn from Pristiq…then I can start to taper til I'm at a low dose…I did very well on just 5 mg a day years ago…so what if you're addicted???? As long as you do not have to increase and I did not. The dr. told me I was psychologically addicted to valium…so what? i was happy.
    I do not understand why dr's today are so happy to give you an antidepressant but not a benzo…I have had doseage increases for every antidepressant I've taken…just in a few months…Anxiety disorders run in my family…I am just so tired of all this crap…I have had such miserable withdrawals from seroquel, paxil and even prozac. I HATE going through this again…the sickness…
    anyway thanks for your advice…I will update after I see the dr. Tues and see what he has to say…

  10. Hi Carol,

    I have to say, if the Pristiq is all you are taking (such a small amount of clonazepam isn't really a factor), those are very unusual side-effects to get. What you are describing sounds more like any antipsychotic. However, if you and your doctor agree it's the medication, then I suppose it must be.

    If Seroquel was the best for you, then you might try another antipsychotic. While they do all carry metabolic risk, some carry less than others, and you might react differently to a different one. People seem to have a good response to the newer ones, but talk to your doctor about the right med for you.

    If you don't want to go the antipsychotic route, another antidepressant is also a reasonable choice. It sounds like you've tried a few but some antidepressants manipulate different neurotransmittors than Paxil and Prozac so you might want to ask your doctor about that. Welbutrin is fairly unique, but again, talk to your doctor about which one is right for you.

    If all you are experiencing is anxiety and hot flashes I wonder if a benzodiazapine might do the trick. Again, that's something to talk to your doctor about.

    All that being said I must stress that I am not familiar with treatments for hot flashes, so that may complicate things for you in ways I don't know.

    My best advice is to sit down with your doctor, be very clear about what you symptoms are, what your side-effects are, and specifically what you want in a treatment.

    For example, "I want a treatment that will reduce my anxiety by 50% and will not cause hypertension."

    I know that seems obvious, but the more you tell the doctor what you need, the better his treatment is likely to be. He's the only one (and you) who know your medical history so he's the right person to discuss options with.

    Good luck.

    – Natasha Tracy

  11. I have been taking Pristiq 50mg for anxiety and hot flashes…been taking it for a year now. It has raised my LDL and Trigycerides both by as much as 60 pts. It has also caused hypertension….I have gained 10 pds in a year. although it has helped a little with my anxiety it is making me depressed…I am tired all of the time but not the "good" type of tired, have difficulty sleeping. I see my dr. next Tuesday. i have been on seroquel which was the best but also raised HDL and triglycerides…lamactil which almost drove me crazy and only 10 mg of Prozac which made me nuts. years ago I took Paxil and gained 35 pds…any advice? I also take .50 mg of clonezepam at bedtime…

  12. I love Pristiq I dont want to stop taking it. Plus you can't beat the side effect of weight loss! :)

  13. Effexor is awful, I would literally start vomiting if I was one hour off my time to take it. Somehow, my (formerly evil) psychiatrist switched drugs on me on miraculously, no side effects when I changed. I wonder if there's something similar for you and Pristiq?

  14. I've heard a lot of horror stories about Effexor. I can't say being _on_ Pristiq is a nightmare, but trying to get off of it sure is.

    I have my own horror drugs. Geodon was the_worst_one_ever. But that's me.

  15. Effexor was awful for me! I literally could hear people breathing from across the room…it heightened all of my senses and not in a good way. It also made me feel like my heart was going to explode. I wouldn't give it to a dog…I didn't like!