Antidepressant Comparison: Are Pristiq and Effexor the Same?

Does Pristiq Just Serve to Extend the Effexor Patent?

If you live in the US, you’ve probably seen all the commercials for the new and pastel-pink-coloured antidepressant Pristiq. (Yes, prescribed for depression.) Pristiq is new and has a huge marketing push behind it and is a selective serotonin norepinephrine reuptake inhibitor (SNRI) antidepressant. In other words, it’s an antidepressant that works on both serotonin and norepinephrine neurotransmitters. It is not the only antidepressant to do this, but SNRIs are a smaller class of drugs than those that just effect serotonin alone (like Prozac). (Although admittedly, there seems to be a suspicious number of SNRI antidepressants in development.)

Pristiq and Effexor Are Almost the Same Drug

What you might not know, is the same company that makes the drug Pristiq (Wyeth) also makes Effexor, which is an almost identical antidepressant, and Effexor has recently become available in generic form (Venlafaxine). Pristiq, O-desmethylvenlafaxine, is actually the main metabolite of Effexor, venlafaxine hydrochloride.

Should We Ignore Pristiq Because We Have Effexor?

This means that if you take Effexor, your body breaks it down into Pristiq and other chemicals. Yes, Pristiq and Effexor are almost the same drug.

So Pristiq is the Same Drug as Effexor?

For this reason, some people say Pristiq is nothing but a “patent extender”. In other words, Wyeth’s patent ran out on one drug (Effexor), so they patented another, almost identical, antidepressant (Pristiq) to keep up their profits.

This, is probably true. If I were a company exec, I would understand that this is an easy way to make money.

And some doctors are claiming that Pristiq should simply be “forgotten about“.

No, Pristiq Is Not the Same Antidepressant as Effexor

The thing is, they are not the same drug. A metabolite is not the same this as the initial compound. When you take Effexor your body metabolizes it into Pristiq and other stuff. That “other stuff” might be good for you, or it might not. It depends on who you are. We all have different needs and chemistries.

Pristiq Has Fewer Side Effects Than Effexor?

But what I think can’t be argued is the fact Pristiq has to, by definition, have fewer side effects on the whole than Effexor. For an individual this may or may not be true, but overall it has to be because Effexor contains more compounds. That’s just logic. (It’s also logical to assume less withdrawal effects too.)

People May Respond or Tolerate Pristiq Where They Didn’t Effexor

Regardless though, even if these two antidepressants are very similar, some people will respond to Pristiq that did not respond to Effexor or could not tolerate the side effects of Effexor. This is a certainty. We, and mood disorders, are all so different that it is obviously true some people will have this response. [push]Quite frankly, Effexor has a lot of side effects and withdrawal issues associated with it, so it wouldn’t surprise me if even a slightly cleaner version would be better tolerated.[/push]

And most importantly, if you and your mental illness fall into the category of people who are helped by Pristiq, who were not helped with Effexor, you really don’t give a shit about patents, metabolites, profits, or self-righteous doctors. You just care you’re being helped. You just care you’re less depressed. And that’s really all you and your doctor should care about. Let doctors be concerned about drug politics on their own time.

Pristiq Will Help Some (Probably Intractably Depressed) People

And that group of people is precisely why doctors should not forget about Pristiq, or any other drug. Humans are unique and many of us depressed/bipolar/other are very difficult to treat, and removing tools from a psychiatrist’s tool belt just because they upset some self-righteous doctor’s situationally convenient morals, is ridiculous.

Is the pharmaceutical company just looking for profits? Yes, of course they are. Is there first concern helping people? No, it probably isn’t. Are the research numbers on Pristiq stunning? Not really. But if you’re in the group of people helped by this antidepressant, you don’t care.

Those of us who have been in treatment for a mental illness for a while know that it’s all a crap shoot anyway, so why take away an option that might get you better? It’s just a stupid thing to do.

Notes

Note #1: All that being said, if you’re successful on Effexor, don’t just switch to Pristiq, those other chemicals in Effexor might be the ones helping you. No one can predict whether you’ll have the same reaction to Pristiq. If something is working – don’t mess with it!

Note #2: I’m not endorsing either drug here, just suggesting not ruling them out.

Note #3: Pristiq isn’t my favorite medication. It has absolutely brutal withdrawal symptoms that (for me) kick in within two hours of expected dosing time. I gather this also happens with Effexor, and Effexor’s withdrawal effects tend to be even worse.

Antidepressant Comparison: Pristiq Vs. Effexor

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