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Pristiq XR (Desvenlafaxine) is an extended-release antidepressant manufactured by Pfizer. It belongs to the serotonin-norepinephrine reuptake inhibitor (SNRI) class of medications and is FDA-approved for the treatment of major depressive disorder (MDD) in adults. Desvenlafaxine is the active metabolite of Venlafaxine (Effexor XR). It is also used off-label for generalized anxiety disorder, hot flashes associated with menopause, panic disorder, neuropathic pain, and fibromyalgia.
Pristiq XR works by inhibiting the reuptake of serotonin and norepinephrine in the brain. By blocking the reabsorption of these two key neurotransmitters, Desvenlafaxine increases their levels in the synaptic cleft, which helps improve mood and relieve symptoms of depression. The extended-release formulation allows for once-daily dosing. Tablets should be swallowed whole and not crushed, chewed, or dissolved. It can be taken with or without food.
The recommended dose for most adults is 50 mg once daily. Doses up to 400 mg/day have been studied, but higher doses have not been shown to provide additional benefit and are associated with more side effects.
Pristiq XR scores a 75 out of 100 on our findability scale, meaning most patients can locate it without too much trouble. There is no current FDA-listed shortage for Desvenlafaxine or Pristiq. However, some patients have reported sporadic difficulty finding specific strengths or formulations at certain pharmacies. Generic Desvenlafaxine is widely available and easier to find than brand-name Pristiq. If your local pharmacy is out of stock, Medfinder can help you locate nearby pharmacies that have it available.
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Several types of healthcare providers commonly prescribe Pristiq XR:
Pristiq XR is also available through telehealth services, making it convenient to get a prescription without an in-person visit.
No, Pristiq XR is not a controlled substance. It is not classified under any DEA schedule. However, it should not be stopped abruptly, as doing so can cause discontinuation symptoms such as dizziness, nausea, headache, and irritability. Always taper off Pristiq XR under medical supervision.
Serious side effects to watch for include serotonin syndrome, increased blood pressure, abnormal bleeding, hyponatremia, and seizures. Pristiq XR carries a boxed warning about increased risk of suicidal thinking and behavior in young adults (ages 18–24).
Pristiq XR is an effective SNRI antidepressant for adults with major depressive disorder. With a findability score of 75, it is generally accessible, though some patients may experience occasional difficulty finding specific strengths. Generic Desvenlafaxine offers a significantly more affordable option at $18–$30 with coupons compared to $400–$543 for brand-name Pristiq. Pfizer also offers a savings card that can bring the brand cost down to as little as $4 per fill for eligible commercially insured patients. If you're having trouble finding Pristiq XR at your local pharmacy, use Medfinder to search for pharmacies near you that currently have it in stock.