Effexor Vs. Pristiq: Drug Comparison

The information below is about Effexor XR^®, an extended-release formulation of venlafaxine. This information may not be accurate for the immediate-release formulation, Effexor^®.

Effexor XR (venlafaxine extended-release) is a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat mood disorders by increasing the available levels of serotonin and norepinephrine in the brain, which helps regulate mood and anxiety. Its FDA-approved indications include major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. Off-label uses may include treatment for migraine prevention as well as treatment for premenstrual dysphoric disorder (PMDD) and neuropathic pain. Effexor XR comes in extended-release capsules, taken once daily. Common side effects include nausea, dizziness, insomnia, and sweating. It has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the early stages of treatment.

Pristiq^® (desvenlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat major depressive disorder (MDD) by increasing the available levels of serotonin and norepinephrine in the brain, which helps improve mood and emotional balance. Its FDA-approved indication is for the treatment of major depressive disorder in adults. Off-label uses may include managing anxiety disorders, hot flashes related to menopause, and other mood disorders. Pristiq comes in extended-release tablet form, taken once daily. Common side effects include nausea, dizziness, dry mouth, male sexual dysfunction, and insomnia. It carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial stages of treatment.

Serotonin and norepinephrine reuptake inhibitor (SNRI)

Serotonin and norepinephrine reuptake inhibitor (SNRI)

Effexor XR (venlafaxine hydrochloride) is indicated for the treatment of adults with:

• Major depressive disorder (MDD)

• Generalized anxiety disorder (GAD)

• Social anxiety disorder (SAD)

• Panic disorder (PD)

Pristiq (desvenlafaxine succinate) is indicated:

• For the treatment of adults with major depressive disorder (MDD)

• Typically taken orally once daily

• Comes in 37.5 mg, 75 mg, and 150 mg extended-release capsules

• Typically taken orally once daily

• Comes in 25 mg, 50 mg, and 100 mg extended-release tablets

Most common adverse reactions (incidence ≥5% and at least twice the rate of placebo):

• Nausea

• Sleepiness

• Dry mouth

• Sweating

• Abnormal ejaculation

• Anorexia

• Constipation

• Impotence (men)

• Libido decreased

Most common adverse reactions (incidence ≥5% and twice the rate of placebo in the 50 or 100 mg dose groups) were:

• Nausea

• Dizziness

• Insomnia

• Excessive sweating

• Constipation

• Sleepiness

• Decreased appetite

• Anxiety

• Specific male sexual function disorders

• Hypersensitivity to venlafaxine hydrochloride, desvenlafaxine succinate, or any excipients in the Effexor XR formulation

• Concomitant use of monoaminoxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI

• Hypersensitivity to desvenlafaxine succinate, venlafaxine hydrochloride, or any excipients in the Pristiq formulation

• Serotonin syndrome and MAOIs

• Serotonin syndrome

• Elevated blood pressure

• Increased risk of bleeding

• Angle‑closure glaucoma

• Activation of mania or hypomania

• Discontinuation syndrome

• Seizures

• Low blood sodium

• Interstitial lung disease and eosinophilic pneumonia

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for symptoms of poor neonatal adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate

• Serotonin syndrome

• Elevated blood pressure

• Increased risk of bleeding

• Angle closure glaucoma

• Activation of mania/hypomania

• Discontinuation syndrome

• Seizure

• Low blood sodium: Can occur in association with SIADH.

• Interstitial lung disease and eosinophilic pneumonia

• Sexual dysfunction

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric patients and young adults taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors.

Effexor XR is not approved for use in pediatric patients.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased the risk of suicidal thoughts and behaviors in children, adolescents and young adults taking antidepressants.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

Pristiq is not approved for use in pediatric patients.

*This information is from the label for brand name Effexor XR^®. See the Full Prescribing Information for more complete information. Venlafaxine, the active ingredient in Effexor XR, is also the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient venlafaxine.

*This information is from the label for brand name Pristiq^®. See the Full Prescribing Information for more complete information. Desvenlafaxine, the active ingredient in Pristiq, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient desvenlafaxine.