How Do You Taper Pristiq (Desvenlafaxine)?

In our latest question and answer, the pharmacist discusses how to taper off of Pristiq (desvenlafaxine).

Feb 06, 2018

Becca asked

I take Pristiq (desvenlafaxine) daily for mild depression and anxiety. I am on a very low dose, only 25 mg daily, whereas the starting dose is typically 50 mg. I don’t really like it, it does keep my anxiety somewhat at bay, but the side effects are not worth it. My question is, since I am on such a low dose already (also I have only been taking it for 4 or 5 months), would it even be dangerous to stop taking it? My depression is not that bad, I only started taking this to give myself a little kick in the pants. I’d rather figure it out without this medication. Thank you for your time.

Answer

For several different medications, tapering is recommended to prevent potential withdrawal symptoms and a worsening of the disease state (e.g. depression). There generally is not one single recommended tapering method that applies to all medications and all patients. Methods employed tend to be very individualized based on someones medical history, age, length of prescription use etc...

Most antidepressants are recommended to be tapered if an individual has been on them for as little as a few months. For Pristiq (desvenlafaxine), a SNRI (Selective Serotonin-Norepinephrine Reuptake Inhibitor), some sources recommend tapering the medication if it has been taken for as little as one week!

When tapering Pristiq, potential withdrawal symptoms are noted by the acronym FINISH:

  • Flu-like symptoms
  • Insomnia
  • Nausea
  • Imbalance
  • Sensory disturbances
  • Hyperarousal

If symptoms do occur, they are typically mild and usually begin within a week of starting your taper and last anywhere from a few days to a few weeks.

As mentioned above, there is no single recommended way to successfully taper off of Pristiq. One commonly used method is as follows:

  • Reduce your current dosage of Pristiq by 25% every four to six week. Adjust tapering schedule based on symptoms and tolerability.

As everyone's situation and medical history in unique, it is important to speak with your doctor to discuss which tapering method is the best option for you.

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