How Pristiq (Desvenlafaxine) Works for Panic Disorder

Pristiq pills on a counter

Tom Varco / Wikimedia Commons

Antidepressant medications are frequently prescribed to help manage the symptoms of panic disorder.

What Is Pristiq?

Pristiq (desvenlafaxine) is one type of antidepressant medication commonly used in the treatment of panic disorder.

Type of Antidepressant

Pristiq belongs to a class of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs). Other common SNRIs include Effexor (venlafaxine) and Cymbalta (duloxetine). These medications were first used to treat mood disorders, such as major depressive disorder.

SNRIs were later found to be an effective treatment for a variety of mental health conditions. Currently, SNRIs are also used to treat panic disorder, agoraphobia, obsessive-compulsive disorder (OCD), and social anxiety disorder (SAD). They've also been found to be beneficial in treating pain associated with medical conditions like fibromyalgia and chronic fatigue syndrome (CFS).

Pristiq and Panic Disorder

Naturally occurring chemicals in the brain, known as neurotransmitters, are responsible for various bodily functions. These chemical messengers are believed to be imbalanced for those with mental health conditions.

Antidepressants work to restabilize certain neurotransmitters.

Pristiq specifically impacts the neurotransmitters serotonin and norepinephrine, both of which are thought to be dysregulated in people with panic disorder. Serotonin influences many functions including your mood and sleep regulation.

Norepinephrine is connected to the fight-or-flight response, which is the way you react to stress and anxiety. Pristiq can help bring equilibrium to these two neurotransmitters, leading to reduced anxiety, less severe panic attacks, and enhanced mood.

Common Side Effects

As with any prescribed medication, there are potential side effects of taking Pristiq. Here are some of the most common side effects:

  • Constipation
  • Dry mouth
  • Drowsiness and fatigue
  • Yawning
  • Sexual side effects
  • Dizziness
  • Sweating
  • Appetite loss
  • Strange dreams

You may experience some, all, or none of these side effects. Typically, they diminish or become more manageable over time. When taking Pristiq, consult your doctor if your side effects persist or worsen.

Serious Side Effects

Contact your prescribing doctor or pharmacy immediately if you show any strange symptoms or any of these serious side effects:

  • An allergic drug interaction, such as difficulty breathing, swelling of the face, mouth, or tongue, choking sensations, rash, or hives
  • Headache
  • Nausea
  • Cough
  • Seizures
  • Nosebleeds
  • Weakness
  • Difficulty concentrating
  • Falling
  • Fainting
  • Confusion
  • Unusual bleeding or bruising
  • Hallucinations
  • Fever
  • Vomiting
  • Diarrhea
  • Chest pain
  • Coordination difficulties

How Long It Takes to Work

You probably won't notice immediate improvements when taking Pristiq for the symptoms of panic disorder. Though you may notice changes within a few days to a few weeks when you're first on Pristiq, it may take some time following your treatment plan to see the fuller effects.

Risk Factors

Some of the risk factors involved in taking Pristiq include:

  • Black box warning: In 2007, Pristiq and other antidepressants were given what's called a “black box warning.” This label was prompted by the U.S. Food and Drug Administration after it was determined that these medications could potentially increase the user’s risk of suicidal thoughts and behaviors. Adolescents and young adults can be especially impacted by this possible side effect. Any young person taking Pristiq must be closely monitored for mood alterations and suicidal thoughts.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

  • Alcohol consumption: Drinking alcohol is not recommended while taking Pristiq as doing so may increase the toxicity of this medication. This can lead to ineffectiveness.
  • Pregnancy/nursing: It's possible to pass Pristiq to a child during pregnancy or through breast milk. If you're pregnant or nursing, consult your doctor about the possible risks of taking Pristiq.
  • Older adults: The side effects of Pristiq can be more intense for older adults. Monitoring and dosage changes can be made to reduce side effects in older adults.

A Word From Verywell

The information provided here is meant to be an overview of using Pristiq for panic disorder. It doesn't cover all possible scenarios, such as overdose symptoms, precautions, and contraindications. Always consult your medical provider or pharmacist about any questions or concerns you may have about your Pristiq prescription.

3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bighelli I, Castellazzi M, Cipriani A, et al. Antidepressants versus placebo for panic disorder in adults. Cochrane Database Syst Rev. 2018;4:CD010676. doi:10.1002/14651858.CD010676.pub2

  2. Sansone RA, Sansone LA. Serotonin norepinephrine reuptake inhibitors: A pharmacological comparison. Innov Clin Neurosci. 2014;11(3-4):37-42.

  3. Liebowitz MR, Tourian KA. Efficacy, safety, and tolerability of Desvenlafaxine 50 mg/d for the treatment of major depressive disorder:a systematic review of clinical trials. Prim Care Companion J Clin Psychiatry. 2010;12(3). doi:10.4088/PCC.09r00845blu

Additional Reading

By Katharina Star, PhD
Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness.