Could Pristiq Help My OCD?

You have tried every SSRI in the book, but they are just not working. So, your doctor decides to try something new with you – a new approach. Its name? Pristiq. Pristiq is an SNRI (slightly different than your go-to SSRI). Could it work? You hope so, but you are skeptical. Your therapy sessions are going well, but it is not enough. 

You fear that you are experiencing treatment-resistant OCD so much that you have begun to obsess over that as well. You need something to work because you are at your wits-end. So, you decide to give Pristiq a chance…but you need some information about it first. The last thing you need is for this medication to make your OCD symptoms worse.

Well, you are in luck because this article will help you muddle through all of the information out there about Pristiq, and especially Pristiq for OCD. Should you try it or not is the question. With this article, you will attain enough information as to if this medication will be beneficial for your type of OCD.

What is OCD?

Well, OCD, clinically known as obsessive-compulsive disorder, is a chronic anxiety condition that affects millions of people all over the world. OCD is large, complex, and powerful. It is also very real, lonely, and debilitating. It can and will affect your life in all sorts of ways – with no mercy or compassion. OCD is so all-encompassing that it can prevent you from leaving your home, keeping a job, maintaining friendships and relationships, and just feeling good about yourself. 

This anxiety condition makes you feel ashamed and guilty, which in turn makes you want to “hide” it from the people you love. There are many “types” of OCD, ranging from hoarding OCD to reading OCD – each one as life-altering as the next one. And, because there are no “official” OCD tests (it is diagnosed through observation, self-reports, and psychological tests), it is often misdiagnosed – or dismissed altogether. 

When this occurs, it prolongs OCD treatment, who desperately needs it. However, the good news is OCD is highly treatable. In fact, the standard OCD treatment involves a variety of therapies, ranging from cognitive-behavioral therapy (CBT) and exposure-response and prevention (ERP) therapy to acceptance and commitment therapy (ACT) and other therapies, such as TMS and EDMR “trauma” therapies, to individual counseling, couples/marriage counseling, addiction counseling, grief counseling, group counseling, family therapy, etc. 

The go-to therapy for OCD is ERP therapy. If counseling/therapy alone is ineffective a doctor may prescribe one or more medications to help get your OCD symptoms under control. The go-to medication for OCD is SSRI antidepressants, like Prozac, Zoloft, Luvox, and Paxil. When your OCD symptoms fail to respond to therapy, this is called treatment-resistant OCD. 

Natural remedies, holistic/alternative treatments, and self-help tools, like mindfulness meditation, hypnotherapy/hypnosis, healthy coping skills and strategies, crystals, CBD, a healthy diet with lots of vitamins and minerals, OCD forums, support groups, books, and podcasts, and online OCD treatment programs, like Impulse Therapy, are also great ways to wrangle your OCD symptoms under control.

What is Pristiq?

Pristiq (desvenlafaxine) is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. More specifically, Pristiq boosts serotonin in the brain. Serotonin is a hormone/neurotransmitter that affects how a person thinks and behaves. People with mental health conditions, like OCD, tend to have low levels of serotonin and norepinephrine in their brains. Pristiq blocks the reuptake of serotonin and norepinephrine, unlike selective-serotonin reuptake inhibitors (SSRIs) that only block serotonin.

What is Pristiq FDA-Approved to Treat?

Pristiq is only FDA-approved to treat major depressive disorder (MDD).

Is Pristiq Available in a Generic Form?

Yes, it is. 

Pristiq is available as a brand-name drug or as a generic (desvenlafaxine) and comes as an extended-release tablet

What Dosages and Forms Does Pristiq Come In?

Pristiq is available in extended-release tablets taken once a day in three strengths: 25mg, 50mg, or 100mg.

Do I Need a Prescription for Pristiq?

Yes, Pristiq is only available with a prescription.

Can I Take Pristiq While Pregnant?

Yes, you can but use caution. Although, Pristiq may be safe for many pregnant women. It could cause serious side effects, like high blood pressure or preeclampsia, in some pregnant women. Keep in mind that no well-controlled studies have been conducted on if Pristiq can harm your unborn baby so you must speak with your doctor if you are pregnant or plan to become pregnant while on this medication.

Can I Breastfeed While on Pristiq?

Similar to being pregnant while on Pristiq, breastfeeding while on Pristiq is possible, but there are no well-controlled studies on the effects of Pristiq on a breastfed baby, so ultimately it is unknown if the medication will pass through your breastmilk to your child. There is also no data on how the medication will affect your baby if he or she is exposed to it. So, discuss the pros and cons of using Pristiq while breastfeeding.

Will Pristiq Interact with My Other Medications, Vitamins, or Herbs?

It is possible. 

Pristiq like other medications may interact with other medications, vitamins, and herbs. 

• Let your doctor know if you are taking opioids, sleeping pills, muscle relaxers, or anxiety or seizure medications.
• Many prescription and over-the-counter medicines and herbal products can increase your risk of bleeding if you take them while also taking Pristiq. These medications include blood thinners (i.e., warfarin), and NSAIDs (i.e., aspirin, ibuprofen, etc.).

Can I Drink Alcohol While Using Pristiq?

Alcohol is generally not recommended while on Pristiq, however, your doctor may allow you to drink moderately while on the medication.

How Long Can I Use Pristiq?

Pristiq is designed to be used long-term. It is important to use the medicine at least 4-to-9 months after your depression or OCD symptoms improve. Taking your medication and following your treatment plan can help reduce your risk of depression or OCD symptoms returning in the future. Some people experience an OCD relapse if they abruptly stop taking their medication, so it is important to talk with your doctor before stopping the medication.

What Are Pristiq’s Side Effects?

Like almost all medicines, Pristiq comes with mild-to-severe side effects. 

Mild Side Effects

• Nausea
• Dry “Cotton Mouth”
• Fatigue 
• Dizziness
• Profuse Sweating
• Constipation
• Poor Appetite
• Sleepiness or Drowsiness
• Insomnia 
• Anxiety
• Sexual Issues (i.e., Erectile Dysfunction, Low Libido, Impotence, Premature Ejaculation, etc.)

Serious Side Effects

Although rare, Pristiq can cause serious side effects in some people. 

• Worsening Depression
• Thought of Dying or Self-Harm
• Suicidal Ideation (i.e., Suicidal Thoughts and/or Attempts)
• New or Worsening Anxiety 
• Panic Attacks
• Agitation 
• Restlessness
•  New or Worsening Insomnia 
• Irritability
• Anger
• Aggressive Behaviors
• Extreme excitement 
• Extreme Activity
• Excessive Talking or Talking Fastly
• Impulsiveness
• Serotonin Syndrome (Too Much Serotonin in Your Brain). Symptoms may include: Accelerated Heart Rate, Dizziness, Profuse Sweating, Facial Flushing, Tics, Tremors, or Twitching, Stiff Muscles, Loss of Coordination, Nausea, Vomiting, Diarrhea, Agitation, Hallucinations, Seizures, and/or Coma
• New or Worsened High Blood Pressure. Symptoms may include: Headaches and Chest Pain
• Easy Bleeding. Symptoms may include: Nosebleeds, Excessive Bruising, Vomiting Blood, Bloody Stools, and/or Tar-Colored Stools
• Closed-Angle Glaucoma (Sudden Accumulation of Pressure Inside the Eye). Symptoms may include: Seeing Haloes Around Lights, Blurred Vision, Eye Pain and/or Redness, Sudden and Severe Headache, and/or Nausea
• Low Blood Sodium Levels. Symptoms may include: Headache, Trouble Focusing, and Concentrating, Loss of Memory, Mental Confusion, Weakness or Unsteadiness, Hallucinations, Fainting, and/or Seizures
• Lung Problems. Symptoms may include: Trouble Breathing, Coughing, and/or Chest Pressure and/or Pain
• Seizures. Symptoms may include: Involuntary Muscle Spasms, Loss of Consciousness, Drooling, Sudden Eye Movements, and/or Loss of Bowel or Bladder Control
• Allergic Reaction

Can Pristiq Be Used to Treat OCD?

Yes, it can. 

However, Pristiq is not FDA-approved for OCD, so it would have to be used “off-label” for the condition. 

What is the Ideal Pristiq Dosage for OCD?

The ideal Pristiq dosage for OCD is 50mg once daily with or without food. The 50mg dosage is both the starting dose and the therapeutic dose.

Is Pristiq Effective for OCD?

Because Pristiq is not FDA-approved for OCD, it has not been properly studied for its effectiveness in the treatment of this condition. More research is needed to determine if Pristiq is effective for the majority of OCD sufferers.

What is It Like to Take Pristiq for OCD?

The best way to determine if a medication, like Pristiq, can and will be beneficial for you is to hear other people’s experiences with it. 

Listed below are real-life Pristiq reviews from OCD sufferers, who either took it in the past or who are currently taking it for their OCD symptoms: 

Samantha

“I have been struggling with OCD for as long as I can remember (22F), coinciding with a later diagnosis of PTSD. Intrusive thoughts, and counting, and my hands are always extremely dry from all the handwashing. At the beginning of the pandemic in March of 2020, I decided to finally go on medication for the first time (health anxiety/intrusive thoughts at the beginning of the pandemic were too overwhelming), so I was prescribed Prozac. 

After about a month and a half, it clicked. I realized this is how people live; my intrusive thoughts diminished, and I could finally live my life without looking for the nearest sink to scrub my hands. The biggest side effect though was my libido. I was numb, and having a healthy sexual life is extremely important to me, whether with my partner or solo. Rather dumb on my part, I went off my medication, because I felt like I could once again tackle my compulsions on my own and regain my sex drive back. 

Flash forward to February 2022. I decide to go back on medication, and explicitly tell my doctor that I want a sex drive. I’ve been taking 50mg of Desvenlafaxine (Pristiq) daily, since mid-February. My doctor said it should take about 2 weeks to kick in. So far, I haven’t seen a change.” 

Katherine

“My intrusive thoughts were worse in the first month or two of taking Pristiq 50mg (at the time) but slowly got better as I got used to the medication. I did up my dosage to 100mg to help furthermore, and it did for a long while (around a year). It has been a year and 5 months now, and now I get the odd intrusive thoughts a few times a week, which is a huge improvement for me considering I used to have them almost 24/7, from the ages of 7-18. 

I still experience a lot of symptoms of OCD. The only thing Pristiq helps me with is intrusive thoughts, however, it has given me a lot of brain fog and dissociation problems, which may be why my intrusive thoughts have stopped. What I mean by that is brain fog and dissociation are negative side effects of Pristiq. But it helps my intrusive thoughts because they were quite literally making my thought processes horrible.”

Bobby

“Thank you so much for all your insight!! I felt like Pristiq was making me unbelievably worse. I usually have a nighttime routine that takes me 15 minutes to do, but after taking Pristiq for 2 months, I was doing my routine for upwards of 45 minutes. I was trying not to get angry because I did not know why it was so heightened, and I just wanted it to stop. So, I weaned myself off, which helped A LOT. For the last two weeks, I have been taking a small hit of a pen that I got at a dispensary just to help calm me down at night. So far, it has been working! 

I am too tired to keep redoing things for 30 minutes, and all I can think about is sleep. I used to take Prozac back in 2020, and it worked REALLY well. I had a breakthrough where I was like “Wow, this is what normal people think.” The only downside and the reason I stopped taking it was it killed my sex drive, just completely numb. I definitely recommend trying Prozac, and seeing how it affects you!”

Lindsey

“I hope that ultimately you can find something helpful. Pristiq was a game-changer for me. I suffer from OCD and BDD and really struggle with intrusive thoughts. I have learned coping skills with therapy interventions (CBT and ERP therapy), but the Pristiq really helped with the irritability, depression, and anxiety. I was once on Anafranil, which is a tricyclic antidepressant that targets OCD, and IT WORKED, but whoa, the side effects were terrible, and getting off of it was a NIGHTMARE. It does work though. Therapy was sooooo helpful, so if that is not already part of your journey, I encourage it.”

Mack

“I took this medication after taking citalopram for several years. The citalopram worked well, but it wasn’t fully helping my OCD symptoms. I took a genetic test to help choose what drugs would be best for me and my issue, and desvenlafaxine (Pristiq) was the only one noted that was not supposed to cause me side effects and work best for my body. 

At first, the side effects were very little on 25mg, jaw tightening, some headaches, and weird dreams, but my anxiety and OCD were doing pretty well. But I was still tapering off citalopram, so I think the two together were doing this. By the time I very slowly tapered off citalopram and reached 50mg of Pristiq, my headaches were outrageous, mood swings, heart palpitations, and weird dreams. 

My doctor put me back down to 25mg, and the headaches went away for about 2 weeks, and then came back daily, lightheaded, lost my train of thought, had heart palpitations daily, and had mood swings after 4 more weeks. I did take a genetic test which said this medicine is best for me, but clearly it is not. I will say that when I was on 50mg, it definitely helped my anxiety and OCD, but the headaches were just too horrible to bear it. My blood pressure also went up while on it.”

Is There Anything Else I Should Know About Pristiq Before Taking it for OCD?

Yes, there are some things you should know before taking this medication for OCD.

Consult your doctor before taking Pristiq if you have one or more of the following conditions: 

• Heart Disease
• High Blood Pressure
• High Cholesterol
• A History of Strokes
• Bipolar Disorder (Manic Depression)
• Depression
• Suicidal Thoughts
• Liver Disease 
• Kidney Disease
• Glaucoma
• Seizures or Epilepsy
• Sexual Issues
• Lung Problems
• Breathing Problems
• Easy Bleeding or Blood-Clotting Disorder
• Low Blood Sodium Levels

References

Drugs.com. (n.d.). Pristiq. Retrieved from https://www.drugs.com/pristiq.html#before-taking