The Difference between VENLAFAXINE (EFFEXOR) and DESVENLAFAXINE (PRISTIQ) | A Psychiatrist Explains

Venlafaxine (EFFEXOR) is a serotonin and noradrenaline reuptake inhibitor (SNRI) that is indicated for major depressive disorder (MDD), generalized anxiety disorder, social anxiety disorder, and panic disorder with or without agoraphobia.
Desvenlafaxine (PRISTIQ) meanwhile is a synthetic succinate version of venlafaxine’s major active metabolite, although its approval is limited to MDD.
#venlafaxine #desvenlafaxine #effexor #pristiq #antidepressants
Dr Sanil Rege explains the difference between the two.
1. Venlafaxine sequentially inhibits Serotonin transporter (SERT) and Noradrenaline Transporter (NAT).
2. Venlafaxine has a 30-fold higher affinity for the reuptake of serotonin over noradrenaline whilst desvenlafaxine has a 10-fold affinity
3. Venlafaxine at its minimal effective dose in depression (75 mg/d), venlafaxine acts as a selective 5-HT reuptake inhibitor. In contrast, when administered at higher doses (225 and 375 mg/d), it acts as a dual 5-HT and NE reuptake inhibitor exhibiting dose-dependent pharmacology in relation to efficacy and tolerability.
4. The sequential inhibition of serotonin and NA is reflected in its side effect profile-that initial side effects are predominantly related to serotonin (e.g., headaches, nausea, fatigue, sexual dysfunction). In contrast, subsequent side effects with higher dosing are related to serotonin and norepinephrine (e.g., activation effects, dry mouth, night sweats).
5. Desvenlafaxine, on the other hand, blocks the serotonin and norepinephrine reuptake at starting doses.
Both Venlafaxine and desvenlafaxine have applications in a range of disorders beyond depression and anxiety.
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[@maxasaurus3008]

If there are any prescribing medical professionals reading this PLEASE don’t think of Effexor if you can avoid it: the normal taper off is BRUTAL! Very hard to get off! The Brain Zaps suck! Love you guys ❤❤

[@UsagiMochi1]

Finally thank you so much!! I been looking for an explanation. I have tried both and could not figure out why Effexor works better when Pristiq is what Effexor breaks down to. God bless you for doing this!! Totally going to save this for my psychopharmacology class!!

[@Mountain_Spirit]

You will never be able to get off Pristiq. Don’t take it

[@jeewanrajnirola4789]

Thank you sir. You may not be getting views you deserve. But sir you are helping us. Huge respect.

[@dopaminergik]

Excellent and clear explanation. Desvenlafaxine was a revelation for my treatment-resistant depression. Now I understand why it didn't work with venlafaxine (especially at lower doses).

[@Trish-ql9kz]

Started on 37.5 mg for 5 weeks, now on 75,5 for the past 4 weeks and not feeling any better, I also take 30mg mirtazapien at night, been taking that for 10 weeks, will have to up the dose of venlafaxine... was on Prozac for three months before taking this with no effect either!

[@meredithfriday7798]

This is very fascinating. I was on Cymbalta for several months and it did nothing for my GAD. The doctor switched me over to Effexor XR and I’m on 225mg. It has saved my life. I can function and it has made me feel like myself again. So thankful for these medications. Thank you for this video

[@tiffanykivett4221]

Why don't think they just find out what is causing the issues.

[@DanielSRosehill]

Dr Rege - could you do a video about the relationship between dopamine and norepinephrine?

[@jasonborne5359]

I got pins and needles with effexor. They are switching me to cymbalta. Im being prescribed for vestibular migraines

[@diveshbachoo5621]

From Mauritius. You are doing a great job! Keep up the good work to help doctors worldwide!

[@steveaguay]

Thank you! Interesting to learn about as I just started pristiq. And I never knew what emotional blunting was a side affect and possibly what my last anti depressent did to me

[@nikkik1977]

This was awesome! Especially for patients. Thank you for explaining this.

[@DanielSRosehill]

This was a fascinating explanation!

[@solala1312]

thank you for the clear explanation and the subtitles! I'm on venlafaxine and the side effects of higher doses that you described are very accurate. it's a life saving drug and I'm willing to trade it off because I can manage my life again.

[@leeboriack8054]

Thank you for the great information, doctors don’t take time share because of hourly patient quotas. Pls consider intro music that would cater to an educated listener. The music is fun but reminds me of my party hard days as college kid.

[@drmohammadashraflone9979]

So nice to watch this your informative video clip since I am on"Venlaxaine,37.5 SR"once daily and assume good results in my anxiety with depressive illness disorder taking for last 6 months and feel nothing like that to increase the dosage, thank you sir for your further informative clip regarding this subject...

[@kingrabbit7360]

Well shoot. I thought it was my body getting used to the medication and that's why my Anxiety would come back a few months after increasing dosages. Very well explained video. Thank you.

[@Tailsthef0x]

From what I understand venlafaxine needs greater dosage to show increase in norepinephrine whereas devenlafaxine requires lower dosage.

[@THEJIG-IS-UP]

Greetings from Arkansas. I stumbled upon your video. Very informative. I just was prescribed venlafaxine for chronic fatigue that has lasted off and on almost 2 yrs now. I'm hoping that it works. I'm having trouble urinating right now from the side effect. I trust that goes away. Thanks for the video. God bless