Pristiq vs. Effexor & Other Drugs Comparison

Last Updated: April 2, 2024

Nena Messina Authored by Nena Messina, Ph.D.
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There are many drugs similar to Effexor that can be used for treating anxiety and depression, but they work in different ways. These medications may be used for patients who cannot afford Effexor or have contraindications to its use. In some cases, alternatives may have fewer side effects. Sometimes comparing Effexor vs. Zoloft or Effexor vs. Lexapro, one may find out that these alternatives can be safer and have fewer side effects. A healthcare provider can recommend which antidepressant is more suitable in each case. Switching to another medication without a doctor’s advice may be dangerous to health.

Pristiq vs. Effexor

Venlafaxine and Pristiq (desvenlafaxine) are grouped in a class of medications called SNRIs (selective serotonin and norepinephrine reuptake inhibitors). Both are approved to treat depression. They are available as extended-release oral tablets.


The half-life of Venlafaxine and desvenlafaxine is about 12 hours. It means that they will leave the person’s system approximately after the same period. Drinking on Effexor or Pristiq is dangerous and is not recommended.

Pristiq and Effexor pills and other pills on the table.

Speaking about similarities with Pristiq vs. Effexor, it should be noted that both medications have similar adverse reactions such as drowsiness, constipation, and erectile dysfunction. They are pregnancy category C, which means that they may have negative effects on the fetus. Taking Pristiq as well as Venlafaxine while pregnant requires a doctor’s consultation to avoid possible adverse reactions.


Although these antidepressants share many similarities, there are also differences. These differences can determine whether a doctor will prescribe the particular medication to the patient.

These Differences Are: 

  • Comparing pharmacological uses of desvenlafaxine vs. Venlafaxine, the latter is used for treating major depressive disorders, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, and panic disorder. Desvenlafaxine is used only for major depressive disorders.
  • There is a difference between Pristiq vs. Effexor in how they are metabolized. Pristiq is metabolized by the CYP3A4 hepatic enzyme, while the CYP2D6 enzyme processes Venlafaxine.
  • When comparing the use of Pristiq vs. Effexor in hepatic and renal patients, Pristiq can be safely used after monitoring its dose. In contrast, Effexor doses should be adjusted for those patients.
  • Venlafaxine is available in tablet and capsule form, while desvenlafaxine is only available in extended-release tablets.

If comparing Pristiq vs. Effexor in terms of effectiveness, both medications have shown similar efficacy in treating depression. They share similar side effects, and none is associated with more severe adverse reactions. Still, patients taking desvenlafaxine typically experience less nausea.

Cymbalta vs. Effexor

Effexor and weight loss go hand in hand. Some patients might prefer to switch to an SNRI antidepressant that doesn’t cause them to lose weight. Cymbalta (Duloxetine) can, therefore, become an option. However, by opting for duloxetine, patients can experience fatigue, diarrhea, and constipation.

When comparing Cymbalta vs. Effexor and deciding to switch from one to another, the doctor will recommend a moderate switching strategy. This means that Venlafaxine will be tapered off and stopped. After a washout period of 2 to 5 days, the patient can start a low dose of duloxetine.

Sick woman lying in bed taking pills.

Both are effective SNRI medications that can treat depression. When comparing Cymbalta vs. Effexor for anxiety, both are effective for relieving anxiety disorders. However, Cymbalta can also treat diabetic neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. Venlafaxine can be used for insomnia, but Cymbalta can not.

Here Are Some More Differences and Similarities Between These Drugs:

  • When comparing Cymbalta vs. Effexor for sedation, Venlafaxine is preferred for insomnia because it is more sedative than Cymbalta.
  • Both have similar half-lives for around 12 hours.
  • Both drugs have similar adverse reactions such as nausea, constipation, and dry mouth. The difference between them is that Cymbalta doesn’t cause erectile dysfunction.
  • Both medications may cause hypertension.
  • The two drugs may cause a high risk of suicidal thoughts and behaviors in teenagers.
  • Both are pregnancy category C drugs. It is recommended to consult a doctor before taking these medications during pregnancy.
  • When comparing duloxetine vs. Venlafaxine, patients with hepatic and renal problems must avoid Cymbalta, while Venlafaxine may be used after dose monitoring.

Effexor vs. Zoloft (Sertraline)

Both are used for treating social anxiety disorder and panic disorder. They are also used for treating post-traumatic stress disorder and premenstrual dysphoric disorder. What is the difference between Effexor vs. Zoloft?

Zoloft is an Antidepressant Drug as Well as Venlafaxine, but Zoloft Works Differently:

  • Sertraline is effective for bulimia and binge eating disorder.
  • When comparing the mechanism of action of Effexor vs. Zoloft, sertraline is a selective serotonin reuptake inhibitor (SSRI) that results in increasing serotonin in the brain. But Venlafaxine increases both serotonin and norepinephrine centrally.
  • Zoloft half-life is twice longer – about 26 hours.
  • Most side effects of Venlafaxine are similar to Zoloft. However, sertraline may cause anorgasmia, agitation, shaking, and diarrhea.
  • Venlafaxine causes more sleepiness than Zoloft. It is not advised to take Venlafaxine while driving or operating heavy machinery. Therefore, the healthcare provider may recommend taking Zoloft instead of Venlafaxine as it causes less sleepiness.
  • Both are pregnancy category C medicines.

Effexor vs. Lexapro (Escitalopram)

If a patient presents with more anxiety symptoms than depression, a doctor might choose to switch from Venlafaxine to Lexapro. Escitalopram can treat depression and anxiety too.

Although They Treat Similar Conditions, The Difference Between Effexor vs. Lexapro Is In How They Work:

  • Lexapro is not effective in treating social anxiety disorder and panic disorder. According to a study published in the Journal of the U.S. National Library of Medicine, when both medications are rapidly titrated to maximum recommended doses, Lexapro is at least as effective in treating major depressive disorders as Venlafaxine and significantly well tolerated.
  • Speaking about Lexapro vs. Effexor drug class, Lexapro is a selective serotonin reuptake inhibitor (SSRI), but the latter is SNRI.
  • Lexapro half-life is sometimes three times longer – about 27-33 hours.
  • When comparing Effexor vs. Lexapro side effects, escitalopram is less likely to cause adverse effects. However, Lexapro may cause agitation, shaking, and diarrhea.
  • Both are pregnancy category С drugs.
  • It is recommended to avoid taking Lexapro in patients who have hepatic or renal problems.

Venlafaxine vs. Prozac (Fluoxetine)

Although both are used in the treatment of anxiety and depression, they may differ in some properties.

The Following Are Some More Similarities and Differences Between These Medications:

  • Prozac is a selective serotonin reuptake inhibitor (SSRI), while the Venlafaxine class of drug is SNRI.
  • Prozac is more energizing than Venlafaxine. It is not recommended to use Prozac for patients who have trouble sleeping.
  • There is a significant difference between these antidepressants in their half-lives. Prozac half time is about three days. It takes about 1 to 2 weeks for its effects to appear.
  • Comparing the safety for patients with heart problems, it is preferred to use fluoxetine for patients who have cardiac issues. Venlafaxine may cause tachycardia and hypertension. As a result, it is not preferred to be used in cardiac patients.
  • There is a connection between Venlafaxine and weight gain. Therefore, a doctor may decide that it would be more sensible to use fluoxetine for patients with excess weight, as it may cause significant weight loss.
  • Urticaria and angioedema are common adverse symptoms of Prozac. Effexor doesn’t cause these effects.
  • Both medications are pregnancy category C.

Effexor Compared to Paxil (Paroxetine)

Both medications are suitable for treating depression and anxiety. However, they can have some similar and different properties.

These Properties Are:

  • When comparing Paxil vs. Effexor in depression treatment, Venlafaxine provides more immediate symptom relief than Paxil.
  • Paroxetine is a selective serotonin reuptake inhibitor (SSRI).
  • Both medications undergo ‎hepatic‎ metabolism by CYP2D6.
  • These medications have different half-lives. Paroxetine half-life is about 21 hours.
  • About 64% of the Paxil dose undergoes renal excretion, while 87% of the Effexor dose is excreted in the urine.
  • Venlafaxine has a higher rate of adverse health effects such as nausea and constipation than Paxil.
  • Paxil is pregnancy category D. Using Paxil during pregnancy may increase the risk of fetal heart defects.

Venlafaxine vs. Celexa (Citalopram)

Celexa and Effexor are used for treating depression and anxiety. They can be similar in the way they work or in the conditions they treat.

The Differences and Similarities Between Them Are:

  • Citalopram acts primarily on serotonin reuptake channels (SSRI).
  • The half-life of the citalopram is about 35 hours.
  • When comparing Celexa vs. Effexor regarding possible adverse reactions, Celexa causes less drowsiness.
  • It is not preferred to use both medications for people who have heart impairments. According to the U.S. Food and Drug Administration, high doses of Celexa can cause serious cardiac electrical activity abnormalities.
  • Both medications are pregnancy category C.

Comparison with Xanax (Alprazolam)

Venlafaxine and Xanax may be used in relieving generalized anxiety disorder associated with depression and panic disorder.

Although They Treat Similar Conditions, There Is a Difference in How They Work:

  • Xanax works by binding to gamma-aminobutyric acid (GABA) receptors in the brain.
  • Both have nearly similar half-lives. Xanax half-life is about 12 to 15 hours.
  • Side effects of Xanax are different from Venlafaxine and include stuffy nose, diarrhea, and swelling in the extremities.
  • Xanax is pregnancy category D. The use of Xanax during pregnancy is associated with congenital abnormalities.
  • It is not recommended to take both medications for hepatic patients.

People sometimes combine these medications to get high effects reinforced by Xanax. However, the recreational use of these drugs is significantly dangerous and can cause many adverse reactions, and even lead to overdose.

Natural Alternatives

What natural alternatives can one take instead of Effexor? Some natural alternatives may help depressed patients without dangerous side effects of Venlafaxine. Natural venlafaxine alternatives aren’t a replacement for depression treatment.

Herbal alternatives to Effexor, pills and capsules.

To ensure the safe use of natural alternatives, it is recommended to consult a medical provider before starting the treatment.

The Following Are Some Natural Alternatives for Venlafaxine:

  • S-Adenosyl- L-Methionine (SAMe)
  • Omega-3 Fatty Acids
  • Ginkgo Biloba
  • St. John’s Wort
  • Saffron
  • L-Theanine
  • Sceletium
  • Turmeric

All Effexor alternatives, both other medications and natural ones, should be used only after consultation with a doctor. Self-medication can be dangerous and may lead to health problems, including addiction.

How to Choose the Right Alternative

Sometimes, patients may find it beneficial to switch from Venlafaxine to another medication with fewer adverse health effects. However, it is recommended to consult a doctor to choose the most suitable alternative as negative and allergic reactions are still possible. Moreover, each condition and health status is unique, and the doctor has to consider all the pros and cons before starting the treatment. Before resorting to Venlafaxine or the use of its alternatives, it’s crucial to consult a medical specialist. Venlafaxine withdrawal symptoms may appear after stopping its use suddenly or after switching to alternative medication without a doctor’s approval. It would be essential to look for a suitable treatment plan to start recovering in such a case. Finding a rehab facility is highly recommended to accelerate the recovery process.

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Page Sources

  1. Coleman, K. A., Xavier, V. Y., Palmer, T. L., Meaney, J. V., Radalj, L. M., & Canny, L. M. (2012). An indirect comparison of the efficacy and safety of desvenlafaxine and venlafaxine using placebo as the common comparator. CNS spectrums, 17(3), 131-141.
  2. US National Library of Medicine, Desvenlafaxine.
  3. Liebowitz, M. R., & Tourian, K. A. (2010). Efficacy, safety, and tolerability of desvenlafaxine 50 mg/d for the treatment of major depressive disorder: a systematic review of clinical trials. Primary care companion to the Journal of clinical psychiatry, 12(3).
  4. Wright, C. L., Mist, S. D., Ross, R. L., & Jones, K. D. (2010). Duloxetine for the treatment of fibromyalgia. Expert review of clinical immunology, 6(5), 745–756.
  5. Crow S. (2014). Treatment of Binge Eating Disorder. Current treatment options in psychiatry, 1(4), 307–314.
  6. Clarification of dosing and warning recommendations for Celexa. The US Food & Drug Administration. 2016.
  7. Bielski, R. J., Ventura, D., & Chang, C. C. (2004). A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. The Journal of clinical psychiatry, 65(9), 1190-1196.
  8. Tuman, T. C., Tuman, B., Polat, M., & Çakır, U. (2017). Urticaria and angioedema associated with fluoxetine. Clinical Psychopharmacology and Neuroscience, 15(4), 418-419.
  9. Einarson A. Paroxetine use in pregnancy and increased risk of heart defects: Evaluating the evidence. Canadian Family Physician. 2010; 56(8): 767–768.

Published on: November 29th, 2019

Updated on: April 2nd, 2024

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