Pristiq For Major Depression – Clinical Details on CorePsych Radio

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July 16, 2009
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Depression Medications Turn a New Corner – Pristiq Details Help Understand Why and How

Some think that Pristiq is just another Effexor XR – but they aren’t thinking about the details. In this CorePsych Radio [Program 19 – tomorrow at 4 EDT] I will break down the specific details, the benefits and the concerns on this significantly different, safe and effective new medication. Download the pdf  outline for Pristiq details and tune in to the live program here.

All antidepressant are clearly not the same, and discontinuation challenges amply demonstrate the problem of assuming that all serotonergic medications hit the same receptors. If you switch them out without a careful ‘switch taper’ you will witness discontinuation – even if in the same family.

Pass this along to your colleagues and friends who are curious about the latest from the clinical and research fronts on this very interesting new antidepressant – it’s different.


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  1. Chris says:

    Hi Dr. Parker,

    Have been following your blog for sometime now and really enjoy it, keep up the great work!

    I am interested in the differences between Effexor and Pristiq for treating depression. I recently two weeks ago started taking 75mg of Effexor XR, and am wondering if I would be better off trying Prestiq instead. I noticed the audio-cast you’ve linked on your website overviewing the topic in detail – but have unfortunately been unable to locate the audio file at the website link provided above. I was wondering, if you have the time, if you would possibly be able to entertain a few questions on the subject. Ive noticed you prefer Pristiq to its predecessor, and am wondering if it would be possible for you to overview the advantages of Pristiq over Effexor XR? Am curious as well, if from a clinical viewpoint you have noticed a tendency for your patients to respond better to one over the other as well?

    Thank you and I really appreciate your time,


    • Chris,
      The real differences are a bit technical, but here’s the basic scoop:

      Effexor is metabolized through both 2D6 and 3A4 CYP pipelines in the liver. It’s been many months since I reviewed these facts/percentages – but the problems goes roughly like this: 60% of Effexor runs up thru 2D6 whilst 40% runs up through 3A4. Because 2D6 changes genetically and can come in a variety of pipeline sizes, thus changing the metabolic patterns for Effexor with a variety of patients – Wyeth decided to treat the Effexor first as if it had already passed through 2D6, thus avoiding that side effect [in more than 50% of folks with that possible size-challenge].

      The outcome: Pristiq is often more tolerable on the front end, with fewer side effects, and often a lower dose will turn the tide as it is pre-metabolized and therefore more bioavailable.

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