Pristiq's Dosage: What to Know

Medically Reviewed By Brittany A. Duke, PharmD, RPh

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Like other antidepressant medications, Pristiq may raise the risk of suicidal thoughts or behaviors in some people. This includes children and adults up to age 24 years, which is noted in clinical studies.

Pristiq is not approved for use in people under age 18 years.

Conversely, like other antidepressants, Pristiq may reduce the risk of suicidal thoughts or behaviors in some people. These include adults older than age 24 years, according to the clinical studies noted above.

While you’re taking Pristiq, your doctor will monitor you for changes in your behaviors or moods. You and close friends or family should also watch for any of these changes. Examples of the changes include:
• feelings of hopelessness, guilt, or worthlessness
• loss of interest in activities you usually enjoy
• difficulty thinking or concentrating

If you have changes such as these in thoughts, moods, or feelings while taking Pristiq, call your doctor immediately.

Pristiq: Introduction

Pristiq is a brand-name prescription medication that contains the active drug desvenlafaxine. It belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). Pristiq is available in a generic form.

This medication has been approved by the Food and Drug Administration (FDA) to treat depression in adults. This condition is sometimes called major depressive disorder.

In this article, you’ll find information about Pristiq’s dosage and details on how to take the drug. For a comprehensive overview of Pristiq, view this article.

Finding a healthcare professional

If you’re interested in taking Pristiq, search here to find a doctor who might prescribe it.

This article describes typical recommended dosages for Pristiq. These dosages are provided by the drug’s manufacturer.

Always follow the dosage of Pristiq that your doctor prescribes.

Pristiq: Dosage

Below are the commonly recommended dosages for Pristiq. You should take the dosage your doctor prescribes for you.

Pristiq’s form and strengths

Pristiq comes as extended-release tablets that you swallow. (Extended release means the drug releases into the body slowly over time after you take the tablets.)

Pristiq tablets are available in these strengths:

  • 25 milligrams (mg)
  • 50 mg
  • 100 mg

Typical recommended dosages

Your doctor will prescribe the dosage of Pristiq that’s right for your condition. Ultimately, they will prescribe the smallest dosage of Pristiq that gives the desired effect.

Pristiq dosage for depression

Below is an overview of Pristiq’s recommended dosages for depression in adults.

  • Starting dosage: 50 mg once per day
  • Maintenance dosage: 50 mg once per day
  • Maximum dosage: 400 mg* once per day

* The maximum dosage evaluated in Pristiq’s clinical studies was 400 mg taken once per day. However, the studies didn’t find this dosage more effective than the 50-mg dosage for treating depression.

Length of treatment

Doctors typically prescribe Pristiq as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.

Pristiq: Common questions about dosage

Below are some common questions related to Pristiq’s dosage.

Could my doctor increase my Pristiq dosage to 100 mg, 150 mg, or 200 mg once daily?

It’s possible. If the 50-milligram (mg) dose isn’t working well enough, your doctor might prescribe one of these dosages.

In Pristiq’s clinical studies, 400 mg once per day was the maximum dosage evaluated. (It’s also the recommended maximum dosage.) Regardless, the studies didn’t find this dosage more effective than the 50-mg dosage for treating depression.

If you’d like to learn more about Pristiq’s dosages, review the “Pristiq: Dosage” section above. You can also talk with your doctor or pharmacist to learn more.

Is Pristiq prescribed for anxiety? If it is, what’s its dosage?

Pristiq is not approved to treat anxiety. Some doctors might prescribe it off-label for this use, however. Off-label use means prescribing a drug for a purpose other than what it’s approved to treat.

To learn more about off-label uses for Pristiq, talk with your doctor or pharmacist. They can advise you on possible dosages and medications for anxiety as well.

What is the recommended dose range of Pristiq?

The only recommended dose of Pristiq is 50 mg, which you take once per day.

The highest dosage evaluated in Pristiq’s clinical studies was 400 mg once per day. However, the studies didn’t find this dosage more effective than the 50-mg dosage for treating depression.

The lowest dosage prescribed for Pristiq is 25 mg once per day. However, this is used only to help someone stop taking Pristiq. It’s not a dose effective for treating depression, according to the clinical studies noted above.

To learn more about the 25-mg dose, see the question just below or ask your doctor.

Can I take a Pristiq dosage of 25 mg once daily?

You might take that dosage, but not usually. Doctors don’t prescribe the 25-mg dosage to treat depression. Instead, this dosage may be used if you and your doctor decide you’ll stop taking Pristiq.

The 25-mg dosage helps lower your dose gradually over time before you stop Pristiq entirely. This helps prevent you from having discontinuation syndrome. This side effect may happen when you stop taking Pristiq.

To learn more about this syndrome, see the “Pristiq: Withdrawal and dependence” section below. Remember that it’s important to talk with your doctor first before stopping Pristiq.

Pristiq: How to take

Pristiq comes as a tablet. You’ll take it by swallowing it. Swallow the tablet whole without chewing, splitting, or crushing it. You can take it with or without food.

If you have difficulty swallowing tablets, view this article. It provides suggestions on how to take this form of medication. Also, talk with your doctor or pharmacist about taking your medication.


If you find it challenging to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies provide medication labels with large print or braille. They may also offer labels containing a scannable code that your smartphone can convert from text to speech. If your pharmacy doesn’t provide these choices, your doctor or pharmacist may be able to recommend a pharmacy that does.

If it’s difficult for you to open medication bottles, ask your pharmacist if they can dispense Pristiq in an easy-open container. They also may recommend ways to help make it easier to open the bottles.

Pristiq: Missing a dose

If you miss a dose of Pristiq, take it as soon as you remember. However, if it’s nearly time for your next dose, skip the missed dose. Then, take your next dose at the usual time. Do not take more than one dose of Pristiq at a time.

View these medication reminder options to help avoid missing doses. You could also set an alarm or download a reminder app on your phone.

Pristiq: Overdose

If you take more than the recommended dosage of Pristiq, serious effects can occur. Do not take more Pristiq than your doctor prescribes. 

Symptoms of overdose

An overdose of Pristiq could cause several symptoms, including:

What to do in case of overdose

Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or a local emergency number. Or go to the nearest emergency room right away.

Pristiq: Withdrawal and dependence

You should not stop taking Pristiq unless you have talked with your doctor first. Stopping Pristiq may cause symptoms of discontinuation syndrome. Further, stopping treatment abruptly can raise the risk that these symptoms will be severe.

Symptoms of discontinuation syndrome include:

  • nausea
  • excessive sweating
  • mood changes
  • agitation or irritability
  • electric shock sensation
  • tinnitus
  • difficulty sleeping

If you’re considering stopping Pristiq treatment, talk with your doctor. If you both agree that you’ll stop taking Pristiq, your doctor can help you stop taking it safely. They can lower your dosage gradually over time until it’s safe to stop taking it entirely. This lowers your risk of discontinuation syndrome.

Pristiq: What to discuss with your doctor

Talk with your doctor or pharmacist for additional information about Pristiq’s dosage. Keep in mind that the dosages presented in this article are typical dosages provided by the drug’s manufacturer. Your doctor will recommend the dosage of Pristiq that’s right for you and your condition. Always follow the dosage that your doctor prescribes for you.

As with any medications you’re taking, do not change your Pristiq dosage without a recommendation from your doctor.

In addition to discussing Pristiq with your doctor, you may find the following articles helpful in learning more.

  • Overview of Pristiq. For comprehensive details on Pristiq, see this article.
  • Drug comparison. To learn how Pristiq compares with Effexor XR, read this article.
  • Information on side effects. If you’d like to know about possible side effects of Pristiq, view this article.
  • Details about depression. To learn more about depression, which Pristiq is used to treat, see this article.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Medical Reviewer: Brittany A. Duke, PharmD, RPh
Last Review Date: 2022 Nov 19
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