Pristiq Warnings and Precautions
Warnings and precautions to be aware of prior to taking Pristiq include the following:
- Antidepressants (including Pristiq) may increase the risk of suicidal thinking or behavior (see Depression and Suicide). Therefore, if you notice any changes in symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include:
- Extreme hyperactivity
- Suicidal thinking or behavior.
- Before prescribing Pristiq for depression, your healthcare provider should make sure you do not have bipolar disorder instead. Sometimes, the symptoms of bipolar disorder and depression are similar, and Pristiq can cause problems in people with bipolar disorder.
- The medication can increase blood pressure. If you already have high blood pressure (hypertension), your blood pressure should be under control before you start Pristiq. Everyone who takes the drug should have their blood pressure checked periodically.
- Because Pristiq can increase heart rate and blood pressure, it may not be safe for some people with heart disease.
- Antidepressants can cause a group of dangerous symptoms known as serotonin syndrome. Taking Pristiq with other medications that affect serotonin can increase your risk of serotonin syndrome. These other medications include other antidepressants, triptans (migraine medications), and others (see Pristiq Drug Interactions). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, such as:
- Seeing or hearing things that are not really there (hallucinations)
- Fast heartbeat (tachycardia)
- Feeling faint
- Muscle spasms
- Difficulty walking
- Pristiq may increase your risk of bleeding. This may be especially problematic in people who already have a bleeding disorder or who take other medications that also increase the risk of bleeding.
- Pristiq can cause seizures, high cholesterol, high triglycerides, or worsening of glaucoma. Your healthcare provider should monitor you closely if you have any of these conditions.
- Since the medication is removed from the body using the liver and kidneys, you may need a lower Pristiq dosage if you have liver or kidney problems.
- Pristiq can interact with certain medications (see Pristiq Drug Interactions).
- If you are elderly or taking a diuretic, Pristiq could cause low salt levels in the blood (hyponatremia). This generally returns to "normal" when the medication is discontinued.
- If you stop taking the drug, you should be monitored by a healthcare professional for withdrawal symptoms. If you do develop symptoms of Pristiq withdrawal, such as irritability, anxiety, confusion, headache, lethargy, or insomnia, your healthcare provider may slow down the rate at which the drug is stopped.
- Pristiq is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using the drug when pregnant (see Pristiq and Pregnancy).
- Pristiq passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to using the drug (see Pristiq and Breastfeeding).