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Prozac vs Pristiq
Introduction
For those dealing with major depressive disorder (MDD) or other forms of depression, certain medications can help stabilize mood by altering the levels of neurotransmitters in the brain. Prozac and Pristiq are two such drugs commonly prescribed for these conditions. They each impact different neurotransmitters but have similar effects on mood stabilization. Prozac is a selective serotonin reuptake inhibitor (SSRI), primarily influencing serotonin levels in the brain to help alleviate depressive symptoms. On the other hand, Pristiq falls under a class of medications known as serotonin-norepinephrine reuptake inhibitors (SNRIs). This means it affects both serotonin and norepinephrine neurotransmitters to maintain mental balance.
Prozac vs Pristiq Side By Side
| Attribute | Prozac | Pristiq |
|---|---|---|
| Brand Name | Prozac | Pristiq |
| Contraindications | Should not be taken if you are using or have used monoamine oxidase (MAO) inhibitors within the past 14 days. | Should not be taken if you are using or have used monoamine oxidase (MAO) inhibitors within the past 14 days. |
| Cost | The price of 30 capsules of Prozac (20 mg) averages around $570, which works out to approximately $19/day. Generic versions can cost as low as $0.05 per day. | The price of 30 tablets of Pristiq (50 mg) is about $380, working out to roughly $12.60 per day. Generic versions range between roughly $.80 - $6 per day. |
| Generic Name | Fluoxetine | Desvenlafaxine |
| Most Serious Side Effect | Increased thoughts of suicide or self-harm especially among young adults and teenagers. | Signs of an allergic reaction such as hives, difficulty breathing or swelling in your face, lips, tongue or throat. |
| Severe Drug Interactions | MAO inhibitors. | MAO inhibitors. |
| Typical Dose | Not specified in the provided text. | Typically initiated at a dose of 50 mg/day. |
What is Prozac?
Desvenlafaxine (the generic name for Pristiq) is a newer generation antidepressant, part of the SNRI class of antidepressants. It was first approved by the FDA in 2008. Pristiq works by increasing levels of serotonin and norepinephrine in the brain, preventing them from being reabsorbed back into neurons and thus prolonging their effects on mood regulation. This medication is prescribed to treat major depressive disorder, one type of depression. Unlike Prozac which primarily influences serotonin levels, Pristiq actively affects both serotonin and norepinephrine neurotransmitter systems. This dual-action mechanism may mean that some patients find it more effective; however, it could also potentially lead to a wider range of side effects than those experienced with SSRIs like Prozac.
What conditions is Prozac approved to treat?
Pristiq is approved for the treatment of several types of depression:
- Major depressive disorder (MDD)
- Social anxiety disorder (SAD)
- Generalized anxiety disorder (GAD) It's important to note that while Pristiq can be used alone, it may also be prescribed as part of a combination therapy with other medications.
How does Prozac help with these illnesses?
Pristiq, like Prozac, is used for managing depression but it operates slightly differently. It increases levels of serotonin and norepinephrine in the brain by inhibiting their reabsorption into neurons. Both serotonin and norepinephrine are neurotransmitters that play significant roles in mood regulation. Serotonin affects mood, cognition, memory, sleep patterns among other factors while norepinephrine acts mainly as a stress hormone - increasing alertness, arousal and speeds reaction time alongside its role in mood stabilization. By raising the levels of these two neurotransmitters, Pristiq can mitigate depressive symptoms enabling patients to effectively manage their condition and stabilize their moods.
What is Pristiq?
Pristiq is the brand name for desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), which means it increases the levels of both serotonin and norepinephrine in the brain by reducing their reabsorption. It was first approved by the FDA in 2008. Unlike Prozac, an SSRI antidepressant that solely inhibits the reuptake of serotonin, Pristiq works on both neurotransmitters. This dual-action can offer different therapeutic benefits especially for those who do not respond well to traditional SSRIs such as Prozac. The side effects profile of Pristiq differs from SSRIs: while sexual dysfunction and weight gain can still occur they are often less common than with medications like Prozac. Furthermore, because of its action on norepinephrine alongside serotonin, it may be more energizing and possibly beneficial for patients suffering from fatigue or lethargy associated with their depression.
What conditions is Pristiq approved to treat?
Pristiq is a medication which has been approved by the FDA for treating:
- Major depressive disorder (MDD), a condition characterized by persistent feelings of sadness and loss of interest in activities.
- Pristiq can also be used off-label to manage symptoms of menopause, such as hot flashes and night sweats.
How does Pristiq help with these illnesses?
Serotonin and norepinephrine are neurotransmitters that play vital roles in many processes in the body, impacting mood regulation, alertness, concentration, and stress response. Low levels of these chemicals have been linked to depression. Pristiq works by increasing the availability of both serotonin and norepinephrine in the brain, which can help alleviate depressive symptoms. Its action on these two neurotransmitters makes it a serotonin-norepinephrine reuptake inhibitor (SNRI), distinguishing it from selective serotonin reuptake inhibitors (SSRIs) like Prozac. While SSRIs primarily affect serotonin levels, SNRIs target both serotonin and norepinephrine. This dual-action approach can be beneficial for patients who haven't responded well to SSRI treatment alone or when more comprehensive symptom management is desired.
How effective are both Prozac and Pristiq?
Both fluoxetine (Prozac) and desvenlafaxine (Pristiq) are well-established in their effectiveness for treating patients with depression, having been approved by the FDA in 1987 and 2008 respectively. Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor while fluoxetine is a selective serotonin reuptake inhibitor which means they act on different neurotransmitters and may be prescribed under different circumstances.
The efficacy of Prozac has been extensively studied since it was the first SSRI-class antidepressant developed. A review of meta-analysis reports from 2004 shows that it is effective in reducing symptoms of depression starting from the first week of treatment, its side effect profile compares favorably to many other antidepressants, and it is well-tolerated across diverse populations including elderly and pregnant individuals. Furthermore, beyond alleviating depressive symptoms, Prozac also appears to reduce suicidal ideation and behavior.
On the other hand, Pristiq's ability to treat depression seems more effective than placebo according to a review conducted in 2016. Additionally, this review suggests that Pristiq offers similar efficacy as other common antidepressants but data confirming its standalone efficacy isn't quite as robust as that for Prozac due to lesser time on market thus fewer studies available compared with Prozac. However because Pristiq acts not only on serotonin but also norepinephrine receptors provides an alternative option for patients who did not respond well or have certain adverse effects like sexual dysfunction or weight gain associated with SSRIs such as Prozac.
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At what dose is Prozac typically prescribed?
Oral dosages of Pristiq typically start at 50 mg/day for the treatment of major depressive disorder in adults. It's important to note that Pristiq is not approved for use in children and adolescents. In adults, if there is no response or insufficient response after several weeks, dosage may be increased to a maximum of 400 mg/day under the guidance of a healthcare provider. However, because increasing doses beyond 50 mg/day may result in an increase in side effects without additional benefits, it's recommended that any dosage increases are done with caution and close monitoring by your healthcare provider.
At what dose is Pristiq typically prescribed?
Pristiq treatment is typically initiated at a dose of 50 mg/day. For some patients, depending on their individual response and tolerability, the dosage may then be increased to 100 mg/day. The higher dose is taken as a single daily dose and can be consumed with or without food. A maximum dose of up to 400 mg/day has been tested in clinical trials for safety; however, no additional benefit was seen over the 50mg/day dose. If there's no significant improvement observed after several weeks of treatment at the initial dosage level, your healthcare provider might consider an increase in dosage or possibly switching to another medication. It's always crucial that any changes are done under medical supervision.
What are the most common side effects for Prozac?
Pristiq, like Prozac, can also cause common side effects such as:
- Anxiety and Nervousness
- Insomnia (difficulty sleeping)
- Drowsiness or somnolence
- General weakness or fatigue (Asthenia)
- Tremors or unintentional shaking
- Decreased appetite (Anorexia)
- Nausea and dyspepsia
- Diarrhea and constipation
- Dry mouth
- Sweating excessively -Negative impact on sexual desire, performance, or satisfaction.
Additional potential side effects include high blood pressure and abnormal cholesterol levels. However, each person may respond differently to the medication. If you experience any of these symptoms persistently while taking Pristiq, it's important to consult with your healthcare provider.
Are there any potential serious side effects for Prozac?
While Prozac and Pristiq are both used to treat depression, their side effects can vary. When taking Pristiq, be watchful for:
- Increased thoughts of suicide or self-harm especially among young adults and teenagers
- Signs of an allergic reaction including: hives; difficulty breathing; swelling in your face, lips, tongue or throat
- Vision changes such as blurred vision, eye pain or swelling
- Rapid heartbeat, fluttering in your chest or shortness of breath that could indicate serious heart problems
- Lowered sodium levels which may cause headache, confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady -Severe nervous system reaction - rigid muscles high fever sweating fast uneven heartbeats tremors feeling like you might pass out. -Symptoms suggestive of serotonin syndrome: restlessness hallucinations rapid heartbeat dilated pupils muscle stiffness twitching loss of coordination nausea vomiting diarrhea
If any these symptoms occur while taking Pristiq contact your healthcare provider immediately.
What are the most common side effects for Pristiq?
When taking Pristiq, patients may experience:
- An uptick in perspiration or sweating
- Insomnia and sleep disturbances
- Increased heart rate
- Nausea, diminished appetite, constipation
- High blood pressure
- Dizziness or feeling light-headed
- Dry mouth or throat irritation
- Blurred vision occasionally
- A certain level of nervousness and agitation
- Potential weight loss due to decreased appetite Frequent urination may also occur. Patients have reported experiencing migraines as well as muscle stiffness or joint pain. It's important to note that these side effects vary from person to person and not everyone will experience them all. Contact your healthcare provider if any of these symptoms persist or become bothersome.
Are there any potential serious side effects for Pristiq?
While Pristiq is generally considered safe, it can occasionally lead to serious side effects. These may include:
- Signs of an allergic reaction such as hives, difficulty breathing or swelling in your face, lips, tongue or throat
- Unusual changes in mood or behavior including feeling agitated, hostile, aggressive or having thoughts about suicide
- Symptoms of serotonin syndrome such as agitation, hallucinations (seeing things that aren't there), rapid heartbeat, fever and severe nausea
- Changes in vision including eye pain/swelling/redness and blurred vision
- Easy bruising or unusual bleeding
- High levels of serotonin leading to symptoms like fast heart rate, muscle stiffness and twitching
- Low sodium levels manifesting through headache confusion slurred speech severe weakness vomiting
If you experience any of these effects while on Pristiq treatment, please consult your healthcare provider immediately for further evaluation.
Contraindications for Prozac and Pristiq?
Both Prozac and Pristiq, like many other antidepressant medications, may exacerbate symptoms of depression in some people. If you observe a worsening of your depressive state or an increase in suicidal thoughts or behavior, please reach out for immediate medical help.
Neither Prozac nor Pristiq should be taken if you are using or have used monoamine oxidase (MAO) inhibitors within the past 14 days. You must always inform your healthcare provider about all the medications you are currently taking; MAOIs require approximately two weeks to clear from your system to avoid potential dangerous interactions with both Prozac and Pristiq.
How much do Prozac and Pristiq cost?
For the brand name versions of these drugs:
- The price of 30 capsules of Prozac (20 mg) averages around $570, which works out to approximately $19/day.
- The price of 30 tablets of Pristiq (50 mg) is about $380, working out to roughly $12.60 per day.
Thus, if you are in a standard dosage range for Pristiq (i.e., 50-400 mg/day), then brand-name Prozac tends to be more expensive on a per-day treatment basis. However, it's crucial to note that cost should not be the primary consideration in determining which of these medications is right for you.
When it comes to their generic versions:
-
Fluoxetine (the generic version of Prozac) is available in packs ranging from 15 up to 1,000 capsules with strengths at 20mg each. Costs start as low as just $0.05 per day when purchasing the largest pack upfront and won't exceed about $0.90 per day.
-
Desvenlafaxine ER (generic equivalent for Pristiq), ranges between around $.80-$2 per tablet depending on strength and quantity purchased; this translates into daily costs between roughly $.80 - $6 based on typical dosages from 50mg up to potentially higher prescribed doses such as the less common but allowable dose like that at say perhaps even upwards towards reaching levels near or at max level thresholds i.e., those approaching closer toward its maximum recommended medical guidance limit set at ~400mg/day).
Popularity of Prozac and Pristiq
Fluoxetine, also known by its brand name Prozac, was prescribed to about 4.7 million people in the United States in 2020. Fluoxetine accounted for nearly one-fifth of SSRI prescriptions and just under a tenth of total antidepressant prescriptions in the country that year. Over the past decade, fluoxetine's prevalence has remained relatively stable.
Desvenlafaxine is another widely used antidepressant often marketed as Pristiq. In 2020 it was prescribed to around 2 million people in America making up a smaller portion of overall antidepressant prescriptions compared to fluoxetine. Although not as commonly used as some other types of SSRIs or SNRIs, desvenlafaxine does offer certain advantages including once-daily dosing and fewer drug interactions which might explain why it continues to be a popular choice among healthcare professionals.
Conclusion
Both Prozac (fluoxetine) and Pristiq (desvenlafaxine) have established histories of use in patients with depression, supported by many clinical studies and meta-analyses demonstrating that they are more effective than placebo treatments. In some scenarios, these drugs may be used together, although this requires careful consideration by a medical professional due to potential contraindications. Thanks to their distinct mechanisms of action - with Prozac primarily affecting serotonin and norepinephrine reuptake, while Pristiq mainly inhibits the reuptake of serotonin - they are typically prescribed in different circumstances.
Prozac is often regarded as a first-line treatment choice for depression whereas Pristiq might generally be employed as supplementary therapy alongside Prozac or in those who didn't respond well to initial SSRIs antidepressants like Prozac.
Both medications can be found in generic form which indicates substantial cost savings especially for individuals paying out-of-pocket expenses. Both Prozac and Pristiq may require an adjustment period where effects aren't immediately noticeable.
The side effect profiles between both drugs bear similarities; both being mostly well-tolerated but differ significantly when it comes to sexual dysfunction side effects, with less prevalence observed from the use of Pristiq compared to Prozac. For either drug, patients must consistently monitor their moods particularly during treatment commencement phase and should promptly seek medical attention if symptoms worsen or suicidal thoughts emerge.
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Refrences
- Pae, C.-U. (2009, April). Desvenlafaxine: a new antidepressant or just another one?. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656560902828351
- Chen, Y., Kelton, C. M. L., Jing, Y., Guo, J. J., Li, X., & Patel, N. C. (2008, September). Utilization, price, and spending trends for antidepressants in the US Medicaid program. Research in Social and Administrative Pharmacy. Elsevier BV.http://doi.org/10.1016/j.sapharm.2007.06.019
- Blier, P. (2016, March 23). Neurobiology of Depression and Mechanism of Action of Depression Treatments. The Journal of Clinical Psychiatry. Physicians Postgraduate Press, Inc.http://doi.org/10.4088/jcp.13097tx3c