Can Pristiq Raise Cholesterol? (+3 Risk Factors)

In this article, we will discuss whether Pristiq raises cholesterol. We will also share what research suggests, risk factors for high cholesterol while taking Pristiq, and other relevant information. 

Can Pristiq raise cholesterol?

Yes, Pristiq may raise cholesterol in some individuals. An increase in the level of cholesterol is not an officially listed side effect. However, elevated cholesterol has been observed in some individuals taking Pristiq. 

Pristiq is the brand name for desvenlafaxine which is an antidepressant and a serotonin-norepinephrine reuptake inhibitor. It works by inhibiting the reuptake of serotonin and norepinephrine (NE) which increases their concentration in the brain (1). 

Although it is not clear how Pristiq affects cholesterol levels, some studies have reported a rise in cholesterol in patients who were taking Pristiq. It is important to note that everyone taking Pristiq doesn’t necessarily experience elevated levels of cholesterol. 

How can Pristiq affect cholesterol levels? 

Pristiq increases the levels of serotonin and NE and has a higher affinity for serotonin than NE. Although its direct effect on lipid metabolism is not known, these neurotransmitters have roles outside the brain that may influence lipid metabolism. 

Serotonin plays an important role in the peripheral tissues and affects metabolic processes. Evidence suggests that serotonin influences nutrient absorption and storage, insulin secretion, and lipid metabolism (2). 

Due to the established role of serotonin in the periphery, it can be assumed that the increase of serotonin concentration by drugs like Pristiq, Celexa, and sertraline influences the level of cholesterol in the body. However, the specific mechanism is still an area of ongoing research.  

What does research suggest? 

Different studies have been conducted to assess the safety and tolerability of Pristiq in which reported side effects are also mentioned. Some studies have reported an impact on the cholesterol levels of patients taking Pristiq. 

One study included 1395 patients with major depressive disorder (MDD) who were treated with Pristiq for 10 months. Laboratory assessments at different intervals revealed that in some patients, the total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides were elevated (3). 

Another review of published evidence was conducted to assess the efficacy of Pristiq at the dose of 50mg. The results conclude that an elevation of fasting total cholesterol was observed in the patients. However, this change was not clinically significant (4). 

The research indicates that a rise in cholesterol levels is not a commonly reported side effect of Pristiq but it can occur in some individuals. This increase is usually not clinically significant. 

What factors increase the risk of high cholesterol while taking Pristiq?

Certain factors increase the risk of individuals to have elevated levels of cholesterol in their body. This risk is further exacerbated if they are taking Pristiq. These factors are as follows: 

High doses: 

Prsitiq is generally safe and well-tolerated at the dose of 50mg/day. Its side effects are dose-dependent and heightened at higher doses. Thus, an individual taking higher doses of Pristiq has an increased risk of elevated cholesterol levels. 

Health conditions: 

Different health conditions are listed as a risk factor for high cholesterol. This risk is exacerbated while taking Pristiq. These health conditions include (5,6,):

• hypertension
• diabetes
• obesity
• nephrotic syndrome
• hypothyroidism
• cholestasis

Genetics and Family History: 

Individuals with a family history of high cholesterol and early heart disease are more susceptible to elevated levels of cholesterol. Genetic causes may include mutations in LDL-receptor genes and individuals with such mutations may develop high cholesterol while taking Pristiq (5). 

Lifestyle: 

Different lifestyle factors elevate the risk of high cholesterol in individuals. Individuals who smoke, are physically inactive, have high levels of stress, or consume a diet high in saturated fats are more susceptible to Pristiq-induced high cholesterol (5,6).

How to manage your cholesterol while taking Pristiq?

If you are concerned that Pristiq might affect your cholesterol levels you must communicate it with your healthcare provider. The healthcare provider might evaluate your cholesterol and make necessary adjustments. 

Your healthcare provider might consider a dose reduction if your cholesterol levels are elevated. Generally, changes in cholesterol levels are not clinically significant and can be managed by lifestyle modifications. 

Lifestyle modifications include dietary changes. You must consume limited saturated and trans fatty acids and sufficiently consume fruits, vegetables, and fiber to maintain healthy cholesterol levels. (5). Saturated fats should not make up more than 7%-10% of the diet (6). 

You should avoid smoking and manage your stress well as they are positively linked to elevated cholesterol. Physical exercise for 150 minutes every week is also recommended to manage cholesterol levels (5). 

In my perspective, the research I have done indicates that Pristiq might increase cholesterol levels in some individuals. It is however not commonly reported and every individual does not experience this side effect. The effect of Pristiq on the levels of serotonin might be linked to its impact on cholesterol. Research studies have reported that some individuals taking Pristiq have experienced elevated cholesterol levels as a side effect but it was not clinically significant. Certain factors like Pristiq’s dose, medical conditions, family history, and poor lifestyle also increase the risk of raised cholesterol levels while taking Pristiq. 

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