Does Pristiq cause hives? (3+ findings)

In this article, we will discuss whether or not Pristiq causes hives, scientific studies and research on Pristiq’s role in hives development, factors contributing to individual susceptibility to hives while on Pristiq, what you should do if you experience hives while taking Pristiq, and alternatives to Pristiq for individuals prone to hives.

Does Pristiq cause hives?

Yes, Pristiq can cause a rash, including hives in certain individuals. Hives or urticaria are not common side effects of Pristiq but are considered serious side effects. (1)

Hives can be a sign of an allergic reaction to Pristiq. If you experience hives while taking Pristiq, it’s crucial to seek medical attention right away. Symptoms of a serious allergic reaction may include a rash, itching, or swelling in the face, tongue, or throat.

Pristiq is the brand name of the antidepressant medication desvenlafaxine. It belongs to the class of drugs known as SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors). 

Pristiq functions by inhibiting the reuptake of the neurotransmitters serotonin and norepinephrine, thereby, increasing their concentrations in the brain. (2)

The exact mechanism by which Pristiq can cause hives is not fully understood. However, it is thought to be related to the increased serotonin and norepinephrine levels. 

Elevated serotonin levels may stimulate the body to release histamine in response to allergens, potentially resulting in the development of hives or urticaria. It’s crucial to seek medical attention if you experience hives or any other skin reaction while taking Pristiq. (3)

What does research suggest?

According to research studies, 28.7% of patients experienced side effects while using desvenlafaxine (Pristiq) to treat their MDD (Major Depressive Disorder). One particular patient reported severe pruritus and a macular rash, leading to the discontinuation of treatment with desvenlafaxine. (4)

Similarly, 2% of patients experienced rash and other skin reactions like hives while taking Pristiq. (5)

Although allergic reactions to Pristiq are rare, some individuals may experience a rash as a side effect, which may vary in severity and may or may not be accompanied by other symptoms of an allergic reaction such as itching, swelling, or breathing difficulties.

What factors might contribute to hives while taking Pristiq?

Several factors might contribute to hives and skin reaction symptoms while taking Pristiq, some of which include:

  • Medication dose: Higher dosages of Pristiq can induce hives, as increased serotonin levels can stimulate the body to release histamine, resulting in the development of hives.


  • Underlying medical conditions: Certain medical conditions such as autoimmune diseases like lupus and vitiligo, asthma, infections, vasculitis, and lymphomas can all induce hives and other skin reactions while taking Pristiq.


  • Concurrent medications: Certain medications such as antibiotics like penicillin and sulfonamides, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) like ibuprofen and naproxen, opiates, and anti-seizure medications can all induce hives or allergic reactions while taking Pristiq.


  • Food allergies: Certain foods can trigger hives and allergic skin reactions such as milk, eggs, and peanuts. These foods can induce hives while taking Pristiq.


  • Individual’s sensitivity to the medication: If you are allergic to any of Pristiq’s ingredients, this can result in hives as well as other skin reactions such as itching and difficulty breathing. Therefore, it is crucial to check if you have any drug sensitivity before using any medication.

What should you do if you experience hives while taking Pristiq?

If you experience hives while taking Pristiq, consult your healthcare practitioner about reducing your dosage. Your healthcare provider might gradually reduce your Pristiq dose over weeks or months.

Pristiq can generally take 4-6 weeks to start working for depression and related symptoms. This side effect might fade away as your body adjusts to the medication.

According to your situation, your healthcare provider might reduce your dosage by 10-20% per week. You should take the reduced dose for at least one week before reducing the dose again. 

Additionally, your healthcare provider will thoroughly evaluate your situation to determine whether Pristiq is the cause of hives or whether there are underlying medical conditions or other factors that can cause hives.

Furthermore, your healthcare provider might prescribe antihistamines to help manage hives and other skin reaction symptoms while taking Pristiq such as loratadine or diphenhydramine. (6)

However, Pristiq allergies may occur in certain individuals. Discontinue using Pristiq and seek medical attention immediately if you have an allergy to Pristiq and are exhibiting signs of an allergic response, such as severe rash, difficulty breathing, or swelling in the face, tongue, or throat. 

After careful evaluation, if Pristiq is the cause of hives, your healthcare provider might switch you to an alternative with fewer adverse events.

What are Pristiq alternatives if it causes persistent hives?

Certain alternatives can be used if Pristiq causes persistent hives such as: (7)

  • Fluoxetine: It is an antidepressant medication that belongs to the class of drugs known as SSRIs (Selective Serotonin Reuptake Inhibitors). It can cause fewer skin reactions than desvenlafaxine (Pristiq).


  • Paroxetine: It is an antidepressant medication that belongs to the class of drugs known as SSRIs and was shown to have fewer skin-related adverse effects than other antidepressants.


  • Sertraline: It is an antidepressant medication that also belongs to the SSRI class of drugs and was shown to cause fewer hives and skin-related side effects.


  • Venlafaxine: It is an antidepressant medication that belongs to the SNRI class of drugs and was shown to cause fewer skin-related adverse effects like rash and hives than other antidepressants.

Based on my knowledge and research, Pristiq can cause hives in certain individuals. In my opinion, every person differs in their response to different medications, and not everyone experiences rash or hives while taking Pristiq.

If you experience hives while taking Pristiq, consult your healthcare provider about reducing your medication dose, taking an antihistamine, or switching to an alternative with fewer skin-related adverse effects such as fluoxetine or paroxetine.





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Desvenlafaxine (Oral Route) Side Effects – Mayo Clinic [Internet]. Available from:


Desvenlafaxine: MedlinePlus Drug Information [Internet]. Available from: 


Zabolinejad N, Molkara S, Bakhshodeh B, Ghaffari-Nazari H, Khoshkhui M. The expression of serotonin transporter protein in the skin of patients with chronic spontaneous urticaria and its relation with depression and anxiety. Archives of Dermatological Research [Internet]. 2019 Dec 1 [cited 2023 Dec 1];311(10):825–31. Available from: 


Weihs KL, Murphy W, Abbas R, Chiles D, England RD, Ramaker S, et al. Desvenlafaxine Versus Placebo in a Fluoxetine-Referenced Study of Children and Adolescents with Major Depressive Disorder. Journal of Child and Adolescent Psychopharmacology. 2018 Feb;28(1):36–46. Available from:




Hives and angioedema – Diagnosis and treatment – Mayo Clinic [Internet]. Available from:


Godi S, Singh L. Escitalopram-induced skin rash: Dermatitis medicamentosa. Indian Journal of Dermatology [Internet]. 2022;67(1):93. Available from:

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