Does Pristiq cause Tardive Dyskinesia? (3+ findings)

In this article, we will discuss whether or not Pristiq causes TD (Tardive Dyskinesia), research studies on the link between Pristiq and TD, factors contributing to Pristiq-induced TD, what you should do if Pristiq causes TD, and alternatives to Pristiq if it causes persistent TD.

Does Pristiq cause Tardive Dyskinesia?

Yes, Pristiq can cause Tardive Dyskinesia (TD). However, TD is not a common side effect of using Pristiq. TD is a condition that is characterized by involuntary movements of the face, mouth, limbs, or torso (the trunk of your body). (1)

Pristiq is the brand name of the medication desvenlafaxine. It belongs to the class of antidepressants known as SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors). Pristiq functions by increasing the levels of serotonin and norepinephrine in the brain. (2)

Although Pristiq’s precise mechanism of action in causing TD is unknown, it is believed to be connected to the medication’s effect on dopamine, a neurotransmitter involved in motivation and movement. (3)

Pristiq has the potential to gradually reduce the sensitivity of dopamine receptors in the brain, which can result in uncontrollable movements linked to TD. (4)

What does research suggest?

Research has shown that antidepressants can cause movement disorders, which include a range of conditions such as extrapyramidal symptoms (akathisia, tardive dyskinesia (TD), dystonia, and parkinsonism), tremors, tics, and bruxism.

Reports of extrapyramidal symptoms associated with antidepressants have been documented for SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs, including desvenlafaxine (Pristiq).

Research studies have shown that desvenlafaxine has been linked to TD with an adjusted reported odd ratio (aROR) of 1.37 and a 95% confidence interval. This means that there is a 95% chance that the true mean of the population is contained within this range. 

Desvenlafaxine has also been associated with other movement disorders such as dystonia, myoclonus, Parkinsonism, akathisia, and Restless Leg Syndrome (RLS). (5)

If you are experiencing any of these symptoms while taking Pristiq, it is important to discuss them with your healthcare provider.

What factors might contribute to Pristiq-induced TD?

There are several factors that might contribute to Pristiq-induced TD, some of which include: (6)

Medication dose and duration of use: High doses and prolonged Pristiq use can reduce the sensitivity of dopamine receptors in the brain leading to uncontrollable movements and resulting in Tardive dyskinesia.

Underlying medical conditions: Individuals with underlying medical conditions such as PTSD (Post-Traumatic Stress Disorder), schizophrenia, other mental diseases, diabetes, and HIV (Human Immuno-deficiency Virus) are at higher risk of developing TD while taking Pristiq.

Concomitant medications: Certain medications such as anti-anxiety medications, dopamine antagonists, lithium, malaria medications, neuroleptics, and anti-emetics can cause and induce TD while taking Pristiq.

Age: The elderly population is more prone to experience TD while taking Pristiq. Aging can lead to changes in the brain that may make it more susceptible to the side effects of Pristiq in causing TD.

Gender and Race: The black race population is more likely to develop TD than other races. Additionally, females are more prone to develop TD than males.

What you should do if Pristiq causes TD?

If Pristiq causes tardive dyskinesia, consult your healthcare provider about reducing your medication dose. Your healthcare provider might gradually reduce your Pristiq dose over a period of weeks or months.

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

Your body may experience several extrapyramidal side effects besides TD such as dystonia and akathisia after starting Pristiq medication. However, Pristiq generally takes 4 to 6 weeks to start working for depression and related symptoms. These side effects might fade away as your body adjusts to the medication.

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

After careful evaluation, if Pristiq is the cause of TD and if this side effect is persistent despite reducing your dose, your healthcare provider might switch you to an alternative with fewer adverse events.

What are Pristiq alternatives if it causes persistent TD?

There are certain Pristiq alternatives with fewer extrapyramidal symptoms like TD. Examples include:

Nefazodone: It is an antidepressant that belongs to the class of drugs known as serotonin modulators and is sold under the brand name Serzone. Additionally, it was shown effective in the treatment of neuroleptic-induced extrapyramidal side effects. Nefazodone can be safely used instead of Pristiq. (7)

Vortioxetine: It is an antidepressant that belongs to the class of drugs known as SSRIs (Selective Serotonin Reuptake Inhibitors) and is also a serotonin receptor modulator. Vortioxetine is sold under the brand name Trintellix and was shown to cause fewer TD symptoms than Pristiq. (8)

Duloxetine: It is an antidepressant that belongs to the class of drugs known as SSRIs and is sold under the brand name Cymbalta. Duloxetine was shown to cause fewer TD symptoms when compared to Pristiq. (8)

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

However, if you experience TD while taking Pristiq, consult your healthcare provider about reducing your dose or switching to an alternative with fewer extrapyramidal side effects.

References