Does Pristiq require a prescription? (+3 risks)

In this article, we will discuss whether Pristiq requires a prescription. We will also discuss why Pristiq requires a prescription, how to obtain a prescription for Pristiq, the risks associated with the use of Pristiq without a prescription, and other relevant information. 

Does Pristiq require a prescription?

Yes, Pristiq requires a prescription and it can only be dispensed to those who have a medical prescription issued by a healthcare provider. A prescription is an order or legal document written for the treatment of the health condition of an individual (1). 

Pristiq needs a prescription because it is not an over-the-counter (OTC) drug. OTC drugs do not need a prescription and can be used for self-diagnosed symptoms. Common OTC drugs include medications for fever, allergy, and cough (2). 

Pristiq is a prescription-only drug because it is an antidepressant. Its active ingredient is desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI). It increases serotonin and norepinephrine (NE) concentrations in the body (3). 

Pristiq is an FDA-approved drug to treat major depressive disorder (MDD). It can also be used to manage menopausal hot flashes (3). You can only take Pristiq if you are diagnosed with a health condition that Pristiq is known to treat. 

Why does Pristiq require a prescription?

Pristiq requires a prescription because it alters the levels of neurotransmitters in the brain that play significant roles in the body. Thus, Pristiq should only be taken if the brain is depressed and there is a lack of serotonin and NE. 

Serotonin is a neurotransmitter that manages behavior, mood, and memory and maintains homeostasis in the gastrointestinal tract. It plays a role in the following systems in the body (4): 

  • central nervous system (CNS)
  • ocular system
  • cardiovascular system
  • gastrointestinal system
  • endocrine system
  • genitourinary system 

NE is another neurotransmitter that plays an important role in the CNS and peripheral nervous system (PNS). It regulates arousal, attention, and cognitive function, and is involved in the body’s fight or flight response (5)

Thus, taking Pristiq means your body will experience changes in the neurotransmitter levels and the normal physiology affected by these neurotransmitters. Therefore, taking Pristiq without a prescription is extremely risky. 

In a depressed individual, Pristiq restores the normal levels of neurotransmitters and thus reverses the symptoms of neurotransmitter deficit. However, if someone takes Pristiq without depression, they will experience alterations in their normal body functions.

A depressed individual also requires a prescription because Pristiq is effective in specific doses. Taking Pristiq without a prescription can result in underdosing or overdosing which results in the drug being ineffective or risks of toxicity respectively. 

What is Pristiq prescribed for?

Pristiq is an FDA-approved drug for the treatment of major depressive disorder (MDD). Pristiq is preferred for patients with MDD who also have pain disorders. MDD is characterized by the following symptoms (6):

  • persistent depressed mood
  • decreased ability to feel pleasure
  • sense of guilt 
  • low-self esteem 
  • decreased energy levels
  • poor concentration 
  • suicidal thoughts. 

Pristiq is also used off-label to manage menopausal hot flashes. It is preferred for patients who cannot be treated with estrogen. It also helps to avoid the side effects of hormonal therapy (3). 

How to obtain a prescription for Pristiq?

If you experience a persistent low mood, a reduced ability to experience pleasure, poor concentration and energy, and a sense of guilt and worthlessness, you might have depression (6). 

If you have the above-mentioned symptoms, it does not mean that you can self-diagnose and start taking Pristiq without a prescription. If you experience the symptoms of depression, you must contact your healthcare provider. 

Your healthcare provider will obtain an accurate history and perform assessments to confirm your diagnosis. The healthcare provider will then explain your diagnosis and set therapeutic goals for your treatment (1). 

Your healthcare provider may prescribe Pristiq based on your age, comorbid health conditions, and symptoms. The healthcare provider will then select the appropriate dosage based on the severity of your symptoms (1). 

Once the drug is selected, your healthcare provider will write you a prescription. A complete prescription contains the provider’s information, dose, frequency, and duration of therapy, and specific instructions for use (1). 

Make sure you understand when and how to take Pristiq and the common side effects of this medication before you start taking Pristiq. You can take your prescription to a pharmacy to obtain your medication. 

What are the risks associated with taking Pristiq without a prescription?

If you use Pristiq without a prescription and a diagnosis of depression, you can experience serious consequences. If you are diagnosed with depression, you still need a prescription to avoid overdosing on this drug. 

Taking Pristiq without a prescription is associated with the following risks:

Serotonin syndrome:

If you take Pristiq while the serotonin levels in your body are normal, the serotonin concentration will become more than normal. Excessive serotonin in the body can lead to a lethal condition known as serotonin syndrome. 

Serotonin syndrome has a high mortality rate and is characterized by the following symptoms (3):

  • increased heart rate
  • increased salivation
  • pupil dilation 
  • hyperactive bowel sounds
  • hyperthermia 

Pristiq-associated side effects:

Pristiq is associated with different side effects. Taking Pristiq with or without a prescription results in the following side effects (3):

  • reduced appetite
  • dizziness
  • headache
  • nausea
  • vomiting
  • constipation
  • sweating 
  • abdominal pain 

Other side-effects:

Serotonin and NE play several roles in different body systems (4,5). Changing their levels affects the normal physiology of the body. E.g. increased serotonin can raise the intraocular pressure in the eyes and cause vision problems (4). 

Another example is that serotonin enhances gastric emptying and intestinal movements (4). If someone with normal serotonin levels takes Pristiq, they are likely to experience diarrhea. 

Taking Pristiq without a prescription will also increase NE levels more than normal and alter the physiological functions in which NE is involved. They include fight or flight response, glycogenolysis, gluconeogenesis, and different CNS functions (5). 

Impaired NE levels can result in different conditions like schizophrenia, ADHD, Parkinson’s disease, etc. (5). 

Thus, if you take Pristiq without a prescription, you are likely to change the levels of serotonin and NE in your body and will experience side effects associated with their alterations. 

How to take Pristiq appropriately?

Once you obtain the prescription for Pristiq, take it exactly as prescribed by your healthcare provider. Do not cut the medication in half and do not stop taking it abruptly as it can cause withdrawal symptoms. 

The recommended initial dose of Pristiq is 50mg/day. The maximum dose should not exceed 400mg/day. You can take Pristiq with or without food at any time of the day (3). 

Do not take Pristiq if you are allergic to desvenlafaxine. Do not take Pristiq if you are taking the following medications (3):

  • monoamine oxidase inhibitors 
  • tricyclic antidepressants
  • triptans 

Always communicate with your healthcare provider about all the medications you are taking and every health condition you have. This will allow the healthcare provider to decide whether or not Pristiq is appropriate for you. 

In my perspective, Pristiq requires a prescription. It is not an OTC drug and should only be taken if prescribed by a licensed healthcare provider. A prescription is required for Pristiq because it affects the serotonin and NE concentration which play a role in different organ systems. A change in the concentration of these neurotransmitters can result in different side effects. To obtain a prescription for Pristiq, one should visit their healthcare provider and undergo a detailed assessment. Once a diagnosis is confirmed for which Pristiq is used, they can receive their prescription. 

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