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Pristiq not working anymore


Why Aren’t My Antidepressants Working?

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If you feel like your antidepressant has stopped working, you're not alone. It's common for a medication that once worked wonders to become ineffective, especially if you've been taking it for a long time. Symptoms return for up to 33% of people using antidepressants — it's called breakthrough depression.

"Usually an antidepressant that's worked for a patient will keep working," says Paul Nestadt, M.D., psychiatrist and co-director of the Jack and Mary McGlasson Anxiety Disorders Clinic at Johns Hopkins. "But sometimes, a new episode of depression might come up that's not as responsive to that medication, or the medication might just stop working altogether."

What causes depression medications to stop working?

Multiple factors can change the way your body responds to an antidepressant, including:

  • Drug or alcohol use. Illicit drug use and alcohol can cause strong mood changes, which can make antidepressants ineffective.
  • Pregnancy. Your body's weight and blood volume increase when you're pregnant. Talk to your doctor about taking antidepressants while pregnant, and about potentially adjusting your dosage to continue relieving symptoms.
  • New stressors. A new stressful situation at home or work can result in a mood response for which the antidepressant can't compensate.
  • Other medications. Interactions between antidepressants and medications for other health conditions can affect how well an antidepressant works.

Most often, though, antidepressants stop working for what seems to be no reason. "There's no good research that shows why a medication may stop working for someone," says Nestadt. "I think it's less an issue of building up tolerance and more likely constantly changing stressors and factors in the brain."

When to See a Doctor

If your depression symptoms return for more than a few days, it's time to see your doctor. But even if you feel like your antidepressant isn't working, it's important to keep taking it until your doctor advises otherwise. You may need a dosage increase or a slow tapering off process. With many antidepressant medications, stopping their use too quickly can cause withdrawal effects such as:

  • Headaches
  • Nausea
  • Diarrhea or constipation
  • Greater anxiety
  • Suicidal thoughts

Early warning signs of breakthrough depression are the symptoms you typically experience when an episode of depression is coming on, says Nestadt. Depression symptoms vary from person to person, but signs include:

  • Low mood
  • Changes in sleep or appetite
  • Decreased socializing
  • Loss of interest in previously enjoyable activities

If your symptoms return, don't worry — adjusting the dose or switching to another antidepressant often solves the problem. (Note: If you have self-harm or suicidal thoughts, see your doctor immediately, call 911 or go to an emergency room. )

Changing Your Depression Medications

If you and your doctor have ruled out factors that could interfere with your current medication, your doctor may increase the dosage, switch you to another antidepressant or recommend you take an additional medication. Drug therapies that treat depression include:

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRI drugs are the most commonly prescribed antidepressants and are often considered the first line of defense against depression. They increase your brain's level of a neurotransmitter (a chemical that transfers messages from brain cell to brain cell) called serotonin. This neurotransmitter is associated with feeling happy and content. SSRI side effects tend to be mild, and depression symptoms improve significantly for about 60% of people with moderate to severe depression.

Selective Serotonin Noradrenaline Reuptake Inhibitors (SSNRIs)

Both SSNRI and SSRI medications affect serotonin levels, but SSNRI drugs also impact the level of norepinephrine, another neurotransmitter that may affect mood. This type of medication is helpful for those who have extreme fatigue associated with depression, or who have had side effects or poor response to SSRI drugs.

Tricyclic Antidepressants (TCAs)

TCA drugs increase serotonin and norepinephrine in the brain, but unlike other antidepressant types, they also block acetylcholine, a neurotransmitter associated with increased stress, anxiety and depression. You may experience more side effects with TCA medications than with SSRI or SSNRI drugs.

Monoamine Oxidase Inhibitors (MAOIs)

MAOI drugs inhibit the breakdown of dopamine, norepinephrine and serotonin, which increases their concentration in the brain. Low levels of these neurotransmitters are associated with depression and anxiety. MAOI drugs have a greater number of serious side effects. People taking them have to be mindful of the medication's interactions with certain foods and other drugs.

Bupropion

Bupropion acts on dopamine and norepinephrine. Its main advantage is that it doesn't cause troublesome side effects such as decreased libido and weight gain like other types of antidepressants do. However, it may be less helpful for depression with anxiety features.

Esketamine

This newer drug provides relief from depression symptoms within hours by increasing levels of glutamate, the most abundant neurotransmitter in the brain. Esketamine comes in a nasal spray that must be administered in a clinic because it can cause hallucinations and other sensory side effects for up to two hours after treatment. It's an effective drug for those who haven't responded to other antidepressants.

If you're experiencing breakthrough depression, it's important to consult with your doctor so you can feel better again. "It's not unusual for medications to stop working," says Nestadt. "It happens with other sorts of medical treatments as well. Sometimes your blood pressure medicine is no longer effective and it has to be switched. It's just the nature of treating illness."

12 Signs Your Antidepressant Isn’t Working

For many people, finding the right depression treatment is a trial-and-error process. An antidepressant may work well for one person but not at all for someone else — and experts don’t yet have ways to predict this.

In other cases, a person may start to feel better on an antidepressant, but the side effects are too bothersome for them to keep taking it.

A review published in February 2018 in the Lancet assessed previous studies of 21 antidepressant medications and concluded that although these drugs are an effective treatment for depression, some work better than others, and some are better tolerated by the body than others.

One way to improve your chances of finding the depression medication that works best for you is to look for the following signs that your antidepressant isn’t working well enough or is no longer working the way it should.

6 Depression Symptoms You Shouldn't Ignore

1. You Feel Better Right Away, but It Doesn’t Last

Exactly how antidepressants work is still a mystery. The effects are thought to be related to changes in neurochemicals in your brain, such as serotonin, dopamine, and norepinephrine — changes that usually take 2 to 12 weeks to set in, with a peak at 6 to 8 weeks. So, if you feel different immediately after starting a depression treatment, it could be a placebo effect, says the board-certified psychiatrist Joseph Hullett, MD, the senior medical director of OptumHealth Behavioral Solutions in Minnesota.

Sometimes that placebo effect wears off, and the actual effect of the antidepressant kicks in. Other times, the placebo just wears off, and the intended effects of the antidepressant are never felt. In this second case, it isn’t that the medication stopped working — it’s that the medication (beyond the placebo effect) just didn’t work for you in the first place.

RELATED: 12 Surprising Facts About Depression

2. You Skipped a Dose — or Several

It’s a common situation — busy people often miss doses or take their medication at irregular intervals. The trouble is, not taking an antidepressant medication consistently can prevent it from working as well as it should — or prevent it from working at all, Dr. Hullett cautions. This can cause people to abandon what otherwise might be a very effective treatment.

3. You Can’t Sleep Well

“Antidepressants can make you feel more sleepy, less sleepy, and affect your libido and sex life, which can affect your sleep,” says Karen Lim, MD, a double board-certified psychiatrist in general and child and adolescent psychiatry at Prairie Health, a telepsychiatry platform based in California.

“Some people are also surprised to know that antidepressants can cause vivid dreams, myoclonus (sudden jerking of limbs especially at night and when tired), and, rarely, seizures,” Dr. Lim adds. She says the following tweaks to your bedtime routine can be enough to correct some of these issues:

  • Try relaxation techniques, such as deep breathing.
  • Exercise during the day rather than at night.
  • Listen to calming sounds and music, or watch calming videos.
  • Talk to your doctor about taking an over-the-counter sleep aid like melatonin.

RELATED: 8 Health Problems Linked to Not Getting Enough Sleep

4. Your Mood Is Still Low After a Few Months

“You should see some improvement within three months of starting an antidepressant,” explains Zinia Thomas, MD, a psychiatrist based in St. Louis. “If you have been on an adequate dose of a depression medication for three months and you don’t get results, it’s probably time to try something new.”

5. You Feel More Energetic — but Still Feel Blue

“If you feel more physical energy after starting an antidepressant, but you still have depression, that’s good and bad news,” says Gabriela Cora, MD, a psychiatrist in Miami. “It means the depression medication is starting to work, but not in the right way." Increased physical energy combined with depression is a bad combination that can make you act out or increase your risk of suicide, she explains. “So, report these symptoms to your doctor right away,” urges Dr. Cora.

RELATED: 8 Depression Symptoms You Shouldn’t Ignore

6. You’re Experiencing Unpleasant Side Effects

Deciding which depression medication is best for you often comes down to side effects, says Hullett. If you gain weight or have sexual problems on one antidepressant, for example, you may want to switch to one without those side effects, he advises.

7. You Show Symptoms of Serotonin Syndrome

Although antidepressants are meant to help you feel better, in some cases an antidepressant may combine with other medications you are taking or foods you are eating and lead to serotonin syndrome, an uncommon condition involving an overabundance of serotonin in the body, the Cleveland Clinic states.

Symptoms to watch out for, Lim says, include fever, aches, shakes, sweats, fatigue, irritability, a bad headache, confusion, agitation, restlessness, dizziness, difficulty seeing or walking, muscle twitching, muscle tension, or jaw clenching.

Typically, serotonin syndrome happens within days or weeks of starting an antidepressant or after a dose increase, says Lim. The most common factors that affect your risk of serotonin syndrome, per the Cleveland Clinic, are:

  • Too much of one medication that affects your serotonin levels
  • Multiple medications that affect your serotonin levels at the same time

8. Your Antidepressant Doesn’t Pack the Same Punch

“If you’ve been on an antidepressant for a long time, your body may develop a tolerance,” notes Hullett. As a result, a medication that once worked well at quelling your sadness, anxiety, and other symptom no longer has that power. Sometimes, Hullett says, increasing the dose under supervision by your doctor may help. “If you’ve been taking 10 milligrams (mg) of Prozac (fluoxetine), for example, your physician may increase the dose to 20 mg,” he says. In other cases, trying a different medication or treatment is helpful.

9. Your Depression Worsens

“If your depression symptoms get worse as soon as you start taking an antidepressant, or they get better and then very suddenly get worse, it’s a sign that the depression medication isn’t working properly, and you should see your healthcare professional right away,” Hullett says. Specific warning signs to watch for include feeling agitated or restless, pacing or constant movement, hand wringing, or feeling generally out of control.

10. Your Mood Has Improved, but You’re Still Not Yourself

If you experience some relief on an antidepressant, but it’s not the relief you hoped for, it may be time to try something new, Dr. Thomas says. Options include another depression medication or the addition of counseling, psychotherapy, mood-boosting cardio exercise, or light therapy to your treatment regimen. The combination of medication and other mood-brightening treatments can speed your recovery and reduce your overall time on antidepressants, she says.

11. Your Mood or Energy Improves — but Too Much

“Depression medications can sometimes cause mood swings, especially in people who have a tendency toward bipolar disorder — depression and mania,” Hullett says. If you feel unusually elated or you become very terse with your spouse, feel noticeably more irritable, or have an uncharacteristic bout of road rage, you probably need to change your antidepressant, he advises.

RELATED: 9 Different Types of Depression

12. Your Depression Is Gone

If you’ve been taking an antidepressant for at least six months and you’ve achieved remission, it’s important to slowly taper off your depression medications with the help of your physician. “Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can produce physical symptoms of withdrawal if you stop taking them suddenly,” he says. “So, you need to reduce the dosage of depression medication slowly, usually over a few weeks.”

You may experience some depressive symptoms when discontinuing antidepressants, but this does not mean the depression is returning. Unfortunately, some people stay on their antidepressants longer than needed because the symptoms of discontinuing SSRIs can be mistaken for signs of returning depression.

Work with your doctor to distinguish between the two. You may need to go even slower than a few weeks when tapering off your antidepressant to prevent these withdrawal symptoms.

The Bottom Line

While taking an antidepressant can be very helpful for managing depression, you might not find the right one for you on the first try.

If your medication isn’t meeting your expectations, don’t give up. Consider talking to a doctor who specializes in treating mood disorders if you aren’t already seeing one. And be on the lookout for any worrisome symptoms while you're taking any antidepressant, Lim advises. Manic episodes, serotonin syndrome, and seizures, for example, need to be evaluated by a doctor ASAP.

Additional reporting by Michelle Pugle.

Desvenlafaxine | Side effects, dosage, uses and more

contents

Dedicated to desvenlafaxine

  • Desvenlafaxine oral tablets are available as a trademark and as a generic drug. Trademark: Pristiq and Khedezla.
  • Desvenlafaxine is only available as an extended release tablet that you take by mouth.
  • Desvenlafaxine is used to treat major depression. nine0007

    Important warnings

    FDA warnings

    • This drug has black box warnings. These are the most serious warnings from the Food and Drug Administration (FDA). Black box warnings alert doctors and patients to exposure to drugs that may be dangerous.
    • Increased risk of suicidal thoughts and behavior: This medicine may make depression worse and cause suicidal thoughts or actions. This risk increases during the first four weeks of treatment. The risk is perhaps highest in people aged 24 and younger. If you think about hurting yourself, see your doctor immediately. nine0007
    • Use in children: This medicine has not been shown to be safe or effective in children (under 18 years of age). When used in children, the risks should be weighed against the potential benefits.

    Other warnings

    • Serotonin syndrome warning: This medicine may cause a serious condition called serotonin syndrome. In this condition, levels of serotonin (natural chemicals in the brain) rise to dangerously high levels. This most often happens when you take desvenlafaxine with other medicines that work in a similar way. Serotonin syndrome causes symptoms such as anxiety, hallucinations (seeing or hearing things that are not real), seizures, or nausea. If you have these symptoms, call your doctor right away. nine0007
    • High blood pressure warning: This medicine may increase blood pressure. Call your doctor if you notice changes in blood pressure after starting this medicine.
    • Withdrawal warning: If you suddenly stop taking this medicine, you may experience withdrawal symptoms. These symptoms may include dizziness, headache, sweating, upset stomach, or feeling irritable. Do not stop taking this medicine without first talking to your doctor. If you experience these symptoms after you stop taking your medicine, call your doctor. nine0007
    • Bleeding warning. This medicine affects how the body processes a chemical called serotonin. This may increase the risk of bleeding.

    What is desvenlafaxine?

    Desvenlafaxine is a prescription drug. It comes in the form of extended release tablets that you take by mouth. Long-acting drugs are slowly absorbed into the body over time.

    Desvenlafaxine oral tablets are available as protected formulations Pristiq and Khedezla. It is also available as a generic drug. Generics usually cost less than branded versions. In some cases, they may not be available in all strengths or forms as brand name medicines.

    Desvenlafaxine may be used in combination therapy. This means that you may need to take it with other medicines.

    Why is it used

    Desvenlafaxine is used to treat major depression. Symptoms may include feelings of sadness, loss of interest in daily activities, decreased energy levels, or trouble sleeping. These symptoms persist for two weeks or longer.

    How it works

    Desvenlafaxine belongs to a class of medicines called antidepressants. A certain type of drug is called a serotonin and norepinephrine reuptake inhibitor (SNRI). A drug class is a group of drugs that work in a similar way. These drugs are often used to treat these conditions. nine0003

    Serotonin and norepinephrine are natural chemicals in the brain that help maintain mental balance. Desvenlafaxine may work by stopping the process that breaks down these chemicals. This process is called recollection. Blocking repeated consumption increases the amount of these chemicals in your brain and may help relieve symptoms of depression.

    Desvenlafaxine side effects

    Desvenlafaxine oral tablets may cause drowsiness. During the first few hours after ingestion, it may also cause dizziness, drowsiness, dry mouth, or stomach discomfort. nine0003

    Desvenlafaxine may cause other side effects.

    more common side effects

    more common side effects of desvenlafaxine may include:

    • Nausea
    • Dry In the mouth
    • Bitch
      • Fields 9000 9000
    • blurred vision
    • decreased sex drive
    • problems with sexual function

    If these effects are mild, they may disappear within a few days or a couple of weeks. If they are more severe or do not go away, talk to your doctor or pharmacist.

    Serious side effects

    Call your doctor if you have serious side effects. Call 911 if your symptoms seem life-threatening or if you think you need emergency medical attention. Serious side effects and their symptoms may include the following:

    • Serotonin syndrome. Symptoms may include:
      • excitement
      • hallucinations (seeing or hearing things that are not real)
      • seizures
      • nausea
    • Low salt levels. Symptoms may include:
      • headache
      • confusion
      • weakness
      • seizures

    Disclaimer: Our goal is to provide you with the most current and up-to-date information. But because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information does not replace medical advice. Always discuss possible side effects with a doctor who knows your medical history. nine0003

    Desvenlafaxine may interact with other medicines.

    Desvenlafaxine oral tablet may interact with other medicines, vitamins, or herbs you are taking. An interaction is when a substance changes the way a drug works. It can be harmful or prevent the medicine from working well.

    To avoid interactions, your doctor must carefully administer all of your medicines. Tell your doctor about any medications, vitamins, or herbs you are taking. To find out how this medicine may interact with other medicines you are taking, talk to your doctor or pharmacist. nine0003

    Examples of drugs that can interact with desvenlafaxine are listed below.

    Medicines not to be taken with desvenlafaxine

    Do not take these medicines with desvenlafaxine. This can lead to dangerous consequences for your body. Examples of such drugs include:

    • Monoamine oxidase inhibitors (MAOIs), a type of antidepressant such as phenelzine, tranylcypromine, selegiline, or isocarboxazid. The use of these drugs with desvenlafaxine increases the risk of developing serotonin syndrome. If you start treatment with desvenlafaxine, stop taking the MAOI at least 14 days before. If you need to start treatment with an MAOI, stop taking desvenlafaxine at least 7 days before. nine0007

    Interactions that increase the risk of side effects

    Taking desvenlafaxine with certain drugs increases the risk of side effects of these drugs. These medicines include:

    • Some antidepressants, including:
      • selective serotonin reuptake inhibitors (SSRIs) such as citalopram, fluoxetine or paroxetine
      • serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venduloxetine nine0007
      • tricyclic antidepressants (TCAs), such as amitriptyline or imipramine
      • other serotonergic drugs, including triptan, fentanyl, tramadol, buspirone, lithium, tryptophan, amphetamine, and onion cause serotonin syndrome. Symptoms may include restlessness, hallucinations (seeing or hearing things that are not real), seizures, or nausea. If you have these symptoms, call your doctor right away. nine0003
        • Drugs such as desipramine, atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine or tolterodine. The severity of side effects varies depending on the drug. Your doctor may reduce the dosage of these medicines if your dose of desvenlafaxine is 400 mg per day.
        • Diuretics (diuretic tablets) such as hydrochlorothiazide or furosemide. Increased side effects may include low salt levels. If your salt level is too low, your doctor may gradually stop taking desvenlafaxine and switch you to another antidepressant. nine0007
        • Non-steroidal anti-inflammatory drugs, aspirin and anticoagulants such as warfarin, dabigatran, edoxaban, apixaban or rivaroxaban. Using these drugs with desvenlafaxine increases the risk of bleeding.

        Disclaimer: Our goal is to provide you with the most current and up-to-date information. However, because drugs affect each person differently, we cannot guarantee that these data include all possible interactions. This information does not replace medical advice. Always talk to your doctor about potential interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter medications you are taking. nine0003

        Warnings for desvenlafaxine

        This medicine comes with several caveats.

        Allergy warning

        This medicine may cause a severe allergic reaction. Symptoms may include:

        • trouble breathing
        • swelling of the throat or tongue

        If you have these symptoms, call 911 or go to the nearest emergency room.

        Do not take this medicine again if you have ever had an allergic reaction to it. Repeated use may be lethal (lead to death). nine0003

        Alcohol Interaction Warning

        Avoid drinking alcohol while taking this medication. If you drink alcohol, talk to your doctor about whether this medicine is safe for you.

        Warnings for people with certain medical conditions

        For people with high blood pressure: This medicine may raise blood pressure. If you already have high blood pressure, talk to your doctor. You may need blood pressure medication or regular blood pressure monitoring while you are taking this medicine. nine0003

        For people with glaucoma: This medicine may dilate pupils (widen the dark centers of the eyes). This can trigger an attack of glaucoma. Talk to your doctor before taking this medicine to see if this medicine is safe for you.

        For people with seizure disorders: This medicine may cause seizures. If you have ever had seizures, tell your doctor before taking this medicine.

        For people with low salt levels: This medicine may cause low salt levels. This risk is higher for people who already have low salt levels. This may include the elderly (over 65), people taking diuretics, or people who are dehydrated. Talk to your doctor about whether this medicine is safe for you. nine0003

        For people with kidney problems: This kidney medicine removes it from your body. If your kidneys are not working properly, your body may excrete this medicine more slowly. This can increase the amount of the drug in the body and cause more side effects. To prevent this, your doctor may give you a lower dose of this medication.

        For people with liver problems: This drug is processed by the liver in the body. If your liver is not working properly, your body may be slower in processing this medicine. This may cause more side effects. To prevent this, your doctor may give you a lower dose of this medication. nine0003

        Warnings for other groups

        For pregnant women: There are no data to evaluate the use of this drug in pregnant women. This means that there is a risk of using this medication during pregnancy. However, there are also risks associated with not being treated for depression during pregnancy.

        Talk to your doctor if you are pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk. nine0003

        If you become pregnant while taking this medicine, call your doctor right away. In addition, there is a pregnancy registry that tracks pregnancy outcomes for women taking antidepressants during pregnancy. Your doctor can register you.

        For breastfeeding women: This medicine may pass into breast milk and cause side effects in nursing infants. Talk to your doctor if you are breastfeeding. You may need to decide if you want to stop breastfeeding or stop taking this medicine. nine0003

        For older people: older people's kidneys may not work as well as they used to. This can cause your body to process medications more slowly. As a result, more drugs stay in your system for longer. This increases the risk of side effects.

        If you are over 65 years of age, you may have a higher risk of side effects from taking this medicine. Therefore, your doctor may prescribe you a lower dose.

        For children: This medicine has not been tested in children. It should not be used in children under 18 years of age. nine0003

        How to take desvenlafaxine

        This does not include all possible dosages and forms of drugs. Your dose, form of medication, and how often you take the medication will depend on:

        • your age
        • the condition being treated
        • how serious your condition is
        • other health conditions you have
        • how you respond to the first dose

        Dosage for major depressive disorders

        Generic: Desvenlafaxine

        • Presentation: tablet for oral administration with prolonged release.
        • Strengths: 25mg, 50mg, 100mg

        Trademark: Pristiq

        • Presentation: prolonged release tablet for oral administration.
        • Strengths: 25mg, 50mg, 100mg

        Trademark: Hedesla

        • Presentation: prolonged release tablet for oral administration.
        • Strengths: 50 mg, 100 mg

        Adult Dosage (ages 18 to 64)

        • Typical starting dose: 50 mg once a day.
        • Typical daily dose: 50 mg once a day.
        • Dosage increased: Your doctor may increase your dose to a maximum of 400 mg once a day.

        Pediatric dosage (0-17 years of age)

        Desvenlafaxine has not been studied in children. It should not be used in children under 18 years of age.

        Higher dose (age 65 and over)

        Older people's kidneys may not work as well as they used to. This can cause your body to process medications more slowly. As a result, more drugs stay in your system for longer. This increases the risk of side effects.

        Your doctor may start with a lower dose or a different dosing schedule. This can help keep levels of this medication from building up too much in the body.

        Special dosage recommendations

        For people with kidney disease: Your dose depends on the stage of kidney disease. Your doctor may prescribe 50 mg once a day, 25 mg once a day, or 50 mg once a day.

        For people with liver disease: Your dose depends on the stage of your liver. Your doctor may prescribe 50 mg once a day. In most cases, the maximum dose is 100 mg once a day.

        Disclaimer: Our goal is to provide you with the most current and up-to-date information. But because drugs affect each person differently, we cannot guarantee that this list includes all possible doses. This information does not replace medical advice. Always talk to your doctor or pharmacist about the doses that are right for you. nine0003

        Take as directed

        Desvenlafaxine is used for long-term treatment. It comes with serious risks if you don't take it as prescribed.

        If you suddenly stop taking this medicine or do not take it at all: If you suddenly stop taking this medicine, you may experience withdrawal symptoms. These symptoms may include dizziness, headache, sweating, upset stomach, or feeling irritable. If you have these symptoms after stopping the medication, contact your doctor immediately. Do not stop taking this medicine without first talking to your doctor. nine0003

        If you don't take this medicine at all, your symptoms of depression may not be controlled.

        If you miss a dose or don't take your medicine as scheduled: The medicines may not work properly or may stop working completely. For this medicine to work well, a certain amount must be in your system at all times.

        If you take too much: You may have dangerous levels of the drug in your body. Overdose symptoms with this medicine may include:

        • anxiety
        • hallucinations (seeing or hearing things that are not real)
        • seizures
        • nausea

        If you think you have taken too much of this medicine, call your doctor or local poison control center. If you have severe symptoms, call 911 or go to the nearest emergency room immediately.

        What to do if you miss a dose: Take the dose as soon as you remember. But if you only remember a few hours before your next scheduled dose, take only one dose. Never try to compensate for taking two doses at the same time. This can lead to dangerous side effects. nine0003

        How to tell if a medicine is working: Your symptoms of depression should be less severe or less frequent. However, you may not notice any change in your condition for the first few weeks. It may take up to two months before this medicine works well.

        Important Considerations When Taking Desvenlafaxine

        Keep this in mind if your doctor prescribes desvenlafaxine.

        Basic information

        • You can take this medicine with or without food. nine0007
        • Take this medicine at the time recommended by your doctor.
        • Do not cut or crush the tablet.

        Warehouse

        • Store this medicine at room temperature, 68°F to 77°F (20°C to 25°C).
        • Keep this medicine away from light.
        • Do not store this medicine in damp or damp places such as bathrooms.

        tapping

        The prescription for this medicine can be refilled. You do not need a new prescription to refill this medicine. Your doctor will write the number of refills on your prescription. nine0003

        Travel

        When traveling with medication:

        • Always carry your medication with you. Never put it in your checked bag while flying. Keep it in your bag.
        • Don't worry about air devices at the airport. I can't hurt drugs.
        • You may need to show the pharmacy label for your medicines to the airport staff. Always carry the original prescription container with you.
        • Do not put this medicine in the glove compartment of your car or leave it in your car. Be sure to avoid this when the weather is very hot or very cold. nine0007

        Clinical monitoring

        Your doctor can monitor certain health problems. This may help keep you safe while you are taking desvenlafaxine. These problems include:

        • Kidney and liver function. Blood tests can check how well your kidneys are working. If your kidneys are not working well, your doctor may decide to reduce the dose of this medication.
        • Mental health. Your doctor may ask you various questions to check your symptoms of depression. This can help the doctor know how well this medicine is working. nine0007
        • Blood pressure. Your doctor can monitor your blood pressure. This may help keep this medicine from raising your blood pressure too much.

        availability

        Not every pharmacy stocks this medicine. When filling out a prescription, be sure to call in advance and make sure that it is in the pharmacy.

        Hidden costs

        You may need blood tests while taking this medicine. The cost of these tests will depend on your insurance. nine0003

        Prior approval

        Many insurance companies require prior approval for this drug. This means that your doctor will need to get insurance company approval before your insurance company will pay for the prescription.

        Are there alternatives?

        There are other medicines available to treat your condition. Some may suit you better than others. Talk to your doctor about other treatment options that may help you. nine0003

        Disclaimer: Healthline has made every effort to ensure that all information is correct, complete, and up-to-date. However, this article should not be used as a substitute for the knowledge and experience of a licensed healthcare professional. Always check with your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, instructions, precautions, warnings, drug interactions, allergic reactions, or side effects. The absence of warnings or other information for a particular drug does not mean that the drug or combination of drugs is safe, effective, or suitable for all patients or for all special uses. nine0003

        Why doesn't the medicine work? TOP 10 patient disobediences

        One of the most popular patient complaints: “the medicine does not work”. When we start to find out why this is happening, it turns out that half of the prescribed drugs were replaced with analogues, the second was decided not to buy. And what they have purchased is accepted "as they remember." Consider the most popular "disobedience" and why they are dangerous.

        10th place
        The leg of the chair is too big…
        Many people regulate the dose of the drug on their own. What if the doctor overdid it? nine0398 Why not?
        The dosage is usually determined based on the average body weight of the patient and his age. To think that if it doesn’t hurt a lot, then you can drink half the pill is wrong. There is a concept of therapeutic concentration, which is necessary to achieve the effect.

        9th place. My own doctor.
        The patient does not take the medicines prescribed by the doctor, choosing alternative methods on his own.
        Why is it not possible?
        An untreated disease can become chronic and a lifelong problem.

        8th place. I can't refuse.
        Many patients do not give up bad habits during treatment.
        Why is it not possible?
        Many medicines are incompatible with alcohol and even life-threatening. The same applies to nicotine, which constricts blood vessels and prevents the penetration of the active substance into the tissues.

        7th place. Awl for soap.
        The patient independently changes drugs to analogues.
        Why is it not possible?
        Not all drugs are interchangeable, even if they contain the same active ingredient. To competently replace the drug, you need a medical or pharmaceutical education.

        6th place. What in the world is delicious?
        In sixth place - failure to comply with dietary recommendations.
        Why is it not possible?
        Proper nutrition during illness is part of the treatment. So, if you eat fried potatoes and bacon with cholecystitis, recovery will never come. And if anticoagulants are taken with cranberry juice, there is a risk of bleeding. nine0003

        5th place. Before or after?
        The patient does not care when to take the drug - before, during or after meals.
        Why is it not possible?
        Many medicines can be taken after meals, but there are exceptions. For example, antacids that reduce gastric acidity must be taken 30 minutes before meals, otherwise they will not be useful. And non-steroidal anti-inflammatory drugs should not be taken on an empty stomach, as they irritate its mucous membrane.

        4th place. Healed and good!
        Half of the patients are not examined after treatment.
        Why is it not possible?
        Temporary improvement does not mean that the person is healthy. Often the treatment needs to be adjusted. Complications may develop after some diseases. To avoid this, you need to pass control examinations.

        3rd place. Bitter pill.
        In third place are those who drink medicines with coffee, tea, juice, and milk. nine0398 Why not?
        All drinks listed are reactive. Tea contains tannin, juices - fruit acids, milk - calcium. These substances can react with drugs, weaken or neutralize the effect.

        2nd place. The course has been changed.
        Patients do not drink the full course prescribed by the doctor.
        Why is it not possible?
        The symptoms of the disease may pass quickly, and it may take time to remove the cause. So, on the 2-3rd day of taking antibiotics, relief often occurs, but not all microbes may die during this time. If you interrupt the course, then the remaining microorganisms will gain strength and multiply again. nine0003

        1 seat. Skip a turn.
        The first place in the hit parade is to take medicine as it will.

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