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Desvenlafaxine (Pristiq) can raise the risk of suicidal thoughts or behavior. The risk is highest if you're 24 years or younger. Watch for worsening depression or suicidal thoughts or behavior, especially during the first few months of treatment or when your dose changes. Let your healthcare provider know right away if you or a loved one notices any unusual changes in mood or behavior while you're taking this medication.

In some rare cases, desvenlafaxine (Pristiq) can cause a potentially life-threatening condition called serotonin syndrome. This condition happens when there's too much serotonin in the brain. Serotonin is one of the chemicals in your brain that's responsible for your mood. Your risk for this condition goes up if you take desvenlafaxine (Pristiq) with other medications that raise serotonin levels (e.g., certain antidepressants, certain migraine medications, St. John's wort). Tell your pharmacist about all your prescriptions and over-the-counter products you take before starting desvenlafaxine (Pristiq) so they can check for any interactions. Symptoms of too much serotonin include a fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Tell your healthcare provider or seek medical help right away if you have any of these symptoms.

Desvenlafaxine (Pristiq) can cause a rise in blood pressure. If you already have high blood pressure, talk to your provider to make sure that it's safe for you to take desvenlafaxine (Pristiq) before starting this medication. It's recommended that you regularly check your blood pressure at home during treatment. If you notice that your blood pressure is consistently high for a long period of time while taking desvenlafaxine (Pristiq), let your provider know. You might have to take a lower dose or stop taking this medication altogether.

Desvenlafaxine (Pristiq) can raise your risk of bleeding or bruising, especially if you're also taking blood-thinning medications like aspirin, warfarin (Coumadin), or nonsteroidal anti-inflammatory drugs (NSAIDs). Tell your healthcare provider about any bruising that doesn't improve, black-colored stools, pink or red urine, or unusual bleeding from the nose or gums. If you're taking blood thinners or other clot-preventing medications, your provider will likely want to follow up with you more often when starting, changing the dose of, or stopping desvenlafaxine (Pristiq).

Desvenlafaxine (Pristiq) can worsen certain eye conditions in some people, especially in those with narrow-angle glaucoma. If you notice any changes to your vision while taking desvenlafaxine (Pristiq), let your provider and eye care professional know right away.

Sometimes, depression is the first symptom of bipolar disorder. Treating someone with bipolar disorder with an antidepressant alone can cause a manic episode (great excitement, euphoria, delusions, and overactivity). Your provider will make sure that you don't have bipolar disorder before prescribing desvenlafaxine (Pristiq).

Stopping desvenlafaxine (Pristiq) suddenly can cause withdrawal symptoms, such as nausea, anxiety, distress, flu-like symptoms, trouble sleeping, and dizziness. Your provider will help you to lower your dose of desvenlafaxine (Pristiq) so you can stop the medication safely and slowly. Never try to stop desvenlafaxine (Pristiq) on your own and without the supervision of a healthcare provider.

Some people have reported getting seizures while taking desvenlafaxine (Pristiq). Let your healthcare provider know if you have or have had seizure problems before you start desvenlafaxine (Pristiq). They might want to follow up with you more closely during treatment.

Very rarely, desvenlafaxine (Pristiq) can reduce the sodium levels in the blood. You might be at higher risk if you're older than 65 years of age or if you're taking diuretics ("water pills"). Tell your healthcare provider right away if you experience any symptoms of low sodium levels during treatment, including weakness, confusion, difficulty concentrating, headache, or memory problems while taking this medication.