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Pristiq Twice Daily Dosing?

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Following a 30-day Cymbalta trial for anxiety (not very severe), I started taking Pristiq 50mg 9 days ago. I have had a few mild side effects that seem to be improving so I am thinking that this one may be a keeper. However, I also notice that the drug seems to wear off about 5 or 6 hours prior to my next dose.

Does anyone else take Pristiq twice a day? What are your experiences?


For those of you cataloging side effects, here are mine. Some of these may be related to the Cymbalta withdrawal because I really did not wean down from cymbalta 60 for more than a few days before starting Pristiq. Symptoms started out light, peaked, then started to dissipate:

Days 1-5

Vivid Dreams

Light Sleep

Teeth Clenching


Mild Headache


Day 5

(all of the previous symptoms PLUS...)


Major anxiety

obsessive thoughts

self mutilation urges (NEVER experienced that before)

Heart Racing

Insomnia for 48 hours

Day 6

All of the above, but lessening in severity

Day 7

Light Headache

Tight Muscles

Moody (irritable, then ecstatic)

teeth Clenching

Light Sleep


Day 8



sore muscles

Day 9

Sore muscles

slightly irritable but generally happy

teeth clenching

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Hey -

If you are noticing withdrawal symptoms before your next dose that is a good sign that you should try splitting your dose. HOWEVER if your tablets are "extended release" of any kind, you cannot cut them, so you would need to get your doctor to write you a prescription for smaller pills if you don't have the right pill denominations to split the dose.

Anyway, I have that problem with a lot of medications - even ones that are typically taken once per day, I tend to notice peaks and valleys if I don't take them twice a day.

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Alright! Day 17 update here. I am definitely going to ask my Doctor to write a prescription for 50 mg twice a day. I like this medicine. The only side effect I notice is back pain when the dose wears off (about 8 hours after taking it). Otherwise, it's been pretty great and my libido is crazy high, too.

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  • 2 weeks later...

I also went from Cymbalta (40mg) straight to Pristiq. I have been on Pristiq for 8 days now and am still depressed and anxious as hell. Still have horrible racing, obsessive thoughts also. And I feel like all of this is a little worse since starting the Pristiq. It sounds like there might be hope, though- You mentioned that you started feeling better and the side effects have started to subside? How long did that take for you?

Hope you keep us updated on your progress with this med. I am praying it will help me.

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