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Dear Anon: Your question got cut off, would you mind reposting so we can help you better?

Dear Anonymous,
It seems that I didn't get the whole question, but I will answer (with some assumptions)
You mention that you are on Pristiq 50 mg per day and it is not helping with hot flashes and night sweats as you had heard it might. My assumptions are that you are perimenopausal and that Pristiq might have been prescribed for reasons other than to relieve menopausal symptoms.

My short answer is that Pristiq, an antidepressant, has been shown in some studies to help relieve some of the symptoms of menopause for some women. Other studies have not found this. You have been taking a reasonable dose for a good amount of time and it is NOT working for you in this way. In the medication information given with Pristiq- Hyperhydrosis (sweating) and Hot flushes (flashes) were both side effects found to occur more often than with placebo in double-blind placebo-controlled studies. This medication (and many other antidepressants) can make these symptoms worse.

Now, if you are taking this medication for another condition, such as depression or anxiety (psychiatric term for worry or nervousness), then you have some choices to make. If you are taking it simply for relief of the hot flashes, I would recommend stopping it under the supervision of your doctor. DO NOT STOP COLD TURKEY or you will likely have uncomfortable physical and mental symptoms that occur when stopping most antidepressants without a taper.

Most likely, the medication is for another condition, like depression. If it is effective for treating that condition, you and your doctor have to weigh the risks and benefits of continuing this medication. If it's helping you, probably you should continue the Pristiq if you can tolerate the side effects without too much disruption in your functioning. You also have plenty of other choices that might not have the same undesirable side effects.

I want to make one more comment about the use of antidepressants for menopausal symptoms. It is an "off label usage", meaning the FDA has not approved any of these medications for this type of treatment. That doesn't mean it's illegal or unethical to use the meds this way. It just means that the pharmaceutical companies haven't sought this "indication" or if they have, there haven't been enough convincing studies of efficacy and safety for this condition.

Doctors, including myself, prescribe "off-label" all the time. For instance I might prescribe a medication to a 16 yr old which has not been FDA approved for use in people under 18.

I hope this helps you. If you have further questions, please write back.

Sincerely,
Tanya Feinberg, M.D.
www.drfeinbergmd.com

I got the full question and this woman was taking the medication for depression, but wondered why her hot flashes and night sweats were actually worsening. This doesn't change my answer, however.

I was also taking Pristiq for my depression brought on by excessive sweaty armpits and hyperhidrosis. It was a viscous cycle as it just made me sweat more. I would reccomend trying something else

i am starting my first dose of pristiq today, & i am very nervous.
i'll be taking it mostly for depression, but also for anxiety, with klonopin to use "just in case"

i was diagnosed as bipolar, mostly due to my over-emotional-ness, which can be a tell tale sign of some types of bipolar,
but now that i am being medicated for bipolar, i feel like instead of a roller coaster of ups & downs, i am mostly just downs,
so we are experimenting with anti-depressants to see if we can pull me out of the dumps without pulling me off of my
bipolar meds.

last month we tried Zoloft, & i hated it. it made me sleepy, nauseated, & more lethargic than usual....

I have problems with lethargy as it is, & lack of motivation/desire to do anything, irritability, anxiety, disorganization, procrastination, I just can't seem to find the desire, energy, or reason to complete anything i finish, & the inability to rope myself into getting anything done....
I feel like I make list after list of everything I need to complete, but never get anything- in it's entirety- completed.
It's getting to the point where I am frustrating my family, I can't ever remember when I am supposed to do anything, all of my "To Do's" kind of just get lost in the jumble that is my life... & I am frustrating my boss, I'll make shift changes & totally just space-cadet it & forget i made the changes, i've lost countless relationship opportunities from forgetting certain dates or times i'm supposed to call someone, as well as psyching myself out anxiety-wise to the point where i'll just make up excuses to not go on certain dates or do certain things.
& the culmination of this all just makes my depression worse.

i feel like i will never be able to regulate my systems & feel... "normal"

whew, besides this rant, i am very curious to hear whether or not Pristiq had any "good" sort of effect on your energy level?
i can only HOPE it will help mine,
maybe with at least a TINY nudge in the right direction, i can try to get the dominoes of my life to fall into place.

who knows.

any feedback will be great.