From the FDA Drug Label
Elevations in fasting serum total cholesterol, LDL (low density lipoproteins) cholesterol, and triglycerides occurred in the controlled studies. Some of these abnormalities were considered potentially clinically significant. The percentage of patients who exceeded a predetermined threshold value is shown in Table 4 Table 4: Incidence (%) of Patients With Lipid Abnormalities of Potential Clinical Significance* Desvenlafaxine Placebo 50 mg 100 mg 200 mg 400 mg Total Cholesterol 2 3 4 4 10 *(Increase of ≥50 mg/dl and an absolute value of ≥261 mg/dl) LDL Cholesterol 0 1 0 1 2 *(Increase ≥50 mg/dl and an absolute value of ≥190 mg/dl) Triglycerides, fasting 3 2 1 4 6 *(Fasting: ≥327 mg/dl)
Yes, cholesterol should be monitored while taking Pristiq (desvenlafaxine) due to the potential for elevations in fasting serum total cholesterol, LDL cholesterol, and triglycerides, as observed in controlled studies 1.
From the Research
Yes, cholesterol should be monitored while taking Pristiq (desvenlafaxine), particularly if you have pre-existing cardiovascular risk factors or cholesterol issues. While Pristiq is not known to cause significant cholesterol changes in most patients, some antidepressants in the SNRI class can potentially affect lipid levels in certain individuals. It's recommended to have baseline cholesterol measurements before starting Pristiq and follow-up testing as directed by your healthcare provider, typically during regular check-ups. The monitoring frequency may be increased if you have existing heart disease, high cholesterol, diabetes, or are taking other medications that affect cholesterol. This recommendation stems from the understanding that some antidepressants can influence metabolic parameters through their effects on neurotransmitters that play roles in appetite regulation and metabolism, as seen in a study on the effects of venlafaxine on lipoproteins 2. If you notice weight changes while taking Pristiq, this could potentially impact your cholesterol levels as well, providing another reason for monitoring, and is supported by the fact that venlafaxine, a related medication, has been shown to have dose-dependent effects on blood pressure 3. Always discuss any concerns about medication side effects with your healthcare provider rather than discontinuing Pristiq on your own, and consider the cardiovascular effects of newer antidepressants, including desvenlafaxine, as discussed in a review of their safety in older adults and those with cardiovascular disease 4. Key points to consider include:
- Baseline cholesterol measurements before starting Pristiq
- Follow-up testing as directed by your healthcare provider
- Increased monitoring frequency if you have existing heart disease, high cholesterol, diabetes, or are taking other medications that affect cholesterol
- Potential impact of weight changes on cholesterol levels
- Importance of discussing concerns about medication side effects with your healthcare provider.