Can you take Pristiq (desvenlafaxine) and Strattera (atomoxetine) together?

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Last updated: June 6, 2025View editorial policy

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From the Research

Taking Pristiq (desvenlafaxine) and Strattera (atomoxetine) together is generally not recommended without close medical supervision due to potential drug interactions, as evidenced by the most recent study in 2021 1. These medications can interact to increase the risk of serotonin syndrome, a potentially serious condition characterized by agitation, hallucinations, rapid heart rate, fever, excessive sweating, shivering, tremors, muscle stiffness, and coordination problems. Both medications affect neurotransmitters in the brain - Pristiq is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant, while Strattera is a selective norepinephrine reuptake inhibitor used for ADHD. The combination may lead to excessive levels of serotonin and norepinephrine in your system. Some key points to consider when taking these medications together include:

  • The risk of serotonin syndrome, which can be life-threatening if not treated promptly
  • The potential for increased heart rate and blood pressure, as seen in studies such as 2
  • The importance of close medical supervision to monitor for adverse effects and adjust dosages as needed
  • The need to start with lower doses and gradually increase while watching for adverse effects
  • The importance of reporting any unusual symptoms immediately to your healthcare provider Some patients may take these medications together successfully under proper medical supervision when the potential benefits outweigh the risks, as seen in studies such as 3 and 4. However, it is crucial to prioritize caution and carefully weigh the potential benefits against the potential risks, as the most recent study in 2021 1 highlights the importance of considering the effects of antidepressant drugs on blood pressure profiles and potential interactions with antihypertensive treatments. In terms of specific guidance, the study in 2010 5 notes that desvenlafaxine, the active metabolite of venlafaxine, is a serotonin norepinephrine reuptake inhibitor (SNRI) that has been approved for the treatment of major depressive disorder, and that it may be a valuable treatment option for expanding the limited number of available dual reuptake inhibitors. Ultimately, the decision to take Pristiq and Strattera together should be made in consultation with a healthcare provider, taking into account the individual patient's medical history, current medications, and potential risks and benefits.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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