the public record, side by side

desvenlafaxine vs venlafaxine

Pristiq and Effexor, compared on what the public record actually supports: who takes each one, who pays, what the labels warn, and what the litigation record holds. Sources on every number.

What this page will not do is rank them. For most same-class pairs, head-to-head efficacy differences are smaller than the rankings look — the largest network meta-analysis ever run (21 antidepressants, 522 trials) found every drug beat placebo and the gaps between drugs mostly modest and uncertain. Which one fits you turns on your history, your other medications, and side-effect trade-offs — a prescriber conversation. This page arms that conversation; here are the questions worth taking into it →

desvenlafaxine (Pristiq)

SNRI antidepressant

FDA approval
2008 · full approval journey →
Who takes it (US, 2024)
795,092 patients · 3,875,578 prescriptions (ClinCalc/MEPS)2014 → 2024: up 26% (3,077,312 → 3,875,578 prescriptions)
Who pays (2024)
Medicare: 975,815 claims · 187,042 beneficiariesMedicaid: ≥676,183 prescriptionsCommercial claims: not published in any public dataset — a real absence, not a zero.
Boxed warning
Yes — on the current FDA label. read it in context →
Adverse-event reports (FAERS)
Caveat first: FAERS counts unverified REPORTS, not patients or rates — no denominator, and attention inflates reporting. Never compare these counts head-to-head; a longer-marketed, more-prescribed drug accumulates more reports by exposure alone. how to read FAERS →26,842 all-time reports; most-reported terms: drug ineffective, nausea, headache
Legal & safety record
no dedicated record page yet; the journey page carries label history

venlafaxine (Effexor)

SNRI antidepressant

FDA approval
1993immediate-release; Effexor XR followed in 1997 · full approval journey →
Who takes it (US, 2024)
3,429,959 patients · 16,273,306 prescriptions (ClinCalc/MEPS)2014 → 2024: down 6% (17,385,388 → 16,273,306 prescriptions)
Who pays (2024)
Medicare: 6,169,621 claims · 1,163,195 beneficiariesMedicaid: ≥2,967,610 prescriptionsCommercial claims: not published in any public dataset — a real absence, not a zero.
Boxed warning
Yes — on the current FDA label. read it in context →
Adverse-event reports (FAERS)
Caveat first: FAERS counts unverified REPORTS, not patients or rates — no denominator, and attention inflates reporting. Never compare these counts head-to-head; a longer-marketed, more-prescribed drug accumulates more reports by exposure alone. how to read FAERS →131,573 all-time reports; most-reported terms: drug ineffective, nausea, fatigue

Where these numbers come from

  • Patients and prescriptions: ClinCalc DrugStats (federal MEPS survey), latest published year — counts of people filling prescriptions, not outcomes.
  • Medicare/Medicaid: CMS public datasets; commercial insurance publishes no per-drug series, so it renders as an absence, never a synthesized number.
  • Label facts: the drugs' current FDA labels via DailyMed — quoted in context on each drug's approval-journey page.
  • FAERS: openFDA — reports, never rates; the caveat travels above every count.
  • Litigation: court records and regulator documents only, on the linked record pages; settled is never adjudicated.

Explore both drugs in depth: /m/desvenlafaxine · /m/venlafaxine · or the whole library →