Actually, since Pristiq just came out in January, you are probably more likely to get it as your "first-trial" medication... that is, it is very likely that the Wyeth representatives have made it to all the GPs and Psychiatrists by now and provided them with year-worth-supplies of sample packs to get patients to buy their "latest and greatest, super-new" antidepressant.
Although (imho), if you have never been on any antidepressants, I would (if I were your prescribing doctor) prefer to go with a typical SSRI--either Prozac or Lexapro--if you mention Pristiq during the consultation and the doctor has sample packs then yes, you can probably try Pristiq as your first medication.
I just remember I tried Paxil first (the choice SSRI for depression and anxiety at the time), and after it didn't work, Effexor XR was the 2nd drug I was put-on. I only stayed on it for 4 days b/c the side-effects were awful... which is why I am a little surprised that my reaction to Pristiq (so far) has been very good; I attribute it to the extended release of a less chemically-mixed mess that causes similar--but to a much less degree--side effects.
Anyway, in short, you do not necessarily have to try an SSRI first before an SNRI... it is probably the "standard" pattern that doctors might follow, but if you bring-up Pristiq in the initial consultation, have a good reason for believing it would benefit you, and your doctor also agrees that it would be a potential "good choice" for you, then I wouldn't see why you couldn't start with the SNRI.
Hope that helps a bit, and I apologize for the rambling... it is late!
Good luck, and let us know how it works-out.
- Pristiq Information for Consumers
- Pristiq Information for Healthcare Professionals (includes dosage details)
- Side Effects of Pristiq (detailed)
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