Of course using Pristiq for pain is way off label. The drug is probably mostly a patent extender and not a real improvement over Effexor according to clinical trials. For more information including a lively discussion list see Carlat's Psychiatry blog. There are some anecdotes of use in pain syndromes there but InteractMD.com readers know how I feel about anecdotal evidence. http://carlatpsychiatry.blogspot.com/2008/03/top-5-reasons-to-forget-abo...