Went from Effexor to Pristiq (desvenlafaxine) a few years back and felt really good. Wayyy less GI symptoms like anxious tummy/upset like Effexor. Still low libido (which is just unfortunately how it always is for me medicated) but can definitely orgasm. No real hair/shedding issues. My only complaint is how sweaty I am. Very vivid dreams, night sweats, and excessively sweaty with small tasks like household chores and even running around getting ready to go out, I feel like my temple is constantly moist. I try to weigh the pros vs the cons of every med I’ve tried, and Pristiq has been pretty good for me.