Citation

Lieberman DZ, Massey SH. Core Evidence 2009; 4: 67-82.

Copyright

(Copyright © 2009)

DOI

unavailable

PMID

unavailable

Abstract

INTRODUCTION: Desvenlafaxine, the active metabolite of venlafaxine, is a serotonin norepinephrine reuptake inhibitor (SNRI) recently approved for the treatment of major depressive disorder. It is one of only three medications in this class available in the United States. Aims: The objective of this article is to review the published evidence for the safety and efficacy of desvenlafaxine, and to compare it to other antidepressants to delineate its role in the treatment of depression. Evidence review: At the recommended dose of 50 mg per day the rate of response and remission was similar to other SNRIs, as was the adverse effect profile. The rate of discontinuation was no greater than placebo, and a discontinuation syndrome was not observed at this dose. Higher doses were not associated with greater efficacy, but they did lead to more side effects, and the use of a taper prior to discontinuation. The most common side effects reported were insomnia, somnolence, dizziness, and nausea. Some subjects experienced clinically significant blood pressure elevation. Place in therapy: Like duloxetine, desvenlafaxine inhibits the reuptake of both norepinephrine and serotonin at the starting dose. Dual reuptake inhibitors have been shown to have small but statistically significantly greater rates of response and remission compared to selective serotonin reuptake inhibitors, and they have also shown early promise in the treatment of neuropathic pain. Desvenlafaxine may prove to be a valuable treatment option by expanding the limited number of available dual reuptake inhibitors. © 2009 Lieberman and Massey, publisher and licensee Dove Medical Press Ltd.

Language: en

Keywords

human; Depression; suicide; insomnia; major depression; lithium; pain; review; fatigue; Serotonin; antidepressant agent; neuroleptic agent; cholesterol blood level; doxepin; amfebutamone; amitriptyline; citalopram; clomipramine; desipramine; fluoxetine; fluvoxamine; imipramine; mirtazapine; nefazodone; nortriptyline; paroxetine; protriptyline; selegiline; sertraline; trimipramine; venlafaxine; xerostomia; unclassified drug; automutilation; somnolence; constipation; electroconvulsive therapy; appetite; amoxapine; tranylcypromine; psychopharmacotherapy; drug safety; trazodone; drug fatality; patient compliance; drug cost; drug efficacy; drug receptor binding; nausea; cost effectiveness analysis; drug withdrawal; Hamilton scale; sweating; maprotiline; unindexed drug; fibromyalgia; side effect; duloxetine; escitalopram; evidence based medicine; heart rate; liver injury; body weight; phenelzine; ejaculation; orgasm; nervousness; blood pressure; monotherapy; dizziness; neuropathic pain; treatment response; unspecified side effect; polyneuropathy; drug bioavailability; Norepinephrine; Clinical Global Impression scale; diabetic neuropathy; isocarboxazid; diastolic blood pressure; pulse rate; recommended drug dose; ascendin; budeprion sr; budeprion xl; comparative effectiveness; desvenlafaxine; Desvenlafaxine; psychotic major depression; Reuptake inhibitors; sineguan