Desvenlafaxine

Generic Name: Desvenlafaxine Succinate

Brand Names: Pristiq, Khedezla, Desfax

Drug Class: SNRI, Anti-depressant, Anxiolytic

Similar Class Drugs: Duloxetine, Venlafaxine

Available Dosage forms: Oral tablets (extended-release)

What is Desvenlafaxine?

Desvenlafaxine is used to treat major depressive disorder in adults. It inhibits the action of transporters that play a role in the uptake of serotonin and norepinephrine. The accumulation of both neurotransmitters in the synaptic cleft alleviates depressive symptoms. Desvenlafaxine affects serotonergic neurotransmission ten times more than norepinephrine.¹ It is derived from its parent SNRI, Venlafaxine, and does not have an affinity for histamine, adrenergic, muscarinic, and cholinergic receptors.

Apart from major depression, Desvenlafaxine is used to treat:

– Hot flashes in women who cannot have estrogen prescription¹

– Refractory depression in adolescents

How to use Desvenlafaxine?

The drug is available as extended-release oral tablets only. Swallow the tablet whole or split it in half if your doctor directs you to do so. Avoid chewing, crushing, or mixing the tablet in water as this may cause a quick release of the formulation and consequently risks the increase in side effects. You can take it with or without food or as per the direction of your doctor.

Do not stop treatment even if you feel an improvement in your symptoms. Giving up the drug mid-treatment will potentiate the risk of side effects and relapse of your condition. Consult your specialist if you see an addition or worsening of your symptoms. The formulation takes a few weeks to show effects. Refer to the doctor if your symptoms stay unresolved for a longer duration.

What are the side effects of Desvenlafaxine?

Possible side effects after Desvenlafaxine administration:

– Headache

– Disturbed sleep

– Fatigue

– GI upset

– Reduced appetite

– Nausea

The adverse effects noted with Desvenlafaxine:

– Serotonin syndrome

– Raised blood pressure

– Glaucoma

– Bleeding disorders

– Withdrawal syndrome

– Hyponatremia

– Seizures

– Risk of suicidal tendencies

– Interstitial lung disease

– Eosinophilic pneumonia

Who should not use Desvenlafaxine?

Clinical studies determined the safety and tolerability of Desvenlafaxine in children and adolescents. The subjects treated with the medicine for over 6 months did not show any significant adverse effects. The results concluded that Desvenlafaxine is generally well-tolerated in most children and adolescents.²

However, certain conditions preclude the use of Desvenlafaxine. These are as follows:

– Hypersensitivity

– Patients taking MAOIs and other drugs that can interact with Desvenlafaxine

– Pregnancy and lactation – drug should not be prescribed until benefits outweigh risks

– Impaired kidney function

– End-stage renal disease

References

1. Naseeruddin R, Rosani A, Marwaha R. Desvenlafaxine. [Updated 2021 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534829/
2. Atkinson S, Thurman L, Ramaker S, Buckley G, Jones SR, England R, Wajsbrot D. Safety, Tolerability, and Efficacy of Desvenlafaxine in Children and Adolescents with Major Depressive Disorder: Results from Two Open-Label Extension Trials. CNS Spectr. 2019 Oct;24(5):496-506. doi: 10.1017/S1092852918001128. PMID: 30419989.