Desvenlafaxine: Difference between revisions
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{{MedTemplate | {{MedTemplate | ||
| generic | | generic = Desvenlafaxine (succinate) | ||
| brand | | brand = Pristiq | ||
| structure | | structure = | ||
| classes | | classes = [[:Category:SNRIs|Serotonin-norepinephrine reuptake inhibitor (SNRI)]], [[:Category:Antidepressants|Antidepressant]] | ||
| | | uses = <vote slug="major-depressive-disorder-use">Major depressive disorder (FDA)</vote>, <vote slug="menopausal-vasomotor-use">Menopausal vasomotor symptoms (off-label)</vote>, <vote slug="neuropathic-pain-broad-use">Neuropathic pain (off-label)</vote> | ||
| | | starting_dose = 50 mg PO once daily ('''no titration required''', distinguishing it favorably from venlafaxine) | ||
| | | preparations = ER tablets 25, 50, 100 mg | ||
| | | fda_max = 50 mg/day (no efficacy benefit shown for higher doses despite the 100 mg strength being available) | ||
| | | pill_id = | ||
| routes | | routes = Oral | ||
| onset | | onset = Antidepressant effect emerges over 1-2 weeks | ||
| duration | | duration = 24 hours | ||
| halflife | | halflife = ~11 hours<ref name="pristiq-label">FDA Prescribing Information, Pristiq (desvenlafaxine succinate), Pfizer/Wyeth, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021992s048lbl.pdf</ref> | ||
| bioavailability = ~80% (oral)<ref name="pristiq-label" /> | |||
| pregnancy = Observational signal for neonatal adaptation syndrome with late-pregnancy exposure (SNRI class effect).{{citation needed}} | |||
| legal = [[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="pristiq-label" /> | |||
| | | mechanism = <vote slug="desvenlafaxine-mech-claim">Serotonin and norepinephrine reuptake inhibitor. '''The active metabolite of venlafaxine''' formed by CYP2D6 O-demethylation, separately marketed as a parent compound to bypass the CYP2D6 activation step.</vote> The pharmacological advantage over venlafaxine: less inter-individual variability (no CYP2D6 genotype dependence for activation), fewer CYP-mediated interactions, and simpler 50 mg once-daily dosing without titration. The same SNRI-class concerns apply: severe discontinuation syndrome on abrupt stop (slow taper essential) and dose-dependent diastolic hypertension at higher doses<ref name="pristiq-label" />. | ||
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== References == | |||
<references /> | |||
[[Category:SNRIs]] | |||
[[Category:Antidepressants]] | [[Category:Antidepressants]] | ||
Latest revision as of 07:17, 23 May 2026
Desvenlafaxine (succinate)
Pristiq
Experience
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Summary
Pharmacy
Starting dose
50 mg PO once daily (no titration required, distinguishing it favorably from venlafaxine)
Preparations
ER tablets 25, 50, 100 mg
US FDA Max
50 mg/day (no efficacy benefit shown for higher doses despite the 100 mg strength being available)
Pharmacology
Routes
Oral
Onset
Antidepressant effect emerges over 1-2 weeks
Duration
24 hours
Half-life
~11 hours[1]
Bioavailability
~80% (oral)[1]
Pregnancy
Observational signal for neonatal adaptation syndrome with late-pregnancy exposure (SNRI class effect).[citation needed]
Legal status
Purported mechanism
Serotonin and norepinephrine reuptake inhibitor. The active metabolite of venlafaxine formed by CYP2D6 O-demethylation, separately marketed as a parent compound to bypass the CYP2D6 activation step.0 The pharmacological advantage over venlafaxine: less inter-individual variability (no CYP2D6 genotype dependence for activation), fewer CYP-mediated interactions, and simpler 50 mg once-daily dosing without titration. The same SNRI-class concerns apply: severe discontinuation syndrome on abrupt stop (slow taper essential) and dose-dependent diastolic hypertension at higher doses[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Pristiq (desvenlafaxine succinate), Pfizer/Wyeth, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021992s048lbl.pdf