Desvenlafaxine: Difference between revisions

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{{MedTemplate

| generic = Desvenlafaxine

| generic = Desvenlafaxine (succinate)

| brand = Pristiq

| classes = SNRI, Antidepressant

| structure =

| mechanism = ~~Serotonin–norepinephrine~~ reuptake inhibitor

| 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 = Oral

| onset = Antidepressant effect emerges over 1-2 weeks

| duration = 24 hours

| 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" />.

}}

== References ==

[[Category:SNRIs]]

[[Category:Antidepressants]]

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