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desvenlafaxine; norvenlafaxine; N-desmethylvenlafaxine (Pristiq)

Tradename: Pristiq (FDA approved 2008) Indications: 1) depression (FDA approved use) 2) hot flashes 3) fibromyalgia 4) neuropathic pain 5) generalized anxiety disorder [6] 6) panic disorder, 7) social phobia [6] Dosage: - start 50 mg PO QD; larger doses do not improve efficacy - Maximum dose: 400 mg QD [5] - can be started at therapeutic dose (50 mg QD) - does not require lead-in dose as dose venlafaxine Tabs: 50, 100 mg Pharmacokinetics: - see venlafaxine (not metabolized by liver) Adverse effects: 1) similar to venlafaxine 2) dizziness, nausea, headache most common 3) hypertension most common serious side effect (4%) 4) other: xerostomia, sexual dysfunction, insomnia [3] Laboratory: - norvenlafaxine in tissue - norvenlafaxine in body fluid - norvenlafaxine in blood - norvenlafaxine in serum/plasma - norvenlafaxine in urine Mechanism of action: 1) active metabolite of venlafaxine 2) inibits reuptake of serotonin & norepinephrine

Interactions

drug interactions drug adverse effects (more general classes)

General

serotonin & norepinephrine reuptake inhibitor (SNRI, dual-acting reuptake inhibitor)

Database Correlations

PUBCHEM correlations

References

  1. Prescriber's Letter 14(2): 2007 Follow-on Drugs: Therapeutic benefit of economic burden? Detail-Document#: 230201 (subscription needed) http://www.prescribersletter.com
  2. Speroff L et al, Efficacy and tolerability of desvenlafaxine succinate treatment for menopausal vasomotor symptoms: A randomized controlled trial. Obstet Gynecol 2008, 111:77 PMID: 18165395
  3. Prescriber's Letter 15(5): 2008 Comparison of Commonly Used Antidepressants Detail-Document#: 240509 (subscription needed) http://www.prescribersletter.com
  4. Prescriber's Letter 16(2): 2009 Comparison of Venlafaxine and Desvenlafaxine (Pristiq) Detail-Document#: 250202 (subscription needed) http://www.prescribersletter.com
  5. Prescriber's Letter 17(8): 2010 CHART: Comparison of Venlafaxine and Desvenlafaxine CHART: State Regulations on Generic Substitution Detail-Document#: 260802 (subscription needed) http://www.prescribersletter.com
  6. Deprecated Reference