Desvenlafaxine (Pristiq)

For major depressive disorders.

It is the major active metabolite of venlafaxine (Effexor).

A serotonin-norepinephrine reuptake inhibitor (SNRI).

It binds serotonin and norepinephrine receptors, with inhibition of serotonin uptake being approximately 10 times more potent than norepinephrine uptake.

Succinate salt form of venlaxifine.

50 mg dose without need to titrate.

Higher doses than 50 mg offer no additional benefit and are associated with increased adverse effects and discontinuation rate.

Dosage adjustment needed in renal insufficiency.

Not currently approved for use in pediatric patients.

Most common side effects nausea 22%, dizziness 13%, hyperhidrosis 10%, constipation 9% and decreased appetite 5%.

Metabolism is to hepatic conjugation and urinary excretion, and doses are adjusted for those with the hepatic and renal impairment.

Tapering over 2-4 weeks is recommended for discontinuation.

May increase blood pressure.

Has limited effects on sexual function and weight.

May be beneficial for post menopausal hot flashes.

Not effective for neuropathic pain.

Has minimal inhibitory and induction affects on cytochrome P450 and CYP2D6.

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