The National Prescribing Service Limited (Australia) made an independent evaluation on the role of desvenlafaxine (Pristiq) for the treatment of major depressive disorder.
Summary:
- Desvenlafaxine is the active metabolite of venlafaxine.
- There is no evidence that desvenlafaxine is more effective, safer or better tolerated than venlafaxine or other antidepressants.
- Doses above 50 mg/day are unlikely to provide further clinical benefit and are associated with a higher incidence of adverse effects.
- Common adverse effects include nausea, headache, dizziness, dry mouth and diarrhoea.
- Desvenlafaxine should not be used in children and adolescents.
- Reduce the dose slowly to avoid discontinuation symptoms.
In an article published in Annals of Pharmacotherapy. Desvenlafaxine: Another "Me Too" Drug?, the authors conclude:
“With the overall similarity between these 2 drugs and the potential lack of cost savings, the need for desvenlafaxine and its ultimate utility in treating major depressive disorder appears to be insignificant.”