Desvenlafaxine succinate for the treatment of major depressive disorder

Efficacy and tolerability of desvenlafaxine in the real-world treatment of patients with major depression: a narrative review and an expert opinion paper

INTRODUCTION

Major depressive disorder (MDD) is a common severe mental disorder, requiring a tailored and integrated treatment. Several approaches are available including different classes of antidepressants various psychotherapeutic approaches, and psychosocial interventions. The treatment plan for each patient with MDD should be differentiated on the basis of several clinical, personal, and contextual factors.

AREAS COVERED

Desvenlafaxine - a serotonine-noradrenergic reuptake inhibitor (SNRI) antidepressant - has been approved in the United States in 2008 for the treatment of MDD in adults, and has been recently rediscovered by clinicians due to its good side-effect profile and its clinical effectiveness. A narrative review on efficacy, tolerability and use of desvenlafaxine in clinical practice was carried out. The keywords: 'major depression', 'depression,' 'desvenlafaxine,' 'efficacy,' 'clinical efficacy,' 'side effects', 'tolerability,' 'elderly patients', 'consultation-liaison', 'menopausal', 'young people', 'adolescent' were entered in PubMed, ISI Web of Knowledge, Scopus and Medline. No time limit was fixed, the search strategy was implemented on May 10, 2023.

EXPERT OPINION

Desvenlafaxine should be listed among the optimal treatment strategies for managing people with MDD, whose main strengths are: 1) ease of dosing; 2) favorable safety and tolerability profile, 3) absence of sexual dysfunctions, weight gain and low rate of discontinuation symptoms; 4) low risk of drug-drug interactions.

Desvenlafaxine: a new antidepressant or just another one?

Desvenlafaxine (DVS) is a serotonin-norepinephrine reuptake inhibitor (SNRI) with a different pharmacokinetic and pharmacodynamic profile to venlafaxine. It was approved in February 2008 by the United States Food and Drug Administration for the treatment of major depressive disorder (MDD) based on a number of randomized, placebo-controlled clinical trials demonstrating efficacy and safety for patients with MDD. Current evidence indicates that DVS has proven efficacy, acceptable safety and tolerability profiles, convenient once-daily dosing and minimal impact on cytochrome P450 enzyme system and adverse event-prone neuroreceptors. As with all monoamine-based antidepressants, DVS has mixed efficacy results from individual studies, unestablished dosing strategies and limited long-term data, and comparative efficacy/safety with other existing antidepressants should be further investigated. Preliminary evidence also suggests the clinical usefulness of DVS in the treatment of vasomotor symptoms of menopause, anxiety symptoms and painful physical symptoms, although only MDD is the approved indication.