Major Depressive Disorder
Desvenlafaxine succinate is used in the treatment of major depressive disorder in adults. The antidepressant efficacy of desvenlafaxine has been established in 4 randomized, double-blind, placebo-controlled, fixed-dose studies of 8 weeks' duration in adult outpatients who met DSM-IV criteria for major depressive disorder. In all of these studies, patients receiving desvenlafaxine (50-400 mg daily as extended-release tablets) demonstrated greater improvement in the 17-item Hamilton Rating Scale for Depression (HAMD-17) total score than did patients receiving placebo. Patients receiving desvenlafaxine also demonstrated greater overall improvement as measured by the Clinical Global Impressions Scale-Improvement (CGI-I) compared with placebo recipients in 3 out of 4 of these studies. In the 2 studies that directly compared 50 mg and 100 mg of desvenlafaxine given once daily, there was no evidence of a greater therapeutic effect at the higher 100-mg dosage. In addition, adverse effects and drug discontinuances were reported more frequently at higher dosages of the drug in these studies. No age- or gender-related differences in efficacy were noted in these studies; data were insufficient to determine whether there were race-related differences in efficacy.
The manufacturer states that the efficacy of desvenlafaxine for long-term use (i.e., exceeding 8 weeks) has not been established by controlled studies. If desvenlafaxine is used for extended periods, the need for continued therapy should be reassessed periodically.
For further information on treatment of major depressive disorder and considerations in choosing the most appropriate antidepressant for a particular patient, including considerations related to patient tolerance, patient age, and cardiovascular, sedative, and suicidal risks, .
Like some other SNRIs and SSRIs, desvenlafaxine succinate has been studied for the management of vasomotor symptoms in postmenopausal women.
For further information on treatment of vasomotor symptoms in postmenopausal women and women with breast cancer, .