Desvenlafaxine
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DRUG STATUS
Approvals
N/A
Essential Medicine
N/A
Teratogenicity
N/A
Pharmaceutical Class
Serotonin and Norepinephrine Reuptake Inhibitor
Desvenlafaxine
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Click HereSummary
Desvenlafaxine is primarily used to treat major depressive disorder and generalized anxiety disorder. It can also be used to manage symptoms of neuropathic pain, particularly in diabetic peripheral neuropathy, and in some cases for stress urinary incontinence.
Desvenlafaxine works by increasing the levels of serotonin and norepinephrine in the brain. These are neurotransmitters that help regulate mood and pain. By inhibiting their reuptake into nerve cells, it helps alleviate symptoms of depression and anxiety.
For adults, the usual starting dose of Desvenlafaxine is 50 mg once daily taken orally, with or without food. The dose may be increased based on individual response and tolerability, up to a maximum of 400 mg daily. It's important to take it at the same time each day.
Common side effects of Desvenlafaxine include nausea, dry mouth, dizziness, insomnia, constipation, and sweating. Serious adverse effects may include increased blood pressure, agitation, hallucinations, suicidal thoughts, and withdrawal symptoms upon abrupt discontinuation.
Desvenlafaxine should be used with caution in individuals with a history of high blood pressure, heart problems, or liver/kidney issues. It is contraindicated in those with uncontrolled glaucoma or a history of serotonin syndrome. Caution is also needed for those with a history of depression, bipolar disorder, or suicidal thoughts.
Indications and Purpose
What is Desvenlafaxine used for?
Desvenlafaxine is primarily used to treat major depressive disorder (MDD) and generalized anxiety disorder (GAD). It is also prescribed to manage symptoms of neuropathic pain, particularly in diabetic peripheral neuropathy, and in some cases, for stress urinary incontinence.
How does Desvenlafaxine work?
Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of serotonin and norepinephrine in the brain by inhibiting their reuptake into nerve cells. This helps improve mood, relieve anxiety, and manage pain, as both serotonin and norepinephrine play key roles in regulating these functions.
Is Desvenlafaxine effective?
Studies show that Desvenlafaxine effectively treats major depressive disorder (MDD) and generalized anxiety disorder (GAD). Clinical trials have demonstrated significant improvements in mood, anxiety, and overall functioning in patients compared to placebo. Additionally, it has been shown to reduce physical symptoms of depression, such as pain, providing more comprehensive symptom relief.
How does one know if Desvenlafaxine is working?
The benefit of Desvenlafaxine is evaluated through clinical assessments such as the Hamilton Depression Rating Scale (HDRS) and the Generalized Anxiety Disorder 7 (GAD-7) scale. Improvement in symptoms, including mood, anxiety, and quality of life, is monitored. Additionally, healthcare providers assess side effects and overall functioning during follow-up visits to gauge its effectiveness and safety.
Directions for Use
How do I take Desvenlafaxine?
Desvenlafaxine can be taken with or without food. It is important to swallow the tablets whole, without crushing, chewing, or breaking them, to avoid releasing too much of the drug at once. There are no specific food restrictions, but it’s recommended to avoid alcohol as it may increase side effects like dizziness or drowsiness. Always follow your healthcare provider's instructions for use.
For how long do I take Desvenlafaxine?
The typical duration of use for desvenlafaxine depends on the condition being treated and individual patient needs: Acute Treatment : For major depressive disorder (MDD), acute treatment generally lasts several weeks to months. The initial treatment period often spans 8-12 weeks to assess the medication's effectiveness. Continuation and Maintenance : Continuation therapy for MDD is recommended for several months or longer to prevent relapse. Longer-term maintenance therapy may be necessary for individuals with recurrent depression or chronic symptoms. Periodic Reassessment : Patients should be periodically reassessed to determine the need for continued treatment. The decision to extend or discontinue therapy depends on clinical improvement, relapse history, and overall health.
How long does it take for Desvenlafaxine to start working?
Desvenlafaxine may take 1 to 2 weeks to show initial effects, but it can take up to 4 to 6 weeks for the full benefits, especially in treating depression and anxiety. It is important to continue taking the medication as prescribed and consult a doctor if symptoms do not improve.
How should I store Desvenlafaxine?
Desvenlafaxine should be stored at room temperature, away from moisture, heat, and direct sunlight. It should be kept in its original packaging to protect it from moisture. Ensure that the medication is stored out of reach of children and is not used after its expiration date.
Warnings and Precautions
Who should avoid taking Desvenlafaxine?
Desvenlafaxine should be used with caution in individuals with a history of high blood pressure, heart problems, or liver/kidney issues. It is contraindicated in those with uncontrolled glaucoma or a history of serotonin syndrome. Caution is also needed for those with a history of depression, bipolar disorder, or suicidal thoughts, as it may increase risks.
Can I take Desvenlafaxine with other prescription drugs?
Desvenlafaxine may interact with other antidepressants, especially SSRIs, SNRIs, or MAO inhibitors, increasing the risk of serotonin syndrome. It can also interact with blood thinners like warfarin, increasing bleeding risks, and medications that affect liver enzymes (e.g., ketoconazole) may alter its effectiveness. Always consult a healthcare provider before combining medications.
Can I take Desvenlafaxine with vitamins or supplements?
Desvenlafaxine may interact with supplements like St. John's Wort, which can increase the risk of serotonin syndrome. Additionally, taking it with supplements like magnesium or calcium may affect absorption. Always consult a healthcare provider before using desvenlafaxine with vitamins or supplements to avoid potential interactions.
Can Desvenlafaxine be taken safely while pregnant?
Desvenlafaxine is classified as a Category C drug for pregnancy, indicating that risk to the fetus cannot be ruled out. Animal studies have shown some adverse effects, but there are no well-controlled studies in pregnant women. It should only be used if the potential benefits outweigh the risks, and patients should consult their doctor before use during pregnancy.
Can Desvenlafaxine be taken safely while breastfeeding?
Desvenlafaxine is excreted in breast milk, but the effects on a nursing infant are not well-studied. It is recommended to use caution when prescribing this medication to breastfeeding mothers. If necessary, a healthcare provider may suggest monitoring the infant for potential side effects or considering alternative treatments while breastfeeding.
Is Desvenlafaxine safe for the elderly?
**For older adults:** * **Kidney function:** The kidneys may not work as well, so the dosage may need to be adjusted. * **Blood pressure:** Desvenlafaxine can lower blood pressure, especially when standing up. This is more common in older adults. * **Sodium levels:** Desvenlafaxine can lower sodium levels in the blood, which can be more dangerous for older adults. * **Suicidal thoughts:** Antidepressants like desvenlafaxine may reduce the risk of suicidal thoughts in older adults.
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