Desvenlafaxine
Desvenlafaxine is the newest member of the antidepressant family; it was released in February 2008. Although the U.S. Food and Drug Administration (FDA) has only approved it for the treatment of major depressive disorder in adults, the agency may eventually approve its usage for the treatment of other illnesses, such as anxiety disorders.
Desvenlafaxine may be used once day in extended-release 50 mg and 100 mg capsules.
The main metabolite of venlafaxine is desvenlafaxine, which has many similarities with the original drug. An enzyme that eliminates a methyl group from venlafaxine’s structure transforms it into desvenlafaxine in the liver. Venlafaxine and desvenlafaxine are antidepressants that work well.
- What benefits does Desvenlafaxine provide in comparison to Effexor? As to the manufacturer, Desvenlafaxine doesn’t need a gradual increase in dosage to achieve therapeutic levels, unlike Effexor, and may be begun at the recommended dose of 50 mg once day. The company claims that Desvenlafaxine has an additional benefit over Venlafaxine in that it avoids a metabolic step and may thus have fewer drug interactions with other drugs.
Mechanism of Action
Similar to Effexor, Desvenlafaxine works primarily as an antidepressant by stopping serotonin and norepinephrine from being reabsorbed and thereby preventing these neurotransmitters from breaking down inside of neurons. As a result, Desvenlafaxine belongs to the class of antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs), and its effects are comparable to those of Venlafaxine and duloxetine. Desvenlafaxine increases the neurotransmission of serotonin and norepinephrine via reuptake inhibition. Abnormally low levels (or aberrant neurotransmission) of serotonin, norepinephrine, or other neurotransmitters may be the cause of depression and other mental illnesses.
Affected brain regions may undergo alterations as a consequence of this anomaly, giving rise to psychological symptoms like anxiety or sadness. When the antidepressant enhances neurotransmission, the impacted the disease’s symptoms are lessened when parts of the brain are brought back to normal functioning.
Information about Dosing
Desvenlafaxine is often started at 50 mg once day, ideally in the morning with or without meal. However, at higher dosages, the drug may be used in split doses (twice daily). The dosage may be raised if the patient has taken the drug for the prescribed amount of time and the desired result has not been obtained. Doses of 50–400 mg were shown to be helpful across a range of treatments, although Higher dosages have consequences. Clinicians often begin with lower dosages of Desvenlafaxine until they have more experience with it, then gradually raise it as required.
Typical Side Effects
After beginning Pristiq, nausea, constipation, sweating, exhaustion, dizziness, and headaches are common side effects. During the day, patients may also feel jittery, less hungry, sleepy, and have insomnia.Men who use Desvenlafaxine may have problems with their sex. Higher dosages of Desvenlafaxine might cause these adverse effects impacts occur more often. The prescription is commonly maintained if the adverse effect is tolerable, and the bothersome side effect usually goes away. When a side effect becomes unbearable, the patient needs to speak with doctor, but you shouldn’t stop taking the antidepressant suddenly.
Adverse Events and Safety Measures
Similar to Effexor, Desvenlafaxine has also been linked to moderate hypertension. Blood pressure usually returns to normal when the patient gets used to the new drug. When using Pristiq, those with a history of high blood pressure or any other underlying medical condition should have their blood pressure checked often. Patients should seek urgent medical assistance if their blood pressure is excessively high and should speak with their doctor if their blood pressure continues to rise.- When Desvenlafaxine is used with other drugs that increase serotonin, it may cause the serotonin syndrome, a potentially dangerous response caused by overstimulation of serotonin in the brain.
- Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors are examples of drugs that are serotonergic. (SSRI) antidepressants and anti-migraine triptans, including sumatriptan-containing Imitrex. Early symptoms of serotonin syndrome include flushing, increased perspiration, tremors, restlessness, and involuntary muscular movements.
- If the drugs are not discontinued, the patient may have further potentially fatal side effects, such as strong muscular spasms, a high temperature, breathing difficulties, blood clotting issues, and the breakdown of red blood cells, which might cause a coma, severe renal failure, and even death.
Monoamine oxidase inhibitors (MAOIs) as (selegiline), (tranylcypromine), and (phenelzine) shouldn’t be used with Pristiq. When changing from one therapy to another, Desvenlafaxine cannot be begun until at least 14 days have passed after the MAOI was stopped, and an MAOI cannot be started until at least 7 days have passed since Desvenlafaxine was stopped. The medication combination may cause symptoms such as abnormally high blood pressure, perspiration, a fast heartbeat, flushing, nausea, vomiting, and trembling; if medical attention is delayed, these symptoms might progress to seizures, a coma, and even death.
- It is not advisable to stop taking Desvenlafaxine suddenly without first seeing a doctor. Before stopping the medicine abruptly, the dosage should be reduced gradually to prevent unpleasant side effects as Anxiety, headaches, nausea, sleeplessness, and irritability are some of the withdrawal symptoms that may occur.
Utilization during pregnancy and nursing: Category C
There is no proof that using Desvenlafaxine while pregnant is safe. The fetus or mother cannot be at danger. Be ruled out due to the lack of sufficient research or data on Desvenlafaxine usage by pregnant women. Women who are or may become pregnant should talk to their doctor about this.Desvenlafaxine should not be taken by nursing women since tiny quantities may enter the breast milk and be consumed by the unborn child. Breastfeeding should not begin or should be stopped if quitting the antidepressant is not an option.
Desvenlafaxine Potential Drug Interactions
The antifungal drug ketoconazole may prevent Desvenlafaxine from being metabolized and raise the antidepressant’s blood levels, which may result in a greater frequency of adverse effects.
Desvenlafaxine in combination with other serotonin-enhancing drugs, such as Imitrex, an anti-migraine drug, or other Serotonin-norepinephrine reuptake inhibitors and selective serotonin reuptake inhibitors (SSRIs) (SNRIs) and triptans can lead to serotonin syndrome. Serotonin syndrome’s potentially fatal symptoms may be brought on by serotonergic antidepressants.
- It is not recommended to take Desvenlafaxine and MAOI at the same time.
- Desvenlafaxine may be altered, increasing the risk of bleeding. When beginning, adjusting, or stopping Pristiq, keep an eye on anticoagulation while using Warfarin.
- When used with aspirin or NSAIDs, Desvenlafaxine and other SNRIs may raise the risk of gastrointestinal bleeding.
Overdosing
Since Desvenlafaxine is a relatively new medicine, there isn’t much information available on overdosing on it. But because Desvenlafaxine is the main active ingredient in Effexor, overdoses with Desvenlafaxine can teach us about overdoses with Effexor.
Reactions to Venlafaxine overdose (which would also be expected with Pristiq) have included changes in consciousness (from somnolence to coma), rapid heartbeat, seizures, vomiting, arrhythmia, low blood pressure, liver damage, serotonin syndrome, and death, depending on the dosage and whether the medication was combined with alcohol or other drugs.
- Treating any suspected overdose as an emergency is imperative. The individual has to be brought to the emergency space for care and observation. It is advisable to include both the prescription bottle of medicine and any other medication suspected in the overdose, since the information on the label may be useful in helping the treating physician figure out how many tablets the patient has taken.
Precaution Points to Remember
Antidepressants have been shown in short-term trials to raise the likelihood of suicide thoughts and actions in children and adolescents with major depressive disorder and other mental diseases. The FDA mandates that the prescriber should alert parents and guardians to this risk when initiating or modifying antidepressant treatment in kids and teens. Age is a factor in the likelihood of suicide thoughts and acts connected to antidepressant medications, according to FDA studies.This phenomenon is more likely to happen early in the course of and is more common in the younger population. Antidepressant use did not seem to be associated with a higher incidence of suicidality in people over the age of 24, as compared to placebo use. The results demonstrated that antidepressants have a “Protective effect” against acts and ideas of suicide. Additional research has shown that when more individuals When antidepressants are used by a population, the suicide rate decreases. Suicide risk is a part of depression and might last until the patient responds to therapy.
- Suicide risk is a part of depression and may not go away until the patient responds to therapy. Upon initiating or modifying antidepressant treatment, the individual particularly if they are a child or adolescent should have continuously monitored for increasing symptoms of depression, and any concerns should be reported to the doctor by the family or caregiver.
Caution: If you are experiencing suicidal thoughts, please notify your doctor or a family member right away. Notify your family doctors or psychiatrist if you have worsening depression symptoms or if you find it difficult to resist thoughts or desires to end your life.
- You may take Desvenlafaxine with or without food, but if it makes you feel queasy or nauseous, you should take it with food.
- Avoid stopping Desvenlafaxine suddenly. It is best to reduce your dose gradually in order to avoid the symptoms of withdrawal.
- Desvenlafaxine could make you feel sleepy. Before driving a motor vehicle or dangerous machinery, be aware of how it affects you. Don’t drink whilst using Pristiq.
- If you use Pristiq, have your blood pressure tested often. . Keep the medicine out of direct sunlight and dampness, in the light-resistant container that came with it. Your drug may break down faster in the presence of heat or moisture, which might cause it to lose its therapeutic benefits.
- Make sure kids can’t get to your medicine.
