High-dose desvenlafaxine in outpatients with major depressive disorder

Abstract

The mean daily desvenlafaxine dose range over the duration of the trial was 267-356 mg (after titration). The most frequent TEAEs in the safety population (n = 104) were nausea (52%) and headache (41%), dizziness (31%), insomnia (29%), and dry mouth (27%). All TEAEs were mild or moderate in severity. Thirty-four (33%) patients discontinued from the study because of TEAEs; nausea (12%) and dizziness (9%) were the most frequently cited reasons. The mean change in HAM-D(17) total score for the intent-to-treat population (n = 99) was -9.9 at the last on-therapy visit in the last-observation-carried-forward analysis and -14.0 at month 12 in the observed cases analysis. Conclusion High-dose desvenlafaxine (200-400 mg/d) was generally safe and effective in the long-term treatment of MDD.

The American Society of Clinical Psychopharmacology Survey of Psychopharmacologists’ Practice Patterns for the Treatment of Mood Disorders

“…The evidence base for the treatment of mood disorders, and disorders in general, is usually derived from efficacy trials rather than effectiveness trials, and therefore their applicability to routine psychiatric practice is limited. Many survey respondents indicated using medications at higher than usual doses—a practice which, with careful monitoring, is supported by the evidence‐based literature on treatment resistant mood disorders (e.g., see ). A further strength of the survey is that it provided insights about practitioner decisions in a number of common and important clinical situations that require the thoughtful application of evidence‐based knowledge.…”

Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

“…The incidence of taper/poststudy-emergent adverse events after the discontinuation of desvenlafaxine at 200-400 mg/day ranged from 42 to 52% [44,45]. In both studies the most common discontinuation symptoms were dizziness, nausea, and headache.…”

“…Eight open-label reports evaluated the efficacy and tolerability of venlafaxine [38,39], duloxetine [40][41][42], levomilnacipran [43], and desvenlafaxine [44,45] (online suppl. Table 3).…”

Acute and chronic effects of desvenlafaxine on gastrointestinal transit and motility in dogs

“…In a clinical study, DVS at high doses of 200-400 mg daily were shown to be effective and safe and DVS is currently rated safe for up to 400 mg a day. 26,27 In a previous canine study, DVS at one single dose of 50 mg reduced the percentage of normal slow waves, decreased gastric tone, and inhibited antral contractions in the postprandial state. 14 In the current study, one single dose of DVS at 50 or 100 mg was found to delay gastric emptying of solid in dogs.…”

“…So we aimed to further explore the effects of DVS at high doses on GI motility in dog for the safety in patients. In a clinical study, DVS at high doses of 200–400 mg daily were shown to be effective and safe and DVS is currently rated safe for up to 400 mg a day …”