Desvenlafaxine: another "me too" drug?
OBJECTIVE
To compare desvenlafaxine with its parent drug, venlafaxine, to determine the usefulness of this new medication.


METHODS
Information was obtained through a MEDLINE search (1966-June 2008) and from published abstracts. Search terms included desvenlafaxine, O-desmethylvenlafaxine, Pristiq, major depressive disorder, and venlafaxine.


METHODS
All English-language studies and abstracts pertaining to desvenlafaxine and venlafaxine were considered for inclusion. Preference was given to human data.


RESULTS
Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor and is the active metabolite of the antidepressant venlafaxine. The recommended dose is 50 mg daily, based on the efficacy and safety data of 50, 100, 150, 200, and 400 mg of desvenlafaxine. The response and remission rates of depression at 8 weeks for the 50-mg dose are 51-63% and 31-45%, respectively. These rates are comparable with those seen with venlafaxine (58% and 45%, respectively). Adverse effects are also similar to those of venlafaxine, with the most common being insomnia, somnolence, dizziness, and nausea. The decreased potential of CYP2D6 activity with desvenlafaxine compared with the parent drug may be a potential advantage in patients on other medications metabolized via this enzymatic pathway. Also, desvenlafaxine tablets are less expensive than extended-release (XR) venlafaxine, which may decrease healthcare costs in the short term. However, venlafaxine XR is expected to go off patent in 2010.


CONCLUSIONS
With the overall similarity between these 2 drugs and the potential lack of cost savings, the need for desvenlafaxine and its ultimate utility in treating major depressive disorder appears to be insignificant.
Sopko
Michael A
MA
Institute of Living at Hartford Hospital, Hartford, CT, USA.
Ehret
Megan J
MJ
Grgas
Marina
M
D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D002986:Clinical Trials as Topic; D003511:Cyclohexanols / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D019389:Cytochrome P-450 CYP2D6 / Q000187:drug effects / Q000378:metabolism; D003865:Major Depressive Disorder / Q000188:drug therapy*; D000069468:Desvenlafaxine Succinate; D004305:Dose-Response Relationship, Drug; D016527:Drug Costs; D004347:Drug Interactions; D006801:Humans; D012074:Remission Induction; D000069470:Venlafaxine Hydrochloride
D000928:Antidepressive Agents; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride; D019389:Cytochrome P-450 CYP2D6; D000069468:Desvenlafaxine Succinate