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{"id":556800114761,"title":"Desvenlafaxine Review: The Best Generic Antidepressant?","created_at":"2022-08-01T23:42:40-04:00","body_html":"\u003cscript type=\"application\/ld+json\"\u003e\/\/ \u003c![CDATA[\n{\n \"@context\": \"https:\/\/schema.org\",\n \"@type\": \"Article\",\n \"headline\": \"Desvenlafaxine Review: The Best Generic Antidepressant?\",\n \"keywords\": \"desvenlafaxine, desvenlafaxine review, desvenlafaxine reviews, desvenlafaxine side effects, desvenlafaxine dosage, desvenlafaxine anxiety, desvenlafaxine vs venlafaxine, desvenlafaxine succinate, desvenlafaxine succinate er, desvenlafaxine brand name, desvenlafaxine withdrawals\",\n \"description\": \"Our research team reviews medical studies on desvenlafaxine to determine if the drug is effective for treating depression. We highlight side effects of the drug, explain whether the branded version is more likely to be effective, and compare its efficacy to other popular antidepressants like venlafaxine.\",\n \"url\": \"https:\/\/illuminatelabs.org\/blogs\/health\/desvenlafaxine-review\",\n\"author\": {\n \"@type\": \"Person\",\n \"name\": \"Calloway Cook\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/calloway-cook\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/calloway-cook\/\",\n \"jobTitle\": \"President\",\n \"knowsAbout\": \"entrepreneurship, dietary supplements, herbal supplements, eCommerce, medical research\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": \"S.I. Newhouse School of Public Communications at Syracuse University\"\n },\n \"memberOf\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n }\n},\n\"creator\": {\n \"@type\": \"Person\",\n \"name\": \"Calloway Cook\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/calloway-cook\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/calloway-cook\/\",\n \"jobTitle\": \"President\",\n \"knowsAbout\": \"entrepreneurship, dietary supplements, herbal supplements, eCommerce, medical research\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": \"S.I. Newhouse School of Public Communications at Syracuse University\"\n },\n \"memberOf\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n }\n},\n\"editor\": {\n \"@type\": \"Person\",\n \"name\": \"Taylor Graber MD\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/taylor-graber\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/taylor-j-graber-md-81351642\/\",\n \"jobTitle\": \"Content Partner\",\n \"knowsAbout\": \"medicine, health, anesthesiology, iv therapy, science, drugs, pharmaceutical, medical research, scientific research, medical journals, entrepreneurship, healthcare, orthopedic surgery, biomedical engineering\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": [\n \"University of California San Diego\",\n \"Arizona University\",\n \"University of Arizona College of Medicine\"\n ]\n },\n \"memberOf\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n }\n},\n\"image\": {\n\"@type\": \"ImageObject\",\n\"url\": \"https:\/\/cdn.shopify.com\/s\/files\/1\/0047\/1524\/9737\/files\/Desvenlafaxine_Thumbnail.png?v=1659414763\",\n\"width\": \"2811\",\n\"height\": \"2811\"\n},\n\"citation\": [\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22883315\/\", \n\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2947544\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27280963\/\",\n\"https:\/\/illuminatelabs.org\/blogs\/health\/pristiq-review\",\n\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2012\/021992s030lbl.pdf\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18507895\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22883424\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21812735\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28064110\/\",\n\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6415809\/\",\n\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534829\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18507895\/\",\n\"https:\/\/www.drugs.com\/comments\/desvenlafaxine\/for-depression.html\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19779354\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20414167\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26955576\/\"\n],\n\"mentions\": [{\n \"@type\": \"Thing\",\n \"name\": \"Pristiq\"\n },\n {\n \"@type\": \"Thing\",\n \"name\": \"FDA\"\n },\n {\n \"@type\": \"Thing\",\n \"name\": \"StatPearls\"\n },\n {\n \"@type\": \"Thing\",\n \"name\": \"St. John's Wort\"\n },\n {\n \"@type\": \"Thing\",\n \"name\": \"Drugs.com\"\n }\n],\n\"datePublished\": \"2022-08-01\",\n\"copyrightHolder\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n},\n\"publisher\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\",\n \"url\": \"https:\/\/illuminatelabs.org\/\",\n \"description\": \"Illuminate Labs is the most transparent supplement company in the U.S., and is a leading publisher of research-based health information.\",\n \"knowsAbout\": \"supplements, science, nutrition, exercise, health, medication, pharmaceutical, wellness, diet, weight loss, medical research\",\n \"publishingPrinciples\": \"https:\/\/illuminatelabs.org\/pages\/editorial-guidelines\",\n \"logo\": {\n \"@type\": \"ImageObject\",\n \"url\": \"https:\/\/cdn.shopify.com\/s\/files\/1\/0047\/1524\/9737\/files\/Illuminate_Labs_Logo.png?v=1641249064\", \n \"width\": 150,\n \"height\": 150\n},\n \"foundingDate\": \"2019-01-30\",\n \"Address\": {\n \"@type\": \"PostalAddress\",\n \"streetAddress\": \"50 Union Street, Unit 9\",\n \"addressLocality\": \"Northampton\",\n \"addressRegion\": \"Massachusetts\",\n \"postalCode\": \"01060\",\n \"addressCountry\": \"US\"\n},\n \"sameAs\": [\n \"https:\/\/www.instagram.com\/illuminatelabs\",\n \"https:\/\/twitter.com\/illuminatelabs\",\n \"https:\/\/www.linkedin.com\/company\/illuminate-labs-supplements\",\n \"https:\/\/www.youtube.com\/channel\/UCpgSJAsIPb-fZ25djtTxBEA\"\n ]\n }\n}\n\/\/ ]]\u003e\u003c\/script\u003e\n\u003cp\u003e\u003cimg src=\"https:\/\/cdn.shopify.com\/s\/files\/1\/0047\/1524\/9737\/files\/Desvenlafaxine_Review_Article_Header_Image.png?v=1659414737\" alt=\"\"\u003e\u003c\/p\u003e\n\u003cp\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003eDisclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and published for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to prescription medication.\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003e\u003cspan class=\"dc\"\u003e D\u003c\/span\u003eesvenlafaxine is a prescription drug which is approved by the Food and Drug Administration (FDA) in the U.S. to treat Major Depressive Disorder (MDD). The full name of the active chemical compound is desvenlafaxine succinate, or desvenlafaxine succinate ER,  but it’s typically shortened to just the first word for convenience. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine is the generic term for the drug, and its branded version is called Pristiq. We will use these terms interchangeably throughout this article because they refer to the same active chemical compound.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIn this article we’ll review published medical studies on desvenlafaxine to determine if it’s effective for treating depression. We’ll highlight side effects of the medication, compare its efficacy to other generic antidepressant drugs such as venlafaxine, and share a natural, over-the-counter (OTC) treatment that patients with mild depression may want to consider.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDoes Desvenlafaxine Work?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThere have been a number of clinical trials evaluating the effectiveness of desvenlafaxine for reducing symptoms of depression.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eOne such \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22883315\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003etrial\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e published in 2012 found desvenlafaxine to be effective for patients with MDD. All patients in this trial were previously diagnosed with MDD, which is somewhat standard for antidepressant drug trials, as MDD is typically the most severe and challenging category of depression to treat.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe study authors measured patient scores on the Hamilton Depression Rating Scale (HAM-D), which is a clinical tool that measures changes in a wide variety of symptoms associated with depression, such as sleeplessness and low libido.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe trial participants assigned to desvenlafaxine reported significantly reduced depression based on the HAM-D scoring. The average HAM-D score was greater than 20 at the start of the trial and less than 10 at the end of the trial, representing a decrease in depression symptoms of over 50%.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2947544\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e evaluated the efficacy of desvenlafaxine for patients with major depression. This review analyzed data from three individual clinical trials on the topic.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe researchers concluded that desvenlafaxine improved the condition of depressed patients on average. Remission rates were around 10% higher in the trial participants taking desvenlafaxine compared to the trial participants taking placebo pills. Remission is defined as an extended period free of any major depressive symptoms, so this is a significant result.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA recent \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27280963\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eclinical trial\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e examined whether desvenlafaxine could improve productivity at work for patients who were depressed and employed. The medication did not improve cognitive function or work-related outcomes.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe will conclude from the available research that desvenlafaxine effectively treats depression, but is unlikely to improve productivity at work for patients who are depressed and working a salaried job.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eHow Does Desvenlafaxine Work?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine is a member of a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRI). As we outlined in our \u003c\/span\u003e\u003ca href=\"https:\/\/illuminatelabs.org\/blogs\/health\/pristiq-review\"\u003e\u003cspan style=\"font-weight: 400;\"\u003ePristiq reviews\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e article, the drug is 10 times more selective for serotonin than norepinephrine. This suggests that it has greater effects on serotonin levels in the brain than on norepinephrine.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eSNRI drugs delay the body’s processing and clearance of serotonin and norepinephrine, which are neurotransmitters that have significant effects on mood. By delaying biological processing of these neurotransmitters, desvenlafaxine causes an artificial increase in their circulating levels, which can improve mood and reduce depression.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIt hasn’t been conclusively proven that patients with depression have lower levels of these neurotransmitters than non-depressed patients, but this is the suggested mechanism of action. Researchers don’t have to necessarily understand how a drug works to be able to conclusively state that it’s effective to a statistically significant degree based on clinical trials.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDesvenlafaxine Side Effects\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine has a “black box” warning on its \u003c\/span\u003e\u003ca href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2012\/021992s030lbl.pdf\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eFDA label\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e, which references a risk of severe side effects. The black box warning states that desvenlafaxine may increase risk of suicidal thoughts or actions in children, adolescents and young adults.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18507895\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eclinical trial\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e published in the \u003c\/span\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003eCurrent Medical Research and Opinion\u003c\/span\u003e\u003c\/i\u003e\u003cspan style=\"font-weight: 400;\"\u003e journal provides some useful side effect data. Around 5% more patients taking desvenlafaxine withdrew from the study because of adverse effects than those taking placebo pills. This suggests that desvenlafaxine has a greater risk of side effects than placebo.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe most common side effect documented in the above-linked trial was dizziness, which occurred 8% more frequently on desvenlafaxine than on placebo, dry mouth which occurred 9% more frequently in the desvenlafaxine group, and constipation which occurred 7% more frequently in the desvenlafaxine group.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eClearly the more common side effects of desvenlafaxine are relatively mild, but the rare risk of suicide-related side effects is concerning.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIt may be beneficial for parents who are considering desvenlafaxine for their child to speak with their child’s doctor about alternative antidepressant medications without the potential for increased suicidality. It may be useful for young adults (the age range for “young adult” is not defined on the FDA label) to discuss the same concerns with their doctor.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDesvenlafaxine Vs. Venlafaxine\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eVenlafaxine is another commonly-prescribed antidepressant, which is sold under the brand name Effexor. Patients are often curious about which medication is more effective.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA comparative \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22883424\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e published in 2012 examined the efficacy and safety of these two drugs. The researchers concluded that they were equal in terms of efficacy, but that desvenlafaxine caused fewer side effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAnother \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21812735\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e examined results when patients who were unresponsive to venlafaxine switched to desvenlafaxine. Over 50% of them were categorized as “responders” to desvenlafaxine, which suggests that the drug may be effective for patients who attained no benefit from venlafaxine.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eBased on the available research, there doesn’t seem to be much clinical difference between desvenlafaxine and venlafaxine, but patients with a history of nausea may benefit from speaking with their doctor about desvenlafaxine, which may be less likely to cause nausea as a side effect.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eOTC Antidepressant Option\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWhile desvenlafaxine is prescribed for treating major depression, there exist research-backed OTC options available at drug stores, grocery stores or online that may be effective for mild-to-moderate depression with a more favorable side effect profile.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003eSt. John’s Wort\u003c\/b\u003e\u003cspan style=\"font-weight: 400;\"\u003e is an herbal supplement which was shown in an \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28064110\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eextensive medical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e to be as effective as SSRIs for treating mild and moderate depression. The researchers conducting this review analyzed 27 individual trials on St. John’s Wort for depression.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eSince herbal supplements can vary so much in terms of quality as they aren’t as strictly regulated as prescription drugs, we think it’s worth noting that most of the St. John’s Wort extract used in the medical trials was standardized to 2-5% hyperforin and 0.3% hypericin. These are the active chemical compounds in the supplement, and it seems logical to take a product with standardization ratios which mirrors that used in medical research.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe are not suggesting that St. John’s Wort is as effective an antidepressant as desvenlafaxine; just that it may be a safe and natural option for patients with milder forms of depression. We would strongly advise depressed patients to speak with their doctor prior to using St. John’s Wort, especially if they plan to use the supplement concurrently with their medication.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eTaking supplements and medications which can affect serotonin metabolism can cause a rare condition called Serotonin Syndrome which is life-threatening. This is why it’s so important for patients taking any drug, OTC or prescription, for depression to speak with their doctor first.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eShould I Take the Branded Version of Desvenlafaxine?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAs referenced earlier in this article, the brand-name version of desvenlafaxine is Pristiq. Patients are often curious about which medication to take, given that the two terms contain the same active drug ingredient.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eBecause branded and generic drugs are functionally equivalent, we typically recommend that patients speak with their doctor about the generic version (in this case desvenlafaxine), because it should be equally as effective as Pristiq but may cost significantly less.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA thorough \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6415809\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emeta-study\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e examined the relative efficacy of brand-name versus generic drugs, and found them to be equally effective on average. There were a few exceptions, but desvenlafaxine was not one of them. Thus, it seems logically sensible to consider desvenlafaxine over Pristiq, especially for patients on a lower income.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDesvenlafaxine Dosage\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine is prescribed at multiple different doses \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534829\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eaccording to\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e StatPearls which is one of the largest free medical databases in the U.S. StatPearls reports that the starting dose of desvenlafaxine is typically 50 milligrams (mg), but that the maximum therapeutic dose is 400 mg.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe located an interesting study on dosage that’s worth highlighting. A \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18507895\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eclinical trial\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e compared the efficacy of desvenlafaxine at 50 mg and 100 mg per day for treating MDD.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eContrary to what one might expect, the drug was actually more effective at the lower dose. Trial participants taking 50 mg daily reported lower HAM-D scores than those taking 100 mg daily.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDoctors often start patients on the lowest therapeutic dose in any case, because lower doses tend to confer a lower risk of side effects. But in light of this clinical trial, it may be worthwhile for patients to speak with their doctor about starting at a 50 mg dose, and only increasing dosage if they fail to experience benefit at that dose.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDesvenlafaxine User Reviews\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine has been reviewed over 800 times \u003c\/span\u003e\u003ca href=\"https:\/\/www.drugs.com\/comments\/desvenlafaxine\/for-depression.html\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eon Drugs.com\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e at the time of writing this article. This website allows users to publish reviews of prescription drugs they’re taking. We cannot verify the accuracy or legitimacy of any reviews on this website, but patients sometimes find it useful to read reviews written by people taking medication.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe average rating of desvenlafaxine for depression is 6.9\/10.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe top positive review is written by a user named “Aljo” who claims the medication has provided antidepressant benefits without the sexual side effects of other medications:\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e“I've recently come off lexapro due to some side effects, loss of sex drive and ejaculations without orgasms. How weird is that? Anyway I'm now on [desvenlafaxine] and the fog has lifted. You forget how good life can be when you're in the spirals of depression. But be active in your care and keep trying different meds because one day you'll succeed. I think [desvenlafaxine] is my 6th attempt at finding my happy place.”\u003c\/b\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe top negative review is published by a user named “Mylifeisruined” who gave the drug a 1\/10 star rating and claims that the side effects reduced their quality of life:\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e“I suffered almost every side effect, yawning, insomnia, increased anxiety, tinnitus, sweating, incapable of having an orgasm, vivid nightmares. I took [desvenlafaxine] 50mg for 4 weeks and I only had 1 day that I was not depressed. I quit taking it after 4 weeks of sleepless nights and a very loud high pitched ringing in my head. 2 weeks of feeling dizzy and extreme headaches, then 2 months of bad headaches and extreme anxiety.”\u003c\/b\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDesvenlafaxine Withdrawal Symptoms\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine does appear to have a risk of withdrawal symptoms, which is somewhat common for drugs which modulate neurotransmitter function.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19779354\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emeta-study\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e from 2009 investigated withdrawal symptoms associated with desvenlafaxine discontinuation. The most common withdrawal symptoms were: dizziness, nausea, headache and irritability.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003ePatients taking higher daily doses of desvenlafaxine experienced worse withdrawal symptoms on average. After the third week, patients withdrawing from a 400 mg\/day dose were still experiencing withdrawal symptoms twice as severe than patients withdrawing from a 100 mg\/day dose.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe would strongly recommend that patients speak with their doctor prior to quitting desvenlafaxine use, because a trained medical professional can help reduce the risk of withdrawal symptoms by creating a tapering schedule. By slowly reducing daily dose according to research standards rather than stopping abruptly, the risk of withdrawal symptoms may be lessened.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDesvenlafaxine for Anxiety\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine isn’t typically prescribed to treat anxiety, but patients are often curious about whether it may be effective given that many patients suffer from both depression and anxiety.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20414167\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e published in the \u003c\/span\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003eCNS Spectrums\u003c\/span\u003e\u003c\/i\u003e\u003cspan style=\"font-weight: 400;\"\u003e journal assessed data from nine clinical trials on desvenlafaxine to study its anti-anxiety effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThose taking desvenlafaxine reported significantly reduced anxiety by the end of the trials than at baseline. Anxiety severity was an average of 14% lower in those taking desvenlafaxine than those taking placebo.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAnother \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26955576\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eclinical trial\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e evidenced similar results. Depressed patients taking desvenlafaxine were less anxious by the end of the trial\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine is only FDA-approved for treating depression, so we would not recommend its use for anxiety alone, as this would be an “off-label” use which may be unsafe. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThis research does suggest that desvenlafaxine may be an effective treatment option for patients with both depression and anxiety. For those prescribed desvenlafaxine for MDD, the potential anti-anxiety effects may be considered a secondary benefit.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eConclusion\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine is effective for treating depression, and may also reduce anxiety levels in depressed patients.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe side effect profile of desvenlafaxine is concerning in our opinion, especially for children and adolescents given the FDA warning about potentially increased suicidal thoughts and behaviors. The more common side effects are relatively minor, such as dizziness and irritability.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDesvenlafaxine may be a slightly superior option to venlafaxine, but they seem nearly equivalent based on medical research. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003ePatients interested in an OTC option for treating mild or moderate depression may wish to speak with their doctor about St. John’s Wort supplementation, as this herb has significant research backing its efficacy as an antidepressant, and seems to cause no side effects when dosed appropriately.\u003c\/span\u003e\u003c\/p\u003e","blog_id":49281925193,"author":"Calloway Cook","user_id":26601750601,"published_at":"2022-08-01T23:55:51-04:00","updated_at":"2022-08-02T00:33:07-04:00","summary_html":"We review medical studies on prescription antidepressant desvenlafaxine to determine if it's effective for treating depression. We highlight side effects of the drug, explain whether the branded version is more likely to be effective, and compare its efficacy to other popular antidepressants like venlafaxine.","template_suffix":"","handle":"desvenlafaxine-review","tags":"_related:depression"}

Desvenlafaxine Review: The Best Generic Antidepressant?

Desvenlafaxine Review: The Best Generic Antidepressant?


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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and published for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Desvenlafaxine is a prescription drug which is approved by the Food and Drug Administration (FDA) in the U.S. to treat Major Depressive Disorder (MDD). The full name of the active chemical compound is desvenlafaxine succinate, or desvenlafaxine succinate ER,  but it’s typically shortened to just the first word for convenience. 

Desvenlafaxine is the generic term for the drug, and its branded version is called Pristiq. We will use these terms interchangeably throughout this article because they refer to the same active chemical compound.

In this article we’ll review published medical studies on desvenlafaxine to determine if it’s effective for treating depression. We’ll highlight side effects of the medication, compare its efficacy to other generic antidepressant drugs such as venlafaxine, and share a natural, over-the-counter (OTC) treatment that patients with mild depression may want to consider.

Does Desvenlafaxine Work?

There have been a number of clinical trials evaluating the effectiveness of desvenlafaxine for reducing symptoms of depression.

One such trial published in 2012 found desvenlafaxine to be effective for patients with MDD. All patients in this trial were previously diagnosed with MDD, which is somewhat standard for antidepressant drug trials, as MDD is typically the most severe and challenging category of depression to treat.

The study authors measured patient scores on the Hamilton Depression Rating Scale (HAM-D), which is a clinical tool that measures changes in a wide variety of symptoms associated with depression, such as sleeplessness and low libido.

The trial participants assigned to desvenlafaxine reported significantly reduced depression based on the HAM-D scoring. The average HAM-D score was greater than 20 at the start of the trial and less than 10 at the end of the trial, representing a decrease in depression symptoms of over 50%.

A medical review evaluated the efficacy of desvenlafaxine for patients with major depression. This review analyzed data from three individual clinical trials on the topic.

The researchers concluded that desvenlafaxine improved the condition of depressed patients on average. Remission rates were around 10% higher in the trial participants taking desvenlafaxine compared to the trial participants taking placebo pills. Remission is defined as an extended period free of any major depressive symptoms, so this is a significant result.

A recent clinical trial examined whether desvenlafaxine could improve productivity at work for patients who were depressed and employed. The medication did not improve cognitive function or work-related outcomes.

We will conclude from the available research that desvenlafaxine effectively treats depression, but is unlikely to improve productivity at work for patients who are depressed and working a salaried job.

How Does Desvenlafaxine Work?

Desvenlafaxine is a member of a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRI). As we outlined in our Pristiq reviews article, the drug is 10 times more selective for serotonin than norepinephrine. This suggests that it has greater effects on serotonin levels in the brain than on norepinephrine.

SNRI drugs delay the body’s processing and clearance of serotonin and norepinephrine, which are neurotransmitters that have significant effects on mood. By delaying biological processing of these neurotransmitters, desvenlafaxine causes an artificial increase in their circulating levels, which can improve mood and reduce depression.

It hasn’t been conclusively proven that patients with depression have lower levels of these neurotransmitters than non-depressed patients, but this is the suggested mechanism of action. Researchers don’t have to necessarily understand how a drug works to be able to conclusively state that it’s effective to a statistically significant degree based on clinical trials.

Desvenlafaxine Side Effects

Desvenlafaxine has a “black box” warning on its FDA label, which references a risk of severe side effects. The black box warning states that desvenlafaxine may increase risk of suicidal thoughts or actions in children, adolescents and young adults.

A clinical trial published in the Current Medical Research and Opinion journal provides some useful side effect data. Around 5% more patients taking desvenlafaxine withdrew from the study because of adverse effects than those taking placebo pills. This suggests that desvenlafaxine has a greater risk of side effects than placebo.

The most common side effect documented in the above-linked trial was dizziness, which occurred 8% more frequently on desvenlafaxine than on placebo, dry mouth which occurred 9% more frequently in the desvenlafaxine group, and constipation which occurred 7% more frequently in the desvenlafaxine group.

Clearly the more common side effects of desvenlafaxine are relatively mild, but the rare risk of suicide-related side effects is concerning.

It may be beneficial for parents who are considering desvenlafaxine for their child to speak with their child’s doctor about alternative antidepressant medications without the potential for increased suicidality. It may be useful for young adults (the age range for “young adult” is not defined on the FDA label) to discuss the same concerns with their doctor.

Desvenlafaxine Vs. Venlafaxine

Venlafaxine is another commonly-prescribed antidepressant, which is sold under the brand name Effexor. Patients are often curious about which medication is more effective.

A comparative medical review published in 2012 examined the efficacy and safety of these two drugs. The researchers concluded that they were equal in terms of efficacy, but that desvenlafaxine caused fewer side effects.

Another medical review examined results when patients who were unresponsive to venlafaxine switched to desvenlafaxine. Over 50% of them were categorized as “responders” to desvenlafaxine, which suggests that the drug may be effective for patients who attained no benefit from venlafaxine.

Based on the available research, there doesn’t seem to be much clinical difference between desvenlafaxine and venlafaxine, but patients with a history of nausea may benefit from speaking with their doctor about desvenlafaxine, which may be less likely to cause nausea as a side effect.

OTC Antidepressant Option

While desvenlafaxine is prescribed for treating major depression, there exist research-backed OTC options available at drug stores, grocery stores or online that may be effective for mild-to-moderate depression with a more favorable side effect profile.

St. John’s Wort is an herbal supplement which was shown in an extensive medical review to be as effective as SSRIs for treating mild and moderate depression. The researchers conducting this review analyzed 27 individual trials on St. John’s Wort for depression.

Since herbal supplements can vary so much in terms of quality as they aren’t as strictly regulated as prescription drugs, we think it’s worth noting that most of the St. John’s Wort extract used in the medical trials was standardized to 2-5% hyperforin and 0.3% hypericin. These are the active chemical compounds in the supplement, and it seems logical to take a product with standardization ratios which mirrors that used in medical research.

We are not suggesting that St. John’s Wort is as effective an antidepressant as desvenlafaxine; just that it may be a safe and natural option for patients with milder forms of depression. We would strongly advise depressed patients to speak with their doctor prior to using St. John’s Wort, especially if they plan to use the supplement concurrently with their medication.

Taking supplements and medications which can affect serotonin metabolism can cause a rare condition called Serotonin Syndrome which is life-threatening. This is why it’s so important for patients taking any drug, OTC or prescription, for depression to speak with their doctor first.

Should I Take the Branded Version of Desvenlafaxine?

As referenced earlier in this article, the brand-name version of desvenlafaxine is Pristiq. Patients are often curious about which medication to take, given that the two terms contain the same active drug ingredient.

Because branded and generic drugs are functionally equivalent, we typically recommend that patients speak with their doctor about the generic version (in this case desvenlafaxine), because it should be equally as effective as Pristiq but may cost significantly less.

A thorough meta-study examined the relative efficacy of brand-name versus generic drugs, and found them to be equally effective on average. There were a few exceptions, but desvenlafaxine was not one of them. Thus, it seems logically sensible to consider desvenlafaxine over Pristiq, especially for patients on a lower income.

Desvenlafaxine Dosage

Desvenlafaxine is prescribed at multiple different doses according to StatPearls which is one of the largest free medical databases in the U.S. StatPearls reports that the starting dose of desvenlafaxine is typically 50 milligrams (mg), but that the maximum therapeutic dose is 400 mg.

We located an interesting study on dosage that’s worth highlighting. A clinical trial compared the efficacy of desvenlafaxine at 50 mg and 100 mg per day for treating MDD.

Contrary to what one might expect, the drug was actually more effective at the lower dose. Trial participants taking 50 mg daily reported lower HAM-D scores than those taking 100 mg daily.

Doctors often start patients on the lowest therapeutic dose in any case, because lower doses tend to confer a lower risk of side effects. But in light of this clinical trial, it may be worthwhile for patients to speak with their doctor about starting at a 50 mg dose, and only increasing dosage if they fail to experience benefit at that dose.

Desvenlafaxine User Reviews

Desvenlafaxine has been reviewed over 800 times on Drugs.com at the time of writing this article. This website allows users to publish reviews of prescription drugs they’re taking. We cannot verify the accuracy or legitimacy of any reviews on this website, but patients sometimes find it useful to read reviews written by people taking medication.

The average rating of desvenlafaxine for depression is 6.9/10.

The top positive review is written by a user named “Aljo” who claims the medication has provided antidepressant benefits without the sexual side effects of other medications:

“I've recently come off lexapro due to some side effects, loss of sex drive and ejaculations without orgasms. How weird is that? Anyway I'm now on [desvenlafaxine] and the fog has lifted. You forget how good life can be when you're in the spirals of depression. But be active in your care and keep trying different meds because one day you'll succeed. I think [desvenlafaxine] is my 6th attempt at finding my happy place.”

The top negative review is published by a user named “Mylifeisruined” who gave the drug a 1/10 star rating and claims that the side effects reduced their quality of life:

“I suffered almost every side effect, yawning, insomnia, increased anxiety, tinnitus, sweating, incapable of having an orgasm, vivid nightmares. I took [desvenlafaxine] 50mg for 4 weeks and I only had 1 day that I was not depressed. I quit taking it after 4 weeks of sleepless nights and a very loud high pitched ringing in my head. 2 weeks of feeling dizzy and extreme headaches, then 2 months of bad headaches and extreme anxiety.”

Desvenlafaxine Withdrawal Symptoms

Desvenlafaxine does appear to have a risk of withdrawal symptoms, which is somewhat common for drugs which modulate neurotransmitter function.

A meta-study from 2009 investigated withdrawal symptoms associated with desvenlafaxine discontinuation. The most common withdrawal symptoms were: dizziness, nausea, headache and irritability.

Patients taking higher daily doses of desvenlafaxine experienced worse withdrawal symptoms on average. After the third week, patients withdrawing from a 400 mg/day dose were still experiencing withdrawal symptoms twice as severe than patients withdrawing from a 100 mg/day dose.

We would strongly recommend that patients speak with their doctor prior to quitting desvenlafaxine use, because a trained medical professional can help reduce the risk of withdrawal symptoms by creating a tapering schedule. By slowly reducing daily dose according to research standards rather than stopping abruptly, the risk of withdrawal symptoms may be lessened.

Desvenlafaxine for Anxiety

Desvenlafaxine isn’t typically prescribed to treat anxiety, but patients are often curious about whether it may be effective given that many patients suffer from both depression and anxiety.

A medical review published in the CNS Spectrums journal assessed data from nine clinical trials on desvenlafaxine to study its anti-anxiety effects.

Those taking desvenlafaxine reported significantly reduced anxiety by the end of the trials than at baseline. Anxiety severity was an average of 14% lower in those taking desvenlafaxine than those taking placebo.

Another clinical trial evidenced similar results. Depressed patients taking desvenlafaxine were less anxious by the end of the trial

Desvenlafaxine is only FDA-approved for treating depression, so we would not recommend its use for anxiety alone, as this would be an “off-label” use which may be unsafe. 

This research does suggest that desvenlafaxine may be an effective treatment option for patients with both depression and anxiety. For those prescribed desvenlafaxine for MDD, the potential anti-anxiety effects may be considered a secondary benefit.

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Conclusion

Desvenlafaxine is effective for treating depression, and may also reduce anxiety levels in depressed patients.

The side effect profile of desvenlafaxine is concerning in our opinion, especially for children and adolescents given the FDA warning about potentially increased suicidal thoughts and behaviors. The more common side effects are relatively minor, such as dizziness and irritability.

Desvenlafaxine may be a slightly superior option to venlafaxine, but they seem nearly equivalent based on medical research. 

Patients interested in an OTC option for treating mild or moderate depression may wish to speak with their doctor about St. John’s Wort supplementation, as this herb has significant research backing its efficacy as an antidepressant, and seems to cause no side effects when dosed appropriately.





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