Efficacy and tolerability of desvenlafaxine in the real-world treatment of patients with major depression: a narrative review and an expert opinion paper

ABSTRACT

Introduction

Major depressive disorder (MDD) is a common severe mental disorder, requiring a tailored and integrated treatment. Several approaches are available including different classes of antidepressants various psychotherapeutic approaches, and psychosocial interventions. The treatment plan for each patient with MDD should be differentiated on the basis of several clinical, personal, and contextual factors.

Areas covered

Desvenlafaxine – a serotonine-noradrenergic reuptake inhibitor (SNRI) antidepressant – has been approved in the United States in 2008 for the treatment of MDD in adults, and has been recently rediscovered by clinicians due to its good side-effect profile and its clinical effectiveness. A narrative review on efficacy, tolerability and use of desvenlafaxine in clinical practice was carried out. The keywords: ‘major depression’, ‘depression,’ ‘desvenlafaxine,’ ‘efficacy,’ ‘clinical efficacy,’ ‘side effects’, ‘tolerability,’ ‘elderly patients’, ‘consultation-liaison’, ‘menopausal’, ‘young people’, ‘adolescent’ were entered in PubMed, ISI Web of Knowledge, Scopus and Medline. No time limit was fixed, the search strategy was implemented on May 10, 2023.

Expert opinion

Desvenlafaxine should be listed among the optimal treatment strategies for managing people with MDD, whose main strengths are: 1) ease of dosing; 2) favorable safety and tolerability profile, 3) absence of sexual dysfunctions, weight gain and low rate of discontinuation symptoms; 4) low risk of drug–drug interactions.

KEYWORDS:

• depression
• desvenlafaxine
• efficacy
• effectiveness
• safety
• tolerability

Article highlights

• Major depressive disorder (MDD) is a common, often chronic, and recurring severe mental disorder affecting more than 264 million people worldwide.

• Desvenlafaxine is a SNRI, which has been approved in the United States in 2008 for the treatment of MDD in adults, and was recently rediscovered by clinicians working worldwide due to its good side-effect profile and its clinical effectiveness.

• General advantages of desvenlafaxine include ease of dosing (50 or 100 mg), with low rate of discontinuation symptoms, especially with the 50 mg dosage.

• Desvenlafaxine has a favorable safety and tolerability profile, including lack of sexual dysfunctions over placebo, no clinically significant weight gain with low risk of drug-drug interactions.

• Desvenlafaxine is effective in specific subpopulations of patients, such as perimenopausal and postmenopausal female patients, patients in consultation-liaison settings (including general hospital, primary care, outpatient clinics) and elderly population.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.