Efficacy and safety of desvenlafaxine succinate in the treatment of major depressive disorder

Venlafaxine is a serotonin-norepinephrine-reuptake inhibitor (SNRI) with a well-established efficacy, safety and tolerability profile. Desvenlafaxine succinate is the succinate salt monohydrate of O-desmethylvenlafaxine, an active metabolite of venlafaxine, and, like its parent compound, is an SNRI. A sustained-release form of desvenlafaxine succinate 100 mg/day has demonstrated efficacy for the treatment of adult major depressive disorder in large multicenter trials. Desvenlafaxine succinate has a good overall safety and tolerability profile, with adverse effects comparable with those of other SNRIs. The most frequent side effects of desvenlafaxine succinate include nausea, dry mouth, constipation, dizziness, insomnia, somnolence, anorexia and sweating. The primary advantage of the sustained-release formulation over other SNRIs based on current information is related to its minimal metabolism via the cytochrome P450 (CYP450) pathway and its minimal impact on CYP450 enzyme systems. Its low potential for drug-drug interactions may have significant clinical relevance, especially in depression associated with medical comorbidities.