Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor
“ALERT: US Boxed Warning
Suicidal thoughts and behavior:
Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behaviors with antidepressant use in adults older than 24 years; there was a reduction in risk with antidepressant use in adults 65 years and older. In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for the emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber. Desvenlafaxine is not approved for use in pediatric patients.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Desvenlafaxine, Pristiq/Khedezla is a potent and selective inhibitor of serotonin and norepinephrine reuptake. It does not affect dopamine, muscarinic, histamine 1, or alpha 2 adrenergic receptors or MAO.
Indications For Use
Desvenlafaxine, Pristiq/Khedezla is officially indicated for major depressive disorder. It is also prescribed off-label for vasomotor symptoms associated with menopause. (maybe used for conditions not listed)
Before starting Desvenlafaxine, Pristiq/Khedezla make sure your physician is aware of any allergies or medications you currently take, if you have liver disease, if you have bipolar disorder, kidney disease, a seizure disorder, cardiovascular disease, or are pregnant or breastfeeding. This medication has a risk of causing serotonin syndrome especially if combined with other serotonergic drugs. It can cause suicidal ideation, usually in young patients, with the major depressive disorder so must be used with caution and any major changes in personality or mood should be reported to the physician immediately.
50-100mg once daily. Dosages over 50mg daily were not shown to have any improvement in symptoms, but higher rates of side effects in clinical trials however some experts still recommend higher dosages if inadequate response to 50mg/day.
Pharmacist Tips On Using
How to Take Desvenlafaxine, Pristiq/Khedezla: Follow instructions provided by physician/pharmacy label, swallow whole with or without food, take consistently at same times each day unless otherwise directed, store at room temperature.
You Need to Avoid: This medication can increase the psychomotor impairment from alcohol consumption so extra care should be taken if choosing to consume alcohol. Do not stop this medication without tapering the dose down over time to prevent withdrawal symptoms (nausea, diarrhea, sweating, headaches, agitation, insomnia, anxiety, tremor, vertigo, dizziness).
Insomnia, dizziness, hyperhidrosis (excessive sweating), nausea, and dry mouth
Note this is not a complete list of side effects, only the common ones
Frequently Asked Questions
What do I do if side effects are intolerable?
If you are just starting this medication or just had a dosage increase, then it is common to have more prominent side effects for 2 weeks or so and if any remain at that point they will likely remain. If the symptoms are causing a lot of distress speak to your physician as soon as possible to discuss how to come off the medication.
What do I do if my mood worsens on this medication and I feel much worse?
Contact your physician immediately, it is rare however antidepressant medications can cause suicidal ideation, generally in those under the age of 24.
What is serotonin syndrome?
Serotonin syndrome is a rare, but potentially life-threatening condition of serotonin toxicity from too much of it in your system generally from the use of certain medications and supplements. Usually, multiple agents are at play or high doses are involved. The signs and symptoms include agitation, hallucinations, delirium, coma, tachycardia (rapid heart rate), diaphoresis (excessive sweating), tremor, muscle rigidity, nausea, vomiting, diarrhea, and/or seizures. If serotonin syndrome is suspected, discontinue any serotonergic medications, and seek immediate medical attention.