Higher dosages of Pristiq (desvenlafaxine) are safe, but is there any clinical advantage to using such dosages compared to 100 mg/day? I recall the days when the average dosage of Effexor (venlafaxine) was 150 mg/day with a maximum of 225 mg/day. Now, it is good practice to use dosages of 300 mg/day and higher of that drug before abandoning it. Could the same be true of Pristiq?
- Scott
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CNS Spectr. 2012 Aug 10:1-10. [Epub ahead of print]
High-dose desvenlafaxine in outpatients with major depressive disorder.
Ferguson JM, Tourian KA, Rosas GR.
Source
1 University of Utah School of Medicine, Salt Lake City, Utah, USA.
Abstract
OBJECTIVE:
This study investigated the safety and efficacy of long-term treatment with high-dose desvenlafaxine (administered as desvenlafaxine succinate) in major depressive disorder (MDD).
METHODS:
In this multicenter, open-label study, adult outpatients with MDD aged 18-75 were treated with flexible doses of desvenlafaxine (200-400 mg/d) for ≤ 1 year. Safety assessments included monitoring of treatment-emergent adverse events (TEAEs), patient discontinuations due to adverse events, electrocardiograms, vital signs, and laboratory determinations. The primary efficacy measure was mean change from baseline in the 17-item Hamilton Rating Scale for Depression [HAM-D(17)] total score.
RESULTS:
The mean daily desvenlafaxine dose range over the duration of the trial was 267-356 mg (after titration). The most frequent TEAEs in the safety population (n = 104) were nausea (52%) and headache (41%), dizziness (31%), insomnia (29%), and dry mouth (27%). All TEAEs were mild or moderate in severity. Thirty-four (33%) patients discontinued from the study because of TEAEs; nausea (12%) and dizziness (9%) were the most frequently cited reasons. The mean change in HAM-D(17) total score for the intent-to-treat population (n = 99) was -9.9 at the last on-therapy visit in the last-observation-carried-forward analysis and -14.0 at month 12 in the observed cases analysis. Conclusion High-dose desvenlafaxine (200-400 mg/d) was generally safe and effective in the long-term treatment of MDD.
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