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Desvenlafaxine Succinate (DVS) Controlled-Release Tablets

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Desvenlafaxine succinate (DVS) Controlled-Release Tablets

Educating elderly patients new to DVS: safety guide for Australian Nurses

Class: Serotonin-noradrenaline reuptake inhibitor (SNRI) antidepressant
Brand name: Pristiq®

Indications

Symptomatic treatment of major depressive disorder.1

Pharmacology

Pharmacodynamics (PD): DVS prolongs the action of serotonin (5-HT) and noradrenaline (NA) in the central-nervous-system (CNS) by selectively binding to synaptic reuptake transporters.2-4 (See fig 1).5 5-HT and NA are powerful neurotransmitters that regulate mood and mental wellbeing.3

Pharmacokinetics (PK): Well absorbed in the gastrointestinal tract, metabolised in the liver and excreted in the urine. 1-2,4 The average PK parameters of DVS with once-daily dosing are1,4:

Note: Clearance rates are reduced in elderly patients with renal and/or hepatic dysfunction, resulting in an increased t1/2 and overexposure to DVS1-4,6 (see Dosage Considerations and Adverse Effects).

Dosage

• 50 mg once daily, swallowed whole with water. Not to be crushed, cut, dissolved or chewed, as this will modify the timed-release mechanism, reducing efficiency and causing adverse effects.

• To be taken at the same every day to sustain a therapeutic steady state (devise a routine that works best with the patient as to maintain compliance e.g. after brushing teeth at night).

Dosage Considerations

• Abruptly increasing or decreasing dose causes adverse effects, due to slow CNS
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