Desvenlafaxine succinate: Is it a new promise and hope for management of vasomotor symptoms in postmenopausal women?

Abstract

BackgroundDesvenlafaxine succinate (DVS) is one of several serotonin–norepinephrine reuptake inhibitors (SNRIs) and has been approved by the US Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD) and trials are being performed further to extend its approval in management of vasomotor symptoms in postmenopausal women. ObjectiveTo review the published trials that evaluated the role of serotonin–norepinephrine reuptake inhibitors (SNRIs), especially desvenlafaxine succinate, on vasomotor symptoms (VMS). MethodsPubMed (the web-based version of MEDLINE) was searched using term “desvenlafaxine succinate AND vasomotor symptoms”. Trials examining the efficacy and safety of desvenlafaxine succinate in VMS were considered for critical review. ResultsRecently, a program of clinical trials with desvenlafaxine (a salt from the major metabolite of venlafaxine) has been developed for VMS. Currently, there are seven randomized, double blind clinical trials published, showing a significantly higher efficacy of desvenlafaxine versus placebo on VMS. There were also increased minor side effects with desvenlafaxine, especially nausea, at the beginning of the treatment. ConclusionsA non-hormonal alternative—desvenlafaxine succinate may be useful and is indicated for VMS in some but not most, cases. There was also an increase in minor side effects, especially nausea, at the beginning of the treatment. Studies comparing desvenlafaxine to other available treatment options relative to efficacy and safety are lacking, with the exception of only one trial where the comparative option was tibolone. The lack of head-to-head trials with the nonhormonal treatments, in particular, leaves practitioners with numerous choices. Larger and longer studies are warranted to prove its long-term efficacy and safety.