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desvenlafaxine

Adjunctive therapy • Brands: Pristiq

Last reviewed: 2026-03-31

General information

Class: Adjunctive therapy
Common US brands: Pristiq
Typical dose range: Label dose is 50 mg once daily with or without food; doses >100 mg/day add little efficacy and increase adverse effects.
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-03-31

Dosing & forms

Forms/strengths: Extended-release tablets: 25 mg, 50 mg, 100 mg.
Frequency: Label dose is 50 mg once daily with or without food; doses >100 mg/day add little efficacy and increase adverse effects.
Food: With or without food.
Typical range: Label dose is 50 mg once daily with or without food; doses >100 mg/day add little efficacy and increase adverse effects.

Mechanism (brief)

Serotonin-norepinephrine reuptake inhibitor (SNRI); active metabolite of venlafaxine.

Metabolism & Half‑life

Metabolism: UGT, CYP3A4 (minor), CYP2D6 (minimal)
Half‑life: Single-dose mean 11 h; Single-dose range 9–13 h; Steady-state mean 11 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

Blood pressure and heart rate at baseline and periodically, especially in patients with pre-existing hypertension.
Renal function for long-term therapy so dosing remains aligned with kidney function changes over time.
Discontinuation symptoms during missed doses or tapering; plan refill timing and taper steps are often planned in advance.
Mood elevation or agitation in bipolar-spectrum illness; coordinate prevention plans via the bipolar disorder hub.

Sources

Pristiq (desvenlafaxine) prescribing information — DailyMed (2025)
APA Clinical Practice Guideline for the Treatment of Depression — American Psychiatric Association (2023)
CANMAT 2024 Clinical Guidelines for Major Depressive Disorder — Canadian Journal of Psychiatry (2024)
Desvenlafaxine in the treatment of major depressive disorder — Neuropsychiatric Disease and Treatment (2009)