Lohoff Falk W, Rickels Karl
University of Pennsylvania School of Medicine Mood and Anxiety Disorders Section, Department of Psychiatry, Center for Neurobiology and Behavior, Translational Research Laboratories, Philadelphia, PA 19104, USA.
Expert Opin Pharmacother. 2008 Aug;9(12):2129-36. doi: 10.1517/14656566.9.12.2129.
Major depressive disorder (MDD) remains one of the most common psychiatric disorders with high morbidity and mortality. Effective treatment is limited and response/remission to antidepressant pharmacotherapy remains poor and unpredictable. The development of new antidepressants is thus of great importance to the field. Desvenlafaxine succinate (DVS) is the active metabolite of the serotonin and noradrenaline re-uptake inhibitor venlafaxine and was recently FDA approved for the treatment of MDD. DVS showed efficacy in clinical trials in MDD with doses ranging from 50 - 400 mg. Advantages compared to other antidepressants include once daily dosing at effective doses, no CYP450 metabolism and low drug-drug interactions. Concerns include side effect profile and moderate efficacy. DVS might be a useful addition to the arsenal of antidepressants available to the clinician. Additional studies, in particular head-to-head comparison to other antidepressants and long-term treatment studies, will be necessary to comprehensively evaluate DVS safety and efficacy for clinical practice.
重度抑郁症(MDD)仍然是发病率和死亡率都很高的最常见精神疾病之一。有效的治疗方法有限,对抗抑郁药物治疗的反应/缓解情况仍然不佳且难以预测。因此,新型抗抑郁药的研发对该领域至关重要。琥珀酸去甲文拉法辛(DVS)是5-羟色胺和去甲肾上腺素再摄取抑制剂文拉法辛的活性代谢产物,最近获得美国食品药品监督管理局(FDA)批准用于治疗MDD。DVS在MDD的临床试验中显示出疗效,剂量范围为50 - 400毫克。与其他抗抑郁药相比,其优点包括有效剂量下每日一次给药、无CYP450代谢以及药物相互作用少。需要关注的问题包括副作用情况和疗效一般。DVS可能是临床医生可用的抗抑郁药库中的一个有用补充。需要进行更多研究,特别是与其他抗抑郁药的直接对比研究和长期治疗研究,以全面评估DVS在临床实践中的安全性和疗效。