Tella Sri Harsha, Gallagher John Christopher
Creighton University School of Medicine, Department of Internal Medicine , 601 N 30th St, Suite 6718, Omaha, NE 68131 , USA +1 402 280 4518 ; +1 402 280 4517 ;
Expert Opin Pharmacother. 2014 Nov;15(16):2407-18. doi: 10.1517/14656566.2014.964641. Epub 2014 Sep 25.
The concern for the development of breast cancer, stroke, cardiovascular disease and deep venous thrombosis with the use of hormonal therapy has led to the development of alternative nonhormonal forms of therapy like desvenlafaxine for the management of hot flashes.
This review is based upon a PubMed search and clinical trials. The pharmacokinetics and pharmacodynamics of desvenlafaxine are reviewed. This review outlines the effects of desvenlafaxine in management of severity and frequency of vasomotor symptoms, sleep quality and quality of life in postmenopausal women. The potential adverse effects of desvenlafaxine are summarized.
Based on the evidence from randomized clinical trials, desvenlafaxine is an alternate viable option for reducing the frequency and severity of hot flashes when other treatments fail. In clinical trials, it has been shown that desvenlafaxine reduced the frequency of hot flashes by 55 - 69%. In the trials so far it appears to have good safety and tolerability profile when the drug is initiated in titrating doses. The optimum dose is 100 mg/day and is to be started at 50 mg/day for 3 days and titrated to 100 mg/day. The most common adverse events reported were nausea, dry mouth, fatigue, constipation, diarrhea and somnolence.
对于使用激素疗法引发乳腺癌、中风、心血管疾病和深静脉血栓形成的担忧，促使人们开发了诸如去甲文拉法辛等替代非激素疗法来治疗潮热。
本综述基于PubMed搜索和临床试验。对去甲文拉法辛的药代动力学和药效学进行了综述。本综述概述了去甲文拉法辛在治疗绝经后女性血管舒缩症状的严重程度和发作频率、睡眠质量及生活质量方面的效果。总结了去甲文拉法辛的潜在不良反应。
基于随机临床试验的证据，当其他治疗方法无效时，去甲文拉法辛是减少潮热发作频率和严重程度的另一种可行选择。在临床试验中，已表明去甲文拉法辛可使潮热发作频率降低55% - 69%。在目前的试验中，当以滴定剂量开始用药时，它似乎具有良好的安全性和耐受性。最佳剂量为100毫克/天，应从50毫克/天开始服用3天，然后滴定至100毫克/天。报告的最常见不良事件为恶心、口干、疲劳、便秘、腹泻和嗜睡。
