Pristiq

Drug - Pristiq (desvenlafaxine)

August 2009

Therapeutic area - major depressive disorder

Pristiq (desvenlafaxine) PA criteria

• Patient is 18 years of age or older
• Patient has major depressive disorder
• Patient has had past trials of at least 2 SSRIs and Effexor XR (venlafaxine) for at least 2 months in duration unless adverse events prevent continued use [Hypersensitivity to venlafaxine is a contraindication for the use of Pristiq (desvenlafaxine)]

Medical exceptions

• Medical exception provided for newly discharged patients who were hospitalized for depression and stabilized on Pristiq at discharge
• Medical exception provided for patients if they pose an immediate danger to themselves or others
  This exception is allowed in order to initiate any antidepressant therapy

Dosing limits

Available as 50 mg and 100 mg tablets
One of either strength allowed per day
The recommended dose is 50 mg once daily. No additional benefit has been seen at doses higher than 50mg, while adverse events and discontinuations were more frequent at higher doses.

SSRI drugs

Fluoxetine (Prozac)
Paroxetine (Paxil, Paxil CR)
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)

Rationale

Desvenlafaxine is a metabolite of venlafaxine. Venlafaxine and desvenlafaxine are considered pharmacologically approximately equiactive and equipotent. The drug-drug interaction profile is similar between venlafaxine and desvenlafaxine.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411