Posted by TriedEveryDrug on April 19, 2009, at 10:31:01
In reply to Re: Has Pristiq proven to be clinically useful? » bearfan, posted by Larry Hoover on April 19, 2009, at 8:30:04
Larry,
Do you know if Desvenlafaxine inhibits 2d6 at all? I know it is metabolized by 3A4.
in addition to being metabolized by 2d6, venlafaxine itself had an inhibitory effect, for instance desipramine AUC is raised 4.5 fold by 75mg of venlafaxine.
I've been interested in a desipramine/venlafaxine combo, but the decreased metabolism of desipramine had me worried. Maybe pristiq is the ticket.
Though epocrates claims there is an interaction. Maybe their data are wrong.
Thanks
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> I wish the idea that this is a patent extender would go away. Desvenlafaxine is a specific active metabolite of venlafaxine. It's believed to be responsible for the bulk of the antidepressant effect of venlafaxine. The side effects are mostly produced by other metabolites. In simplified terms.
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> Desvenlafaxine is produced by the liver enzyme 2D6. Many people have impaired activity at that enzyme. Some have none at all. The last time I checked, 118 genetic variants of that enzyme had been identified, with the majority of those leading to poor or no activity.
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> So, for those individuals, Pristiq offers an opportunity for treatment success that could not have been provided by Effexor. And, the theory is that it will be easier to withdraw from than Effexor, which is notorious for being difficult in that regard.
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> Time will tell. We don't have a lot of experiential data yet.
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> Lar
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poster:TriedEveryDrug
thread:891545
URL: http://www.dr-bob.org/babble/20090416/msgs/891566.html