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ORIGINAL ARTICLES

Discontinuation symptoms and taper/poststudy-emergent adverse events with desvenlafaxine treatment for major depressive disorder

Montgomery, Stuart A.a; Fava, Mauriziob; Padmanabhan, Sudharshan K.c; J. Guico-Pabia, Christinec; Tourian, Karen A.c

Author Information

aImperial College School of Medicine, London, England, UK

bMassachusetts General Hospital, Boston, Massachusetts

cWyeth Research, Collegeville, Pennsylvania, USA

Correspondence to Professor Stuart A Montgomery, PO Box 8751,London W13 8WH UK

Tel: +44 20 8997 2689; fax: +44 20 8566 7986;

e-mail:[email protected]

Received 17 March 2009 Accepted 17 June 2009

International Clinical Psychopharmacology24(6):p 296-305, November 2009. |DOI:10.1097/YIC.0b013e32832fbb5a

Abstract

The objective of this study was to assess discontinuation symptoms with desvenlafaxine (administered as desvenlafaxine succinate) treatment for major depressive disorder. Data were analyzed from nine 8-week, double-blind (DB), placebo-controlled studies of desvenlafaxine (50, 100, 200, or 400 mg/day; placebo,n = 319; desvenlafaxine,n = 578) and a relapse-prevention study [12-week, open-label (OL) 200 or 400 mg/day desvenlafaxine (n = 373); 6-month DB placebo (n = 73) or desvenlafaxine (n = 118)]. Rates of taper/poststudy-emergent adverse events were summarized. Discontinuation-Emergent Signs and Symptoms (DESS) checklist scores were analyzed in treatment completers at the end of OL and DB treatment. The most common (≥5%) taper/poststudy-emergent adverse events among desvenlafaxine patients were dizziness, nausea, headache, irritability, diarrhea, anxiety, abnormal dreams, fatigue, and hyperhidrosis. In the short-term studies, the highest DESS scores observed for desvenlafaxine groups occurred at first assessment after discontinuation of all active treatment (1.9–5.7). Desvenlafaxine 50- and 100-mg/day groups had significantly increased scores versus placebo (P values ≤0.028). DESS scores increased significantly for patients discontinuing 12-week, OL desvenlafaxine 200 and 400 mg/day doses compared with those continuing desvenlafaxine (P values ≤0.022). After the 6-month DB phase, DESS scores increased significantly compared with placebo for patients discontinuing 400 mg/day only (P = 0.029). In conclusion, cessation of desvenlafaxine use is associated with discontinuation symptoms after both short-term and long-term treatment.

© 2009 Lippincott Williams & Wilkins, Inc.

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