A number of studies were presented the American Psychiatric Association’s annual meeting last week that showed the safety and efficacy of a new antidepressant, desvenlafaxine, which may be marketed under the brand name, Pristiq.
Although I don’t have access to the main efficacy study at the moment, I did look it up on Medline and saw a few items that caught my eye in the abstract of this study.
Treatment was given to four groups of patients (N ~= 115 per group), three of which were various dosing levels of desvenlafaxine (100, 200 and 400 mg/day), and one was given placebo.
The 200 mg/day treatment group is the black sheep in the results:
CGI-I and Montgomery-Asberg Depression Rating Scale results were significant for all groups; CGI-S results were significant with 100 mg/day and 400 mg/day.
The CGI-S measures the severity of illness, so for the 200 mg/day group, the illness remained as severe as pre-treatment. And here’s why:
Response rates were significantly greater for desvenlafaxine 100 mg/day (51%) and 400 mg/day (48%) versus placebo (35%; p = .017 and p = .046, respectively); the response rate for desvenlafaxine 200 mg/day was 45% (p = .142).
Response rates are great for the 100 and 400 mg/day groups, but not so much for the 200 mg/day group. Interesting.
And there’s always that placebo response rate to highlight — 35% of people respond positively to a sugar pill while being treated for depression.
Visual Analog Scale-Pain Intensity results were significant for desvenlafaxine 100 mg/day versus placebo (p = .002), but not for the higher doses.
This scale measures the self-reported intensity of pain by subjects in the study. Pain appears to still be an issue for the 100 mg/day group.
I’ll get a copy of the study to see if the authors have an explanation as to why the 200 mg/day group stood out in this manner.
But it looks like Pristiq (desvenlafaxine) is on track for FDA approval this year.
Followup: Folks representing Wyeth were kind enough to let me know that although this study was just published last month, it is based upon fairly old data (the study was conducted from Nov. 2003-2004). They are forwarding me some of the studies presented at APA this past week to review more recent data on this new antidepressant.
Reference: DeMartinis NA, Yeung PP, Entsuah R, Manley AL. (2007). A double-blind, placebo-controlled study of the efficacy and safety of desvenlafaxine succinate in the treatment of major depressive disorder. J Clin Psychiatry. 2007 May;68(5):677-88.
(14 votes, average: 4.29 out of 5)
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5 Responses to “New Antidepressant, Desvenlafaxine (Pristiq), Does Well” (Pingbacks/trackbacks not shown below)
GregRogers at 3:45 pm on
June 1st, 2007
So in a case where the 400mg ‘response rate’ was 48%, and the placebo was 35%, the net effect of the of the drug was 13%.
Also, do you have any idea what is meant by “response rate” in this context? Does it mean no more depression, felt a little better sometimes, or just what? They seem to cloak these things is such tricky language.
Assuming that “response rate” doesn’t mean a complete elimination of depression, we have to factor that out of our 13%, and we get what? 3% did really well? 5% did pretty good?
I’m speculating, but you see my point? Pretty thin evidence - and I believe these are typical numbers.
Really Depressed at 1:48 am on
August 11th, 2008
I tried Pristiq for a month or so for my treatment resistant depression. Like just about all modern antidepressants, its side effects were immediately felt while, no beneficial effect detectable. Like all the SSRIs and many among the other classes of antidepressants, Pristiq causes immediate inanorgasmia (inability to acheive orgasm), but no reduction in sexual desire.
After 1 month no reduction in depression was present and no reduction in the intensity of intolerable side effects occured.
Pristiq is a fraud, just like 99% of the antidepressants on the market today.
There tests described above seem to indicate that Pristiq has no or very minimal beneficial effect on depression. As usual, in the tests, the destruction of the ability to continue a normal sexual life is not evaluated or at least the results are not presented.
Go for one of the 40+ year old MOAI inhibitors or TCAs if you need actual antidepressant effect and don’t enjoy chemical castration.
No - I’m not kidding, nor exaggerating.
kim at 6:34 pm on
August 13th, 2008
i’ve been dealing with very high libido (or psas–persistant sexual arousal syndrome) and was prescribed pristiq to lower libido. amazing results in 2 wks. going from not being able to maintain being satisfied (being sexually aroused 24/7 no matter how often having sex) to only needing it once a day. thank god for pristiq!!!
The data does not look that exiciting. Did Wyeth ever provide updated data?
Cin at 6:43 pm on
October 31st, 2008
I’ve been given a 50mg trial for pristiq to see if it assists with PMDD ( Pre-Menstrual Dysphoric Disorder) and was thinking to myself is it possible to break the tablets in half or in quarters as 50 mgs seems a high dosage. I myself are into wholistic treatments and the fact medication freaks me out am trying to research the effects of this drug before commencement.
is there any updated data?? beside’s what comes with wyeth’s website interesting to know thankyou.
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So in a case where the 400mg ‘response rate’ was 48%, and the placebo was 35%, the net effect of the of the drug was 13%.
Also, do you have any idea what is meant by “response rate” in this context? Does it mean no more depression, felt a little better sometimes, or just what? They seem to cloak these things is such tricky language.
Assuming that “response rate” doesn’t mean a complete elimination of depression, we have to factor that out of our 13%, and we get what? 3% did really well? 5% did pretty good?
I’m speculating, but you see my point? Pretty thin evidence - and I believe these are typical numbers.
I tried Pristiq for a month or so for my treatment resistant depression. Like just about all modern antidepressants, its side effects were immediately felt while, no beneficial effect detectable. Like all the SSRIs and many among the other classes of antidepressants, Pristiq causes immediate inanorgasmia (inability to acheive orgasm), but no reduction in sexual desire.
After 1 month no reduction in depression was present and no reduction in the intensity of intolerable side effects occured.
Pristiq is a fraud, just like 99% of the antidepressants on the market today.
There tests described above seem to indicate that Pristiq has no or very minimal beneficial effect on depression. As usual, in the tests, the destruction of the ability to continue a normal sexual life is not evaluated or at least the results are not presented.
Go for one of the 40+ year old MOAI inhibitors or TCAs if you need actual antidepressant effect and don’t enjoy chemical castration.
No - I’m not kidding, nor exaggerating.
i’ve been dealing with very high libido (or psas–persistant sexual arousal syndrome) and was prescribed pristiq to lower libido. amazing results in 2 wks. going from not being able to maintain being satisfied (being sexually aroused 24/7 no matter how often having sex) to only needing it once a day. thank god for pristiq!!!
The data does not look that exiciting. Did Wyeth ever provide updated data?
I’ve been given a 50mg trial for pristiq to see if it assists with PMDD ( Pre-Menstrual Dysphoric Disorder) and was thinking to myself is it possible to break the tablets in half or in quarters as 50 mgs seems a high dosage. I myself are into wholistic treatments and the fact medication freaks me out am trying to research the effects of this drug before commencement.
is there any updated data?? beside’s what comes with wyeth’s website interesting to know thankyou.
