Desvenlafaxine succinate (DVS) is one of several serotonin-norepinephrine 
reuptake inhibitors (SNRIs). Others are venlafaxine hydrochloride, milnacipran, 
and duloxetine. Desvenlafaxine has been approved by the US Food and Drug 
Administration (FDA) for the treatment of major depressive disorder (MDD) based 
on a number of randomized, placebo-controlled clinical trials. Clinical studies 
have investigated the efficacy of DVS in doses ranging from 50 to 400 mg/day for 
the treatment of MDD in adult outpatients. The effects of DVS 50 mg/day have 
been clearly distinguished from placebo in the reduction of MDD symptoms in such 
clinical trials. No additional therapeutic benefits were found at doses > 50 
mg/day. The recommended dose of DVS ranges from 50 to 100 mg. Desvenlafaxine is 
currently the third SNRI approved by the FDA for this indication. Preliminary 
evidence also suggests the clinical usefulness of DVS in the treatment of 
vasomotor symptoms of menopause, anxiety symptoms, and painful physical 
symptoms. The modified pharmacokinetic and pharmacodynamic profiles of DVS 
differentiate this drug from the original product, venlafaxine. Significant 
points of difference, compared with venlafaxine, are once-daily dosing and the 
achievement of steady-state plasma concentrations within 4 to 5 days. To 
summarize, current evidence indicates that DVS has proven efficacy, acceptable 
safety and tolerability profiles, convenient dosing, and minimal impact on the 
cytochrome P450 enzyme system. A reduced risk for pharmacokinetic drug 
interactions is a potential advantage over other selective serotonin 
noradrenaline reuptake inhibitors. Desvenlafaxine succinate has demonstrated its 
efficacy for treating MDD but its variable efficacy, as shown in individual 
studies, limited long-term data, and its different risk-to-benefit ratio 
compared with earlier antidepressants, means that further investigation of this 
drug is necessary.