Desvenlafaxine
| Evidence Level: L4 | Predicted Indications: 8 |
Table of Contents
Desvenlafaxine: Obsessive-compulsive disorder
One-Sentence Summary
Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI), originally used to treat depression (unipolar, endogenous and major depressive disorder) and anxiety disorders. The TxGNN model predicts it may be effective for obsessive-compulsive disorder (OCD), but at present there are no registered clinical trials and only 3 publications, none of which studies desvenlafaxine directly. The prediction rests mainly on the model score.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Obsessive-compulsive disorder |
| TxGNN Prediction Score | 0.9991 |
| Evidence Level | L4 |
| Australia Market Status | Listed on the PBS Schedule (1 of 1 items) – TGA (ARTG) registration status is not included in this data |
| Number of PBS Items | 1 (valid: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available for this report. Desvenlafaxine is known to be an SNRI, and its efficacy in depression is established. OCD responds best to potent serotonergic agents (SSRIs and clomipramine), and some SNRIs, such as venlafaxine, have supporting data. This gives a plausible class-level serotonergic link.
However, no desvenlafaxine-specific trial in OCD was identified. The retrieved literature consists of a review of serotonergic antidepressants in OCD, a review of postpartum depression and a small risperidone augmentation study in somatic symptom disorder. None of these provides direct evidence for this drug. The prediction should therefore be treated as a hypothesis.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 24766145 | 2014 | Review | Expert Opin Pharmacother | Reviews double-blind studies of serotonergic antidepressants in OCD and confirms the central role of the serotonin system. Not specific to desvenlafaxine. |
| 36686097 | 2022 | Review | Cureus | Comprehensive review of postpartum depression. OCD is mentioned only as a possible later complication. Limited relevance. |
| 40224942 | 2025 | Clinical study | Psychiatry Clin Psychopharmacol | Risperidone augmentation in antidepressant-resistant somatic symptom disorder. Indirect relevance only. |
Australia Market Information
| ARTG Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| ARTG 10231L | Desfax | Tablet (modified release) 100 mg | Not available in the data compiled for this report |
Safety Considerations
- Contraindication-related conditions (knowledge graph, not label text): The knowledge graph links desvenlafaxine to the following conditions as contraindications or cautions:
- Cardiovascular and cerebrovascular: hypertension and hypertensive disorder, ocular hypertension, cardiovascular disease, heart disease, cerebrovascular disorder.
- Neurological and psychiatric: epilepsy, bipolar disorder, major affective disorder.
- Organ and metabolic: liver disease, gallbladder disease, impaired renal function, blood coagulation disease, hypertriglyceridemia.
- Eye: angle-closure glaucoma.
- Syndromes: serotonin syndrome, neuroleptic malignant syndrome, syndrome of inappropriate ADH secretion (including the nephrogenic form).
- Respiratory: interstitial lung disease.
- Drug Interactions: 100 interactions were identified. Examples of major interactions include bupropion, lorcaserin, dexfenfluramine, fenfluramine, diethylpropion, mazindol, dolasetron and granisetron, mainly serotonergic or stimulant agents. Moderate interactions include epinephrine, ephedrine, morphine, acetylsalicylic acid, dronabinol and mannitol. Cimetidine is a minor interaction.
Please also refer to the TGA-approved Product Information (PI) for full warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The OCD prediction has a high model score but no desvenlafaxine-specific trials or direct literature, so the evidence is only L4 (mechanistic plausibility at class level).
To proceed, the following is needed:
- Desvenlafaxine-specific clinical data in OCD, such as a controlled trial or well-designed observational study, and comparison with venlafaxine data in OCD
- Detailed mechanism of action data
- TGA Product Information warnings and contraindications, and the approved indication text for the ARTG entry
- A safety review given the major serotonergic drug interactions and the listed comorbidity cautions (cardiovascular, hepatic, renal, bipolar and seizure disorders)
- Consideration of dysthymic disorder as a better-supported alternative repurposing question
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.