Is desvenlafaxine an MAOI? (+3 differences)

In this article, we will answer whether desvenlafaxine is an MAOI or not. We will further discuss the basic differences between desvenlafaxine and MAOI drugs. We will also look at the common perceptions regarding the use of these drugs. 

Is desvenlafaxine an MAOI?

No, desvenlafaxine is not an MAOI. Desvenlafaxine belongs to the serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants drug class. SNRI and MAOI are two separate antidepressant drug classes used for the treatment of depression, anxiety, and related conditions.  

MAOIs possess more side effects and drug interactions as compared to SNRIs because they exert an effect on many neurotransmitters including serotonin, dopamine, histamine, epinephrine, and norepinephrine. 

Desvenlafaxine is a relatively safer drug with fewer side effects and drug interactions due to its effect on serotonin and norepinephrine neurotransmitters. 

What makes desvenlafaxine different from MAOIs? 

There are various differences that make desvenlafaxine not fall into the MAOI drug class. Some of them are discussed below: 

Mechanism of action

Desvenlafaxine is an SNRI antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine in the synaptic cleft resulting in an increase in their levels and activity in the brain thus, maintaining mental balance (1). 

Desvenlafaxine is considered to be 10 times more selective for serotonin than norepinephrine. However, like all other SNRI drugs, desvenlafaxine has a weaker affinity for dopamine reuptake as well (1).   

Desvenlafaxine is the primary active metabolite of venlafaxine. Some other common antidepressant drugs belonging to SNRIs include duloxetine, levomilnacipran, and milnacipran (1).

MAOIs exert their action by blocking the enzyme monoamine oxidase (MAO) which results in inhibiting the breakdown of neurotransmitters and an increased accumulation of serotonin, dopamine, and norepinephrine in the brain (2).

 The most common antidepressant medications belonging to MAOIs include selegiline, isocarboxazid, phenelzine, and tranylcypromine (2). 

Therapeutic effects

Since both, desvenlafaxine and MAOIs are antidepressants, they may possess almost similar therapeutic effects with a few exceptions.

Desvenlafaxine is prescribed and approved for the treatment of (3):

• Major depressive disorder (MDD)
• Hot flashes during menopause 

Some therapeutic uses of the MAOI drug class include (2):

• Atypical depression
• Panic attacks
• Social anxiety disorders
• Treatment-resistant depression
• Parkinson’s disease (selective MAO-B inhibitors)
• Bipolar disorder

Side effects

The common side effects of desvenlafaxine include (1,3)

• Dry mouth
• Dizziness
• Constipation
• Loss of appetite 
• Sleepiness
• Nightmares 
• Sweating
• Sexual problems in males and females
• Difficulty in urinating
• Headache
• Abdominal pain

Whereas, some side effects associated with MAOIs include (4,5):

• Dizziness
• Low blood pressure
• Weight gain
• Muscle cramps
• Sexual dysfunction
• Insomnia
• Hypertensive crisis
• Aggression
• Sedation
• Palpitations
• Headache

However, different patients respond to medications varyingly and may experience different side effects. Not every patient taking these medications may experience these side effects. 

Therefore, it is important to discuss your symptoms and side effects with your doctor. So that, necessary adjustments can be made to avoid such side effects. 

Withdrawal symptoms

Withdrawal symptoms are very common with antidepressants. The missed doses or abrupt discontinuation of such drugs may cause severe withdrawal symptoms in patients (6). 

MAOIs are associated with causing severe withdrawal symptoms such as agitation, anxiety, pressured speech, sleeplessness, drowsiness, delirium, and hallucinations. Abrupt stopping the dose of MAOIs can lead to the worsening of such symptoms (5). 

Desvenlafaxine is also associated with some withdrawal symptoms if the patient stops taking the medication. Some of these symptoms include irritability, nausea, vomiting, dizziness, nightmares, and paresthesias (6). 

Can desvenlafaxine and MAOIs be taken together?

No, desvenlafaxine and MAOIs should not be taken together, There are chances of many potential adverse effects associated if desvenlafaxine and MAOI drugs are taken together since they both act on neurotransmitters. 

Taking desvenlafaxine along with MAOI medications can potentially increase the chance of developing a rare life-threatening condition called serotonin syndrome due to the increased effects of both drugs on serotonin levels and activity (1). 

It is highly risky to take desvenlafaxine with MAOI. Taking these concurrently may require extensive monitoring due to the chances of developing several adversities leading to suicidality and behaviour changes since both classes impact human behaviour by altering brain chemistry (1). 

It is extremely dangerous to take these medications concomitantly due to the chances of potential adversities. It is advised to always consult your doctor before initiating, switching, or dropping any antidepressant medication for safe and better therapeutic outcomes. 

How to choose between desvenlafaxine and MAOIs?

To choose between desvenlafaxine and MAOI medications is based on your signs, symptoms, and health condition. Your doctor may perform a detailed and thorough assessment of you to choose the antidepressant that suits you best to cure and treat you. 

However, prescribing medications is also based on many additional factors such as:

• Past medical history
• Concurrent medications
• Underlying health conditions
• Severity of condition
• Individual preferences

However, medications may possess both therapeutic benefits and side effects. Your healthcare provider always chooses medications for you that outweigh the benefits over side effects and bring positive health outcomes. 

In conclusion, I would recommend you to always communicate your signs and symptoms properly to your doctor so they can prescribe you an antidepressant that suits best to your condition and does not show excessive side effects. 

References