Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Desvenlafaxine(click to collapse)
1/4 selected
Desvenlafaxine
Pristiq · Khedezla · Pristiq Extended-Release
Serotonin-Norepinephrine Reuptake Inhibitor
FDA-approved indications
- Major depressive disorder (adults)
Off-label uses
- Vasomotor symptoms (menopause)
- Generalized anxiety disorder
- Neuropathic pain
Half-life11 hours
Decision GuideWhen to pick each / when to consider an alternative
Desvenlafaxine
Consider when
- CYP2D6 drug interactions are a concern — minimal CYP2D6 metabolism and no 2D6 inhibition; unaffected by 2D6 inhibitors (contrast: venlafaxine)
- Pharmacokinetic simplicity needed — 50 mg is starting and therapeutic dose; no titration required; flat dose-response curve
- CYP2D6 metabolizer phenotype unknown — genetic variation in 2D6 does not affect clinical response or levels (unlike venlafaxine)
- Polypharmacy with CYP2D6 substrates — no outgoing 2D6 inhibition; safe with TCAs, antipsychotics, tamoxifen
- +1 more
Consider an alternative when
- Adherence is fragile — withdrawal incidence 0.40 pooled with venlafaxine (Henssler 2024); symptoms within 24–48 h of missed dose
- Renal impairment present — 45% renally excreted unchanged; max 50 mg in moderate, every-other-day in severe impairment
- Cardiometabolic risk patient — Pillinger 2025 total cholesterol +0.27 mmol/L (significant); hypercholesterolemia 10% at 400 mg vs 2% placebo
- Sexual dysfunction is treatment priority — FDA-labeled ED dose-response 3→11% across 50–400 mg
- +1 more
| Axis | Desvenlafaxine SNRI |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Emotional blunting | |
Seizure risk | |
| Metabolic | |
Weight loss | |
Metabolic (glucose / lipids) | |
| Autonomic | |
Anticholinergic burden | |
Orthostatic hypotension | |
Sweating | |
Angle-closure glaucoma | |
| Cardiac | |
QTc prolongation | |
Heart rate / tachycardia | |
| GI | |
Nausea / GI (general) | |
| Hepatic | |
Liver enzymes / hepatotoxicity | |
| Electrolytes | |
Hyponatremia / SIADH | |
| Dermatologic | |
Rash (including SJS/TEN, pruritus, hypersensitivity) | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
Serotonin syndrome risk | |
CYP interactions / DDI profile | |
| Safety | |
Bleeding risk | |
Overdose toxicity | |
| Pregnancy | |
Teratogenicity | |
Lactation / breastfeeding safety | |
| Drug-specific / distinctive axes | |
Distinctive labeled axis — Interstitial Lung Disease + Eosinophilic Pneumonia (§5.10) only in Desvenlafaxine | |