Pristiq Overdosage

There is limited clinical experience with desvenlafaxine succinate overdosage in humans.
Among the patients included in the major depressive disorder clinical trials of desvenlafaxine succinate, there were four adults who ingested doses greater than 800 mg of desvenlafaxine succinate (4,000 mg [desvenlafaxine alone], 900, 1,800 and 5,200 mg [in combination with other drugs]); all patients recovered. In addition, one patient's 11-month-old child accidentally ingested 600 mg of desvenlafaxine succinate, was treated, and recovered.
No specific antidotes for desvenlafaxine are known. Induction of emesis is not recommended. Because of the moderate volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit.
Treatment should consist of those general measures employed in the management of overdosage with any SSRI/SNRI. Ensure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. General supportive and symptomatic measures are also recommended. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion or in symptomatic patients. Activated charcoal should be administered.