Two medicines, side by side
Desvenlafaxine vs paroxetine
Desvenlafaxine and paroxetine are both labeled for depression. Drugs@FDA records approvals of desvenlafaxine since 2008 and of paroxetine since 1992. Pharmacies paid $0.396 per unit (Desvenlafaxine succnt ER 50 mg) and $0.0611 per paroxetine HCl 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, desvenlafaxine is a serotonin and norepinephrine reuptake inhibitor and paroxetine a serotonin reuptake inhibitor.
Check it at the source: the desvenlafaxine FDA label on DailyMed (effective January 27, 2023); the paroxetine FDA label on DailyMed (effective February 12, 2026).
Highlights of the desvenlafaxine record
Desvenlafaxine (Pristiq) · label of January 27, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older [see Warnings and Precautions (5.1)].
Used for
From the label: indicationsDesvenlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is indicated for the treatment of major depressive disorder (MDD) [see Clinical Studies (14) and Dosage and Administration (2.1)]. The efficacy of desvenlafaxine has been established in four short-term (8-week, placebo-controlled studies) of outpatients who met DSM-IV criteria for major depressive disorder. […]
On the market
- Earliest approval on file
- February 29, 2008
- Generic labelers
- 20 labelers
- Pharmacy cost
- $0.396 per unit
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Highlights of the paroxetine record
Paroxetine (Paxil) · label of February 12, 2026
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1) ]. Paroxetine tablets are not approved for use in pediatric patients [see Use in Specific Populations (8.4) ].
Used for
From the label: indicationsParoxetine tablets are indicated in adults for the treatment of: • Major depressive disorder (MDD) • Obsessive compulsive disorder (OCD) • Panic disorder (PD) • Social anxiety disorder (SAD) • Generalized anxiety disorder (GAD) • Posttraumatic stress disorder (PTSD) Paroxetine tablets are a selective serotonin reuptake inhibitor (SSRI) indicated in adults for the treatment of ( 1 ): • Major Depressive Disorder (MDD) • Obsessive Compulsive Disorder (OCD) • Panic Disorder (PD) • Social Anxiety Disorder (SAD) • Generalized Anxiety Disorder (GAD) • Posttraumatic Stress Disorder (PTSD) […]
On the market
- Earliest approval on file
- December 29, 1992
- Generic labelers
- 45 labelers
- Pharmacy cost
- $0.0611 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 15
Source: FDA drug labels via openFDA (Desvenlafaxine label of January 27, 2023, Paroxetine label of February 12, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do desvenlafaxine and paroxetine differ on the record?
In FDA's classes, desvenlafaxine is a serotonin and norepinephrine reuptake inhibitor and paroxetine a serotonin reuptake inhibitor.
How each works, in its label's words: Desvenlafaxine, “The exact mechanism of the antidepressant action of desvenlafaxine is unknown, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous system, through …”; Paroxetine, “The mechanism of action of paroxetine tablets in the treatment of MDD, SAD, OCD, PD, GAD, and PTSD is unknown, but is presumed to be linked to potentiation of serotonergic activity in the central …”
Half-life, in each label's words: Desvenlafaxine, “The mean terminal half-life (t 1/2 ) was prolonged from 11.1 hours in the control subjects to approximately 13.5, 15.5 …”; Paroxetine, “Elimination Metabolism The mean elimination half-life is approximately 21 hours (CV 32%) after oral dosing of 30 mg …”
Both labels carry a boxed warning; the records quote them.
Generics: desvenlafaxine since 2015; paroxetine since 2003 (Drugs@FDA).
| Desvenlafaxine | Paroxetine | |
|---|---|---|
| Labeled for | Depression | Depression, Anxiety, Menopause symptoms |
| Pharmacologic class | Serotonin and Norepinephrine Reuptake Inhibitor | Serotonin Reuptake Inhibitor |
| How it works (label) | The exact mechanism of the antidepressant action of desvenlafaxine is unknown, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous system, through inhibition of their reuptake. | The mechanism of action of paroxetine tablets in the treatment of MDD, SAD, OCD, PD, GAD, and PTSD is unknown, but is presumed to be linked to potentiation of serotonergic activity in the central nervous system resulting from inhibition of … |
| Half-life (label) | The mean terminal half-life (t 1/2 ) was prolonged from 11.1 hours in the control subjects to approximately 13.5, 15.5, 17.6, and 22.8 hours in mild, moderate, severe renal impairment and ESRD subjects, respectively. | Elimination Metabolism The mean elimination half-life is approximately 21 hours (CV 32%) after oral dosing of 30 mg tablets daily for 30 days of paroxetine tablets. |
| Earliest approval on file (Drugs@FDA) | February 29, 2008 | December 29, 1992 |
| First generic approved | June 29, 2015 | July 30, 2003 |
| Generic labelers (NDC) | 20 labelers | 45 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.396 per unit (Desvenlafaxine succnt ER 50 mg) | $0.0611 per tablet (Paroxetine HCl 20 mg tablet) |
| 12-month price change | -6% | -16% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 15 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 26,842 | 41,809 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Desvenlafaxine label, warnings and precautionsSerotonin syndrome has been reported with SSRIs and SNRIs, including with desvenlafaxine extended-release tablets, both when taken alone, but especially when co-administered with other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John's Wort).
Paroxetine label, warnings and precautionsIncreased risk when co-administered with other serotonergic agents, but also when taken alone.
Source: FDA drug labels via openFDA
What next?
- Alternatives to desvenlafaxine
- every medicine labeled for the same conditions