Efficacy and Safety of Desvenlafaxine for the Treatment of Persistent Idiopathic Dentoalveolar Pain: A Retrospective Observational Study.

BACKGROUND

Previous studies on serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine have demonstrated efficacy in treating persistent idiopathic dentoalveolar pain (PIDP). However, a third-generation SNRI with favorable tolerability remains understudied in treating PIDP. The study aims to investigate the role of desvenlafaxine in improving PIDP.

METHODS

Clinical data for patients diagnosed with PIDP who received desvenlafaxine treatment (50-150 mg per day) from March 2024 to January 2025 were retrospectively reviewed at our hospital. Through systematic review of electronic medical records, we extracted demographic and baseline pain characteristics, along with the effectiveness and safety of desvenlafaxine during a 3-month follow-up assessed by the Numeric Rating Scale-11 (NRS-11) scores for pain and adverse effects. Binary logistic regression was used to identify predictors of response.

RESULTS

Among 103 patients, pain relief was achieved in 90 patients (87.4%), as evidenced by a ≥ 50% reduction in NRS-11 scores (p < 0.001), while the remaining 13 patients (12.6%) discontinued medications due to insufficient therapeutic efficacy. Binary logistic regression analysis identified shorter pain duration as an independent predictor of a favorable response to desvenlafaxine, with an odds ratio of 1.037 (95% CI = 1.016-1.058, p < 0.001). Adverse events were reported in 15 patients (14.6%), all mild and transient.

CONCLUSIONS

The administration of desvenlafaxine serves as an effective and safe therapeutic approach for patients with PIDP. Patients with a short history of PIDP are more likely to benefit from desvenlafaxine treatment.