Desvenlafaxine is the active metabolite of venlafaxine, but unlike the parent compound, the hepatic metabolism of desvenlafaxine largely bypasses the hepatic Cytochrome P450 (CYP450) system. The pharmacokinetic profile and pivotal clinical trials of desvenlafaxine in the treatment of major depression will be reviewed, and the adverse event profile will be examined. The relevance of this data to clinical practice will then be explored.