Desvenlafaxine As the Main Possible Culprit in Triggering Reversible Cerebral Vasoconstriction Syndrome: A Case Report

Reversible cerebral vasoconstriction syndrome (RCVS) is not an uncommon condition. It should be suspected in young patients with new onset headaches and neurologic deficits. We report a 38-year-old male patient with a history of depression on desvenlafaxine for two years and no other triggering factor who was diagnosed with RCVS confirmed by cerebral angiogram. Discontinuation of the medication and calcium channel blockers initiation led to rapid clinical improvement. The diagnosis was further confirmed by angiographic improvement two months later. Although the association of selective serotonin reuptake inhibitors (SSRI)/ serotonin norepinephrine reuptake inhibitors (SNRI) with RCVS has been reported frequently, desvenlafaxine is a much less reported trigger, with only nine cases in total. In contrast to prior reported cases where the time from exposure to onset of RCVS was weeks to months, the time interval, in this case, was two years. This case report aims to support previous literature in suggestion of this association.