Venlafaxine and paroxetine in treatment-resistant depression. Double-blind, randomised comparison.
BACKGROUND
About one-third of patients fail to respond to initial antidepressant therapy, which suggests a need for more effective drugs.


OBJECTIVE
To compare the efficacy and safety of venlafaxine and paroxetine in 122 patients with non-chronic treatment-resistant depression.


METHODS
In-patients or out-patients satisfying DSM-III-R criteria for major depression in evolution for less than eight months, having a baseline HAM-D score > or = 18 and a HAM-D Item 3 score < 3 were eligible. Patients were required to have a history of resistance to two previous antidepressant treatments and a CGI improvement score of 3 at the beginning of treatment. Doses were adjusted to 200-300 mg/day for venlafaxine and 30-40 mg/day for paroxetine.


RESULTS
For the observed-case analysis, the response rate was 51.9% for venlafaxine and 32.7% for paroxetine (P = 0.044), and a remission was achieved in 42.3% of venlafaxine-treated and 20.0% of paroxetine-treated patients (P = 0.01). The incidence of adverse effects was comparable between treatment groups.


CONCLUSIONS
Venlafaxine showed some evidence of superiority to paroxetine in this difficult-to-treat patient population.
Poirier
M F
MF
SHU-Centre Hospitalier Sainte-Anne, Paris.
Boyer
P
P
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003511:Cyclohexanols / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000627:therapeutic use*; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D000928:Antidepressive Agents; D003511:Cyclohexanols; D017374:Paroxetine; D000069470:Venlafaxine Hydrochloride