Venlafaxine in the treatment of dysthymia: an open-label study.
BACKGROUND
Numerous studies have demonstrated the effectiveness of antidepressant medications in the treatment of dysthymia, or chronic mild depression. Venlafaxine blocks reuptake of both serotonin and norepinephrine and may produce a more complete antidepressant response than do single-mechanism selective serotonin reuptake inhibitors. The purpose of this open-label study was to provide preliminary data on the tolerability and effectiveness of venlafaxine for patients with dysthymia.


METHODS
Twenty-two dysthymic subjects (DSM-III-R criteria) were enrolled in this 10-week, open-label trial, and 5 dropped out prior to their second visit. Seventeen subjects (77.3%) received more than 1 week of medication.


RESULTS
Of these 17 subjects, 13 (76.5%) were treatment responders. Results of paired sample t tests were highly significant, indicating that, on average, there was significant improvement on all measures of symptomatology and functioning, with mean +/- SD scores on the Hamilton Rating Scale for Depression decreasing from 20.95 +/- 6.50 at baseline to 6.06 +/- 5.49 at week 10. The mean +/- SD final dose was 178.68 +/- 70.80 mg/day. Side effects were reported by 17 (85%) of the 20 subjects for whom tolerability was assessed (the most common were fatigue, dry mouth, and nausea); 5 (22.7%) of 22 patients discontinued treatment because of side effects, primarily nausea (N = 3).


CONCLUSIONS
These findings suggest the benefit of venlafaxine in the treatment of chronic depression and the need for more rigorous studies.
Hellerstein
D J
DJ
Department of Psychiatry, Beth Israel Medical Center, New York, NY, USA. DHellerstein@BethIsraelNY.org
Batchelder
S T
ST
Little
S A
SA
Fedak
M J
MJ
Kreditor
D
D
Rosenthal
J
J
D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003511:Cyclohexanols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D019263:Dysthymic Disorder / Q000188:drug therapy* / Q000523:psychology; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010352:Patient Dropouts; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride; D014987:Xerostomia / Q000139:chemically induced
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride