Efficacy of venlafaxine in major depression resistant to selective serotonin reuptake inhibitors.
BACKGROUND
Some studies suggest that venlafaxine, due to its pharmacodynamic characteristics, could be an effective drug in depression, resistant to other antidepressive agents. This investigation explores the efficacy and tolerability of venlafaxine in major depression, resistant to a selective serotonin reuptake inhibitor (SSRI).


METHODS
A multicenter naturalistic study was performed during 6 months and included those patients diagnosed of major depression according to the criteria of DSM-IV who had a minimum score of 18 on the Hamilton Depression Rating Scale (HAM-D) and who had not responded to previous treatment with a SSRI at therapeutic doses for a minimum of 4 weeks. The assessment of efficacy was performed with the HAM-D scale, the Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HAM-A) and the Global Clinical Impression (GCI). Tolerability was evaluated by recording the adverse reactions and with the GCI score on overall drug tolerability.


RESULTS
A total of 69 patients, of which 59 were evaluable for efficacy (they had fulfilled at least 4 weeks of treatment), were included. About 81% of all of them obtained a reduction of at least 50% in the HAM-D, 74% were considered as "quite improved" or "very improved" in the GCI and 69% met both criteria. The mean dose of venlafaxine used was 170.4 (S.D.=43.8) mg. Of the 21 patients who did not complete the 6 months of treatment, 3 were due to lack of efficacy, 6 due to adverse effects and 12 for other reasons. About 89.2% of side effects were considered as mild or moderate.


CONCLUSIONS
The results of our study support the efficacy and tolerability of venlafaxine in patients suffering from depression who have not responded to SSRI treatment.
Sáiz-Ruiz
Jerónimo
J
Grupo de Investigación "Ramón y Cajal," Hospital Ramón y Cajal, Servicio de Psiquiatría, Universidad de Alcalá, Ctra. de Colmenar Km 9.1, 28034 Madrid, Spain. jsaiz@hrc.insalud.es
Ibáñez
Angela
A
Díaz-Marsá
Marina
M
Arias
Francisco
F
Padín
Jesús
J
Martín-Carrasco
Manuel
M
Montes
José Manuel
JM
Ferrando
Laura
L
Carrasco
José Luis
JL
Martín-Ballesteros
Eloy
E
Jordá
Lluis
L
Chamorro
Lorenzo
L
D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride