Venlafaxine extended-release: a review of its
use in the management of major depression
by
Wellington K, Perry CM.
Adis International Limited, Auckland, New Zealand.
CNS Drugs 2001;15(8):643-669

ABSTRACT

Venlafaxine inhibits presynaptic reuptake of serotonin (5-hydroxytryptamine; 5-HT) and noradrenaline (norepinephrine). Venlafaxine extended-release (XR) has been investigated in patients with major depression and in patients with major depression with associated anxiety in randomised, double-blind, multicentre trials. A therapeutic response in patients with major depression was evident at week 2 of treatment with venlafaxine XR 75 to 225 mg/day in a placebo-controlled trial. By week 4, the drug was significantly more effective than placebo at reducing both the Hamilton Rating Scale for Depression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS) total scores. Furthermore, cumulative relapse rates were lower among recipients of venlafaxine XR 75 to 225 mg/day than placebo recipients after 3 and 6 months in another trial. Venlafaxine XR 75 to 150 mg/day was significantly more effective than venlafaxine immediate-release (IR) 75 to 150 mg/day or placebo during a 12-week study. Reductions from baseline in all 4 efficacy parameters (HAM-D, MADRS, HAM-D depressed mood item and the Clinical Global Impression Severity of Illness scale) were significantly higher among patients treated with venlafaxine XR than venlafaxine IR or placebo at week 12 (using an intent-to-treat, last observation carried forward analysis). Venlafaxine XR 75 to 225 mg/day was compared with fluoxetine 20 to 60 mg/day in patients with major depression in 2 randomised, double-blind, placebo-controlled, multicentre studies. Remission rates were significantly in favour of venlafaxine XR recipients in one study: 37, 22 and 18% of patients treated with venlafaxine XR, fluoxetine or placebo, respectively, achieved full remission (HAM-D total score

5-HT1
5-HT2
5-HT3
SSRIs
Serotonin
Dopamine
Duloxetine
Noradrenaline
Venlafaxine (Effexor)
Venlafaxine compared
Venlafaxine v fluoxetine
High-dose venlafaxine XL
Venlafaxine pharmacology
Venlafaxine plus bupropion
Venlafaxine and depression
Venlafaxine: pharmacokinetics etc
Venlafaxine for depressive cocaine users
Venlafaxine (Effexor) v clomipramine for OCD
Venlafaxine for treatment-resistant depression
February 2008: FDA licenses antidepressant desvenlafaxine (Pristiq)

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