A double-blind comparison of venlafaxine and fluoxetine in patients hospitalized for major depression and melancholia

Clerc, G.; Ruimy, P.; Verdeau-Pallès, J

doi:10.1097/00004850-199409000-00001

Cited by 265 publications

(111 citation statements)

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“…In fact, several studies showed no change in BP in patients treated with therapeutic doses of venlafaxine. [25][26][27] Studies of duloxetine showed no or clinically insignificant blood pressure elevations with therapeutic dosing. 28 -30 The literature on TCAs varies and includes findings ranging from elevated BP to orthostatic hypotension.…”

Section: Discussionmentioning

confidence: 99%

Antidepressants and Incident Hypertension in Primary Care Patients

et al. 2018

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Objective: Many ADMs can alter blood pressure (BP), but the research on the effect of antidepressant medication (ADMs) on incident hypertension is mixed. We investigated whether the use of ADMs was associated with the subsequent development of hypertension.Methods: A retrospective cohort study was conducted using electronic medical record data from 6224 patients with primary care visits from 2008 to 2015. Prescription orders were used to identify ADM use, and hypertension was defined by medical record diagnosis. Using package insert warnings, a 3-level ADM exposure variable was created: ADMs that increase BP (ADM BP؉), ADMs that do not increase BP, and no ADM. Unadjusted and adjusted Cox proportional hazard models were computed to estimate the association between the ADM exposure and incident hypertension.Results: Unadjusted results revealed that ADM BP؉ use compared with the no ADM group was significantly associated with incident hypertension (hazard ratio, 1.30; 95% confidence interval, 1.08 -1.57). After adjusting for covariates, ADM BP؉ use was no longer significantly associated with incident hypertension (hazard ratio, 1.20; 95% confidence interval, 0.97-1.49).Conclusions Primary care physicians manage hypertension and antidepressant medications (ADMs) almost every day. The age-adjusted prevalence of hypertension is 29.6% among the adult population in the United States. Of those with hypertension, only 48% achieve control of their blood pressure. Hypertension is directly related to both heart disease and stroke, which are counted as the first and fourth leading causes of death in the United States, respectively.1 Given the serious outcomes associated with hypertension, physicians must be mindful of iatrogenic causes of hypertension, which can include frequently prescribed medications. Recent data suggest that 10% to 11% of Americans age 6 years and older are treated with ADMs in a given year.2,3 Some concern has been expressed as to the safety of ADMs with regard to hypertension, especially when considering certain classes of ADMs. In a cohort of depressed participants with low rates of hypertension at baseline, treatment with ADMs was associated with an increased risk of developing hypertension. 4 The same study showed a stronger link between tricyclic antidepressants (TCAs) and hypertension than between selective serotonin reuptake inhibitors and hypertension. However, that study did not contrast ADMs known to increase blood pressure (BP) against those that do not, and the association of individual ADMs and incident hypertension was not studied. 5 A separate study showed an association between serotonin norepinephrine reuptake inhibitors (SNRIs), espeThis article was externally peer reviewed.

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Section: Discussionmentioning

confidence: 99%

Antidepressants and Incident Hypertension in Primary Care Patients

et al. 2018

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“…Comparative studies against amitriptyline (Gentil et al, 2000) report no difference in efficacy in treating depressive symptoms, whereas comparisons with imipramine (Shrivastava et al, 1994) and fluoxetine (Clerc et al, 1994) have suggested venlafaxine to be significantly superior in certain populations. Dierick et al (1996) reported venlafaxine at 75 mg daily to be comparable to fluoxetine, but at 150 mg daily it was shown to be superior to fluoxetine in treating out-patients with major depression.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the relationship of high-dose venlafaxine prescribing to treatment-resistant depression

Thomas

Taylor

2003

Psychiatr. bull.

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Aims and Method Prescribing of venlafaxine in The South London and Maudsley NHS Trust was found to account for over 50% of the antidepressant costs, but only 15% of the prescriptions. There is evidence to suggest that higher doses of venlafaxine may be effective in treating treatment-refractory depression. We aimed to discover if higher doses of venlafaxine used in the trust were related to prior failure to respond to antidepressant treatment. Hospital in-patients being treated with venlafaxine during a 1-week period in October 2001 were identified and case notes were reviewed to determine patient demographic data and prior history of antidepressant therapy. Results There were 38 patients identified as being prescribed venlafaxine (18 of whom had a primary diagnosis of depression). Twenty-five were classed as non-treatment-resistant and 13 were classed as treatment-resistant. Doses of venlafaxine were statistically significantly higher in patients considered treatment-resistant (245 mg v. 180 mg daily, P=0.03). All other recorded patient characteristics were similar. Clinical Implications Higher doses of venlafaxine were prescribed to patients who were retrospectively defined as treatment-refractory. Further studies should address the reasons for this prescribing practice.

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“…Some of the newest antidepressants, however, challenge the notion Some evidence indeed suggests that this is so, [5][6][7][8][9] although not everyone agrees.…”

Section: Take-home Pointsmentioning

confidence: 99%

“…1 One study suggests enhanced efficacy or more rapid onset of action for venlafaxine compared with an SSRI. 7 Similarly, the dual (5-HT/NE)-action agent mirtazapine may also have enhanced efficacy over an SSRI. 8 Although more research is clearly needed for all dual-acting drugs, it would not be surprising if these observations eventually hold up in more rigorously designed studies, because experienced clinicians have often combined antidepressants with independent therapeutic actions to effect a therapeutic response when single agents fail.…”

Section: Brainstorms Is a Monthly Section Ofmentioning

confidence: 99%

Are Two Antidepressant Mechanisms Better Than One?

Stahl¹

1997

J. Clin. Psychiatry

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A double-blind comparison of venlafaxine and fluoxetine in patients hospitalized for major depression and melancholia

Cited by 265 publications

References 0 publications

Antidepressants and Incident Hypertension in Primary Care Patients

Antidepressants and Incident Hypertension in Primary Care Patients

Evaluating the relationship of high-dose venlafaxine prescribing to treatment-resistant depression

Are Two Antidepressant Mechanisms Better Than One?

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