A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients

Dierick, M.; Ravizza, L.; Realini, Renzo; Martin, Alain

doi:10.1016/0278-5846(95)00292-8

Cited by 139 publications

(62 citation statements)

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“…In a 6-week study in hospitalised depressed patients with melancholia, venlafaxine (200 mg/day) showed signi®cantly superior ecacy compared to¯uox-etine (40 mg/day) at weeks 4 and 6 (Clerc et al, 1994). In an out-patient population, 75 mg/day venlafaxine was found to have similar ecacy to 20 mg/day¯uoxetine, but in patients where the dose of venlafaxine was increased to 150 mg/day the ecacy was signi®cantly superior to that with uoxetine (Dierick et al, 1996).…”

Section: Snris Compared With Ssrismentioning

confidence: 63%

Specific serotonin and noradrenaline reuptake inhibitors (SNRIs). A review of their pharmacology, clinical efficacy and tolerability

Briley

1998

Hum. Psychopharmacol. Clin. Exp.

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Section: Snris Compared With Ssrismentioning

confidence: 63%

Specific serotonin and noradrenaline reuptake inhibitors (SNRIs). A review of their pharmacology, clinical efficacy and tolerability

Briley

1998

Hum. Psychopharmacol. Clin. Exp.

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“…The ef ficacy and safety results for each of these five studies have been reported previously [Silverstone and Ravindran, 1998;Clerc et al, 1994;Dierick et al, 1996;Rudolph and Feiger, 1999;Rudolph et al, 1998]. An institutional review board approved each study protocol, and each patient signed a written informed consent prior to initiation of each study.…”

Section: Methodsmentioning

confidence: 98%

Achieving remission with venlafaxine and fluoxetine in major depression: its relationship to anxiety symptoms

et al. 2002

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Venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), produces significantly higher remission rates in depressed patients than do the selective serotonin reuptake inhibitors (SSRIs). In this analysis of pooled data, we explored the relationship between differences in treatment efficacy, early improvement of symptoms, and severity of baseline anxiety in depressed patients treated with either venlafaxine or fluoxetine. A pooled analysis was performed on data from 1,454 outpatients with major depression from five double-blind, randomized studies comparing the 6-week efficacy of venlafaxine (542 patients) with fluoxetine (555 patients). The Hamilton rating scale for depression (HAM-D) total and item scores were analyzed at different treatment times up to 6 weeks. Venlafaxine and fluoxetine both produced statistically significant higher response and remission rates compared with placebo starting from week 2 for response and weeks 3 to 4 for remission. Venlafaxine was statistically significantly superior to fluoxetine from week 3 until week 6 in respect of response rate, and from week 2 until week 6 for remission rate. After 1 week of treatment, greater improvement in individual symptoms was observed in the depressed mood, suicide, and psychic anxiety items of the HAM-D scale for both venlafaxine- and fluoxetine-treated patients compared with placebo. Improvement in psychic anxiety was statistically significantly greater with venlafaxine than with fluoxetine. The presence of baseline psychic anxiety correlated significantly to treatment outcome when analyzing the remission rates. In depressed patients with moderate anxiety (HAM-D psychic anxiety score < or = 2), venlafaxine statistically significantly increased remission rates compared with placebo from week 4 until week 6, while a significant effect of fluoxetine on remission rates was observed starting at week 6. Remission rates in the severely anxious depressed patients (score > 2) were statistically significantly higher with venlafaxine than placebo starting from week 3 until the end of the study period, but no difference could be observed between fluoxetine and placebo. Baseline severity of psychic anxiety had a significant impact on remission rates after treatment of patients diagnosed with depression. Venlafaxine's superior remission rates in the more severely anxious patients and its ability to improve psychic anxiety as early as week 1 compared with fluoxetine suggest that venlafaxine's early efficacy on anxiety symptoms may be the basis for its superior efficacy in depression.

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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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A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients

Cited by 139 publications

References 10 publications

Specific serotonin and noradrenaline reuptake inhibitors (SNRIs). A review of their pharmacology, clinical efficacy and tolerability

Specific serotonin and noradrenaline reuptake inhibitors (SNRIs). A review of their pharmacology, clinical efficacy and tolerability

Achieving remission with venlafaxine and fluoxetine in major depression: its relationship to anxiety symptoms

Antidepressants and Incident Hypertension in Primary Care Patients

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