A systematic review of duloxetine and venlafaxine in major depression, including unpublished data

Schueler, YB; Kösters, Markus; Wieseler, Beate; Grouven, Ulrich; Kromp, Mandy; Kerekes, M.F.; Kreis, Julia; Kaiser, Thomas; Becker, Thomas; Weinmann, Stefan

doi:10.1111/j.1600-0447.2010.01599.x

Cited by 75 publications

(49 citation statements)

References 86 publications

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“…Because venlafaxine is a second-line treatment that is prescribed to individuals that do not respond well to first-line treatments like SSRIs (Schueler et al, 2011), it is possible that women treated with venlafaxine have more severe disease or underlying differences in their depression, which might account for the associations we observed. Depression itself has been shown to be associated with a number of adverse pregnancy outcomes, such as spontaneous abortion, fetal death, low birth weight, and preterm birth (Bonari et al, 2004;Grote et al, 2010).…”

Section: Discussionmentioning

confidence: 93%

Association between reported venlafaxine use in early pregnancy and birth defects, national birth defects prevention study, 1997–2007

Polen

Rasmussen

Riehle‐Colarusso

et al. 2012

Birth Defects Research

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BACKGROUND: Few epidemiologic studies have investigated the use of venlafaxine (Effexor XR capsules, Product Monograph, Wyeth, Montreal, Canada), an antidepressant used to treat major depression and anxiety disorders in adults, during pregnancy. Our objective was to determine whether use of venlafaxine during pregnancy is associated with specific birth defects. METHODS: We used data from the National Birth Defects Prevention Study (NBDPS), a population-based, case-control study in the United States. Our analysis included mothers with pregnancies affected by one of 30 selected birth defects (cases) and babies without birth defects (controls) with estimated dates of delivery between 1997 and 2007. Exposure was any reported use of venlafaxine from 1 month preconception through the third month of pregnancy. We calculated adjusted odds ratios (aORs) and 95% Fisher Exact confidence intervals (CIs) for 24 birth defect groups for which at least 400 case mothers were interviewed. Our adjusted analyses controlled for maternal age and race/ethnicity. RESULTS: Among the 27,045 NBDPS participants who met inclusion criteria, 0.17% (14/8002) of control mothers and 0.40% (77/19,043) of case mothers reported any use of venlafaxine from 1 month preconception through the third month of pregnancy. Statistically significant associations were found for anencephaly, atrial septal defect (ASD) secundum, or ASD not otherwise specified, coarctation of the aorta, cleft palate, and gastroschisis. CONCLUSIONS: Our data suggest associations between periconceptional use of venlafaxine and some birth defects. However, sample sizes were small, CIs were wide, and additional studies are needed to confirm these results. Birth Defects Research (Part A) 97: 28-35, 2013. Ó 2012

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Section: Discussionmentioning

confidence: 93%

Association between reported venlafaxine use in early pregnancy and birth defects, national birth defects prevention study, 1997–2007

Polen

Rasmussen

Riehle‐Colarusso

et al. 2012

Birth Defects Research

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“…However, currently the physician prescribing SNRI is driven by an overestimated consideration of the potential benefits and neglect of the potential vulnerabilities to the adverse effects of treatment, such as dependence-and-withdrawal phenomena. This bias has been clearly outlined in 2 reviews on venlafaxine and duloxetine that have taken unpublished data into consideration and that challenge the use of SNRI as first-line treatment of mood and anxiety disorders [79,80]. Our systematic review was based on published findings only and is thus likely to have underestimated the frequency and severity of withdrawal reactions, particularly with regard to the latest SNRI.…”

Section: Discussionmentioning

confidence: 95%

Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

Fava

Benasi

Lucente

et al. 2018

Psychother Psychosom

163

146

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Background: Serotonin-noradrenaline reuptake inhibitors (SNRI) are widely used in medical practice. Their discontinuation has been associated with a wide range of symptoms. The aim of this paper is to identify the occurrence, frequency, and features of withdrawal symptoms after SNRI discontinuation. Methods: PRISMA guidelines were followed to conduct a systematic review. Electronic databases included PubMed, the Cochrane Library, Web of Science, and MEDLINE from the inception of each database to June 2017. Titles, abstracts, and topics were searched using a combination of the following terms: “duloxetine” OR “venlafaxine” OR “desvenlafaxine” OR “milnacipran” OR “levomilnacipran” OR “SNRI” OR “second generation antidepressant” OR “serotonin norepinephrine reuptake inhibitor” AND “discontinuation” OR “withdrawal” OR “rebound.” Only published trials in the English language were included. Results: Sixty-one reports met the criteria for inclusion. There were 22 double-blind randomized controlled trials, 6 studies where patients were treated in an open fashion and then randomized to a double-blind controlled phase, 8 open trials, 1 prospective naturalistic study, 1 retrospective study, and 23 case reports. Withdrawal symptoms occurred after discontinuation of any type of SNRI. The prevalence of withdrawal symptoms varied across reports and appeared to be higher with venlafaxine. Symptoms typically ensued within a few days from discontinuation and lasted a few weeks, also with gradual tapering. Late onset and/or a longer persistence of disturbances occurred as well. Conclusions: Clinicians need to add SNRI to the list of drugs potentially inducing withdrawal symptoms upon discontinuation, together with other types of psychotropic drugs. The results of this study challenge the use of SNRI as first-line treatment for mood and anxiety disorders.

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“…Although the tolerability profiles of SSRIs and SNRIs in patients with anxiety disorders are not established fully, systematic reviews of studies in depressed patients suggest that duloxetine and venlafaxine may be less well tolerated than the SSRIs [I (M)] (Cipriani et al, 2012;Schueler et al, 2011). Both duloxetine and venlafaxine have been associated with discontinuation symptoms after abrupt withdrawal [I(M)] Perahia et al, 2005) in adult patients, data being limited in children and adolescents [IV] (Hosenbocus and Chahal, 2011).…”

Section: Ssris and Snrismentioning

confidence: 99%

Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from the British Association for Psychopharmacology

et al. 2014

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This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees.

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A systematic review of duloxetine and venlafaxine in major depression, including unpublished data

Abstract: Rather than being a first-line option, venlafaxine appears to be a valid alternative in patients who do not tolerate or respond to SSRIs or TCAs. Duloxetine does not seem to be indicated as a first-line treatment.

Cited by 75 publications

References 86 publications

Association between reported venlafaxine use in early pregnancy and birth defects, national birth defects prevention study, 1997–2007

Association between reported venlafaxine use in early pregnancy and birth defects, national birth defects prevention study, 1997–2007

Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from the British Association for Psychopharmacology

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