Achieving remission from depression with venlafaxine and venlafaxine extended release: a literature review of comparative studies with selective serotonin reuptake inhibitors

Abstract

Objective: To evaluate data supporting the ability of venlafaxine, an antidepressant with a dual mechanism of action, to produce remission from depression. Method: Review of multicentre, double‐blind, randomized studies comparing venlafaxine or venlafaxine extended release (XR) with a selective serotonin reuptake inhibitor (SSRI), using Hamilton Depression Rating Scale total scores in the range of ≤7 and <10 as the final outcome measure, to evaluate the ability of venlafaxine/venlafaxine XR to produce full remission from depression. Results: Venlafaxine/venlafaxine XR demonstrated higher rates of remission than did the SSRIs and placebo. Conclusion: With full remission rather than response as the measure of outcome, venlafaxine/venlafaxine XR demonstrated more robust antidepressant efficacy than the SSRIs and placebo. This finding suggests that venlafaxine/venlafaxine XR are appropriate standard‐of‐care therapies for the treatment of patients with major depressive disorder.

Venlafaxine extended release versus conventional antidepressants in the remission of depressive disorders after previous antidepressant failure: ARGOS study

“…We have found remission rates significantly higher at 24 weeks in the group of patients treated with venlafaxine extended release than in the combined group of patients treated with conventional antidepressants (59.3% versus 51.5%, respectively). Although it could be argued that the large number of patients included in this trial could overestimate treatment-related clinical differences, the significantly higher rates of remission observed at 24 weeks in this study with venlafaxine extended release compared with conventional treatments, mainly SSRIs, is consistent with results of three recent meta-analysis [Nemeroff et al, 2003;Rudolph, 2002;Thase et al, 2001]. The data obtained from these analyses of double-blinded clinical trials comparing venlafaxine (IR or XR) and selected SSRIs show remission rates significantly higher with venlafaxine.…”

“…The efficacy of venlafaxine immediate (IR) or extended release (XR), as measured by remission rate, has been compared in several earlier meta-analyses with the selective serotonin reuptake inhibitors (SSRIs) fluoxetine, sertraline, paroxetine, citalopram, and fluvoxamine [Nemeroff et al, 2003;Rudolph, 2002;Thase et al, 2001]. These meta-analyses show that venlafaxine may be associated with significantly higher remission rates than those of the studied SSRIs.…”

Efficacy and tolerability of venlafaxine in geriatric outpatients with major depression: a double‐blind, randomised 6‐month comparative trial with citalopram

“…Remission, defined as a score of 7 or less on the Hamilton Rating Scale for Depression (HAM-D), was observed regardless of age and gender among 40-55% of patients during venlafaxine and among 31-37% of patients during SSRI ( p < 0.05, between group comparison) . Similar results were obtained in another study showing 45% remission during venlafaxine treatment , and studies have consistently shown a higher remission rate for venlafaxine than for SSRIs with the use of HAM-D (Rudolph, 2002;Nemeroff et al, 2003). Possible explanations for the lower rate observed in our study may be that the patients received fixed dosages and doses were not raised for patients who did not enter remission, and the upper dose limit of 150 mg/day.…”

Re-evaluation of the efficacy and tolerability of venlafaxine vs SSRI: meta-analysis

“…Despite the considerable number of clinical trials, evidence of differential efficacy is sparse. The selective serotonin and noradrenalin re-uptake inhibitor (SNRI) venlafaxine has been claimed to be more effective than selective serotonin re-uptake inhibitors (SSRIs) particularly with respect to remission rates (Rudolph 2002;Shelton et al 2005;Smith et al 2002;Thase et al 2001). The proposed mechanism for the differences in efficacy is the dual action of venlafaxine, suggesting an additive benefit of re-uptake inhibition of serotonin and noradrenalin.…”