Specificity profile of venlafaxine and sertraline in major depression: metaregression of double-blind, randomized clinical trials

Abstract

Despite the well-known efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) in the treatment of major depressive disorder, there is a lack of indications for each drug in different groups of patients. The aim of this study is to investigate the possible role of clinical sociodemographic factors as moderators of clinical response to venlafaxine (SNRI) and sertraline (SSRI). Research was performed on Medline and EMBASE for randomized control trials in English focused on sertraline and venlafaxine in the treatment of major depressive disorder and 59 studies were included. Clinical efficacy of each treatment was assessed on the basis of Hamilton Depressive Rating Scale and Montgomery-Asberg Depression Rating Scale. A metaregression analysis was performed to evaluate the role of clinical and sociodemographic factors as moderators of outcome, calculating the effect of each variable with the random-effects method. Gender, ethnicity and duration of depressive episode could have a role in prediction of clinical response to both antidepressants. Venlafaxine seems to have better effects in females and in Caucasian patients. Sertraline seems to be more efficacious in the treatment of females. Both drugs were more efficacious in patients who suffered a shorter episode of illness. Our results could represent an interesting point of view in the perspective of choosing the most suitable therapy based on clinical and social features for each patient. Metaregression is a retrospective analysis, based on the cumulative results of previous studies, so the lack of original data could represent the main limitation in this report and in the interpretation of the results obtained.

An animal model of female adolescent cannabinoid exposure elicits a long-lasting deficit in presynaptic long-term plasticity

“…Alterations in gamma oscillation have long been thought to be associated with schizophrenic etiology (Chen et al, 2014; Uhlhaas and Singer, 2013). It is noteworthy that developmental NMDAR hypofunction animal models for psychosis have also shown dysregulation in gamma oscillations in the cortex (Anderson et al, 2014; Hunt and Kasicki, 2013) and loss of eCB-LTD, while mGluR2/3-LTD was spared (Lovelace et al, 2014). …”

Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging

“…Apart from neurons and neural stem/ precursor cells, certain other brain cells are particularly sensitive to oxidative stress, such as oligodendrocytes. Szebeni and colleagues, studying the autopsied brains of individuals who had had MDD during their lives, reported decreased TL, decreased TERT expression and decreased antioxidant enzymes in oligodendrocytes in two white matter regions implicated in MDD (Szebeni et al, 2014). …”

Lipid Peroxidation in Psychiatric Illness: Overview of Clinical Evidence

“…Additionally, oxidation also appears to localize to dopamine transporter-positive and tyrosine-hydroxylase neurons in the prefrontal cortex [30]. In depressed or euthymic females patients with bipolar disorder, sleep cycle disruption positively correlates with measures of malondialdehyde levels, a relationship not found in age-matched healthy controls which suggests that lipid peroxidation follows disease course rather than occurring incidentally [31]. Catalase and glutathione peroxidase levels are also elevated in patients with bipolar disorder during depressive episodes [32].…”