Document Detail

Treatment with venlafaxine extended release after SSRI nonresponse or intolerance: a randomized comparison of standard- and higher-dosing strategies.
MedLine Citation:
PMID:  16702889     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Evaluate efficacy of standard and higher doses of venlafaxine extended release (ER) in depressed outpatients who had either not responded to or could not tolerate an adequate trial of therapy with a selective serotonin reuptake inhibitor (SSRI). METHODS: Outpatients (n = 232) with major depressive disorder were randomly assigned to 8 weeks of treatment with either "standard" (n = 119; mean dose = 148 mg/d) or "higher" (n = 113; mean dose = 309 mg/d) dosage therapies. Between weeks 8 and 12, nonresponders in the standard dose group could receive higher dose therapy. RESULTS: Response rates in the higher dose group were significantly greater at week 8 on the Clinical Global Impressions-Improvement scale (68% vs 52%; P < 0.001) and Patient Global Impressions scale (intent-to- treat; 68% vs 52%; P < 0.001). The dosing strategies did not, however, differ significantly in change in HAM-D21 total score or HAM-D21 response or remission rates. At week 12, there were no significant efficacy differences between the two groups in the intent-to-treat sample. Five side effects (constipation, sweating, hypertension, agitation, and urinary frequency) were more common in the high-dose group. CONCLUSIONS: Higher dose therapy with venlafaxine ER (ie, 300-375 mg/d) resulted in a more rapid response on some measures, but was not as well tolerated as therapy at standard doses. Although these data provide further evidence of a dose-response relationship for venlafaxine therapy results suggest that slower titration to higher doses of venlafaxine ER may improve tolerability without greatly diminishing the probability of success.
Michael E Thase; Richard C Shelton; Arifulla Khan
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical psychopharmacology     Volume:  26     ISSN:  0271-0749     ISO Abbreviation:  J Clin Psychopharmacol     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-16     Completed Date:  2006-08-10     Revised Date:  2007-02-12    
Medline Journal Info:
Nlm Unique ID:  8109496     Medline TA:  J Clin Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  250-8     Citation Subset:  IM    
University of Pittsburgh Medical Center, Department of Psychiatry, Pittsburgh, PA 15213-2593, USA.
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MeSH Terms
Antidepressive Agents, Second-Generation / administration & dosage,  adverse effects,  therapeutic use*
Cyclohexanols / administration & dosage,  adverse effects,  therapeutic use*
Delayed-Action Preparations
Depressive Disorder, Major / drug therapy*,  psychology
Dose-Response Relationship, Drug
Drug Resistance
Middle Aged
Psychiatric Status Rating Scales
Serotonin Uptake Inhibitors / adverse effects,  therapeutic use
Treatment Failure
Treatment Outcome
Reg. No./Substance:
0/Antidepressive Agents, Second-Generation; 0/Cyclohexanols; 0/Delayed-Action Preparations; 0/Serotonin Uptake Inhibitors; 93413-69-5/venlafaxine
Comment In:
Evid Based Ment Health. 2007 Feb;10(1):17   [PMID:  17255386 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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