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Titolo:
Venlafaxine extended-release - A review of its use in the management of major depression
Autore:
Wellington, K; Perry, CM;
Indirizzi:
Adis Int Ltd, Auckland 10, New Zealand Adis Int Ltd Auckland New Zealand10 s Int Ltd, Auckland 10, New Zealand
Titolo Testata:
CNS DRUGS
fascicolo: 8, volume: 15, anno: 2001,
pagine: 643 - 669
SICI:
1172-7047(2001)15:8<643:VE-ARO>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
ORALLY-ADMINISTERED VENLAFAXINE; SEROTONIN REUPTAKE INHIBITORS; POTENTIAL-DRUG INTERACTION; HEALTHY ADULT VOLUNTEERS; HUMAN LIVER-MICROSOMES; TRICYCLIC ANTIDEPRESSANTS; WITHDRAWAL REACTIONS; PRIMARY-CARE; IN-VITRO; PHARMACODYNAMIC EVALUATION;
Keywords:
Venlafaxine XR; major depressive disorder; depression; pharmacodynamics; pharmacokinetics; therapeutic use;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
125
Recensione:
Indirizzi per estratti:
Indirizzo: Wellington, K Adis Int Ltd, 41 Centorian Dr,Private Bag 65901,Mairangi Bay, Auckland 10,New Zealand Adis Int Ltd 41 Centorian Dr,Private Bag 65901,Mairangi Bay Auckland New Zealand 10
Citazione:
K. Wellington e C.M. Perry, "Venlafaxine extended-release - A review of its use in the management of major depression", CNS DRUGS, 15(8), 2001, pp. 643-669

Abstract

Venlafaxine inhibits presynaptic reuptake of serotonin (5-hydroxytryptamine; 5-HT) and noradrenaline (norepinephrine). Venlafaxine extended-release (XR) has been investigated in patients with major depression and in patientswith major depression with associated anxiety in randomised, double-blind,multicentre trials. A therapeutic response in patients with major depression was evident at week 2 of treatment with venlafaxine XR 75 to 225 mg/day in a placebo-controlled trial. By week 4, the drug was significantly more effective than placebo at reducing both the Hamilton Rating Scale for Depression (HAM-D) and Montgomery-Asberg; Depression Rating Scale (MADRS) total scores. Furthermore. cumulative relapse rates were lower among recipients ofvenlafaxine XR 75 to 225 mg/day than placebo recipients after 3 and 6 months in another trial. Venlafaxine XR 75 to 150 mg/day was significantly moreeffective than venlafaxine immediate-release (IR) 75 to 150 mg/day or placebo during a 12-week study. Reductions from baseline in all 4 efficacy parameters (HAM-D. MADRS, HAM-D depressed mood item and the Clinical Global Impression Severity of Illness scale) were significantly higher among patientstreated with venlafaxine XR than venlafaxine IR or placebo at week 12 (using an intent-to-treat. last observation carried forward analysis). Venlafaxine XR 75 to 225 mg/day was compared with fluoxetine 20 to 60 mg/day in patients with major depression in 2 randomised. double-blind, placebo-controlled, multicentre studies. Remission rates were significantly in favour of venlafaxine XR recipients in one study: 37, 22 and 18% of patients treated with venlafaxine XR. fluoxetine or placebo, respectively, achieved full remission (HAM-D total score less than or equal to 7 at end-point). In the other trial. venlafaxine XR and fluoxetine had comparable efficacy in reducing HAM-D and Hamilton Rating Scale for Anxiety (HAM-A) total scores compared with placebo. However, the HAM-A response rate was significantly higher with venlafaxine XR than with fluoxetine at week 12. In a comparative study involving paroxetine, reductions from baseline in HAM-D and MADRS total scores in patients given venlafaxine XR 75 mg/day or paroxetine 20 mg/day for 12 weeks were significant, but no significant differences between treatment groups were evident. Discontinuation rates because of unsatisfactory clinical response were similar among patients treated with venlafaxine XR, fluoxetine or paroxetine. Adverse events pertaining to the digestive (nausea. dry mouth), nervous (dizziness, somnolence, insomnia) and urogenital (abnormal ejaculation) systems as well as sweating were the most frequently reported adverse events during 8 to 12 weeks of treatment in 3 randomised, double-blind, multicentre trials. Comparative studies with fluoxetine and paroxetine demonstrated a similar adverse event profile to venlafaxine XR. Conclusion: Venlafaxine XR has shown efficacy in the treatment of major depression and was at least as effective as fluoxetine or paroxetine and moreeffective than venlafaxine IR. Furthermore, it is effective at reducing symptoms of anxiety in depressed patients. The incidence of adverse events inrecipients of venlafaxine XR is similar to that in patients receiving treatment with well established selective serotonin reuptake inhibitors. As an effective and well tolerated antidepressant, venlafaxine XR should be considered as a first-line pharmacological treatment in patients with major depression.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 09:32:10