Venlafaxine and paroxetine in treatment-resistant depression
- 1 July 1999
- journal article
- Published by Royal College of Psychiatrists in The British Journal of Psychiatry
- Vol. 175 (1), 12-16
- https://doi.org/10.1192/bjp.175.1.12
Abstract
Background: About one-third of patients fail to respond to initial antidepressant therapy, which suggests a need for more effective drugs.Aims: To compare the efficacy and safety of venlafaxine and paroxetine in 122 patients with non-chronic treatment-resistant depression.Method: In-patients or out-patients satisfying DSM – III – R criteria for major depression in evolution for less than eight months, having a baseline HAM–D score 18 and a HAM – D Item 3 score < 3 were eligible. Patients were required to have a history of resistance to two previous antidepressant treatments and a CGI improvement score of 3 at the beginning of treatment. Doses were adjusted to 200–300 mg/day for venlafaxine and 30–40 mg/day for paroxetine.Results: For the observed-case analysis, the response rate was 51.9% for venlafaxine and 32.7% for paroxetine (P=0.044), and a remission was achieved in 42.3% of venlafaxine-treated and 20.0% of paroxetine-treated patients (P=0.01). The incidence of adverse effects was comparable between treatment groups.Conclusions: Venlafaxine showed some evidence of superiority to paroxetine in this difficult-to-treat patient population.Keywords
This publication has 13 references indexed in Scilit:
- Venlafaxine in Treatment-Resistant Major Depression: A Canadian Multicenter, Open-Label TrialJournal of Clinical Psychopharmacology, 1999
- Efficacy of venlafaxine in depressive illness in general practice.Acta Psychiatrica Scandinavica, 1997
- Dose escalation vs. continued doses of paroxetine and maprotiline: a prospective study in depressed out-patients with inadequate treatment response.Acta Psychiatrica Scandinavica, 1997
- A randomized, double-blind comparison of a rapidly escalating dose of venlafaxine and imipramine in inpatients with major depression and melancholiaJournal of Psychiatric Research, 1996
- Treatment approaches to therapy-resistant depressionJournal of Psychopharmacology, 1995
- Safety and tolerance profile of venlafaxineInternational Clinical Psychopharmacology, 1995
- A double-blind comparison of venlafaxine and fluoxetine in patients hospitalized for major depression and melancholiaInternational Clinical Psychopharmacology, 1994
- The efficacy of selective serotonin re-uptake inhibitors in depression: a meta-analysis of studies against tricyclic antidepressantsJournal of Psychopharmacology, 1994
- Paroxetine: A selective serotonin reuptake inhibitor showing better tolerance, but weaker antidepressant effect than clomipramine in a controlled multicenter studyJournal of Affective Disorders, 1990
- Clinical efficacy of paroxetine in resistant depressionJournal of Psychopharmacology, 1987