Posted by SLS on March 25, 2005, at 8:05:34
In reply to Re: Effexor » SLS, posted by gromit on March 25, 2005, at 3:59:08
The results of the following meta-analysis reflect the experiences of the clinicians I have seen since 1992 when venlafaxine (Effexor) was still investigational. Harvard has been working with this drug for over 20 years.
I am not advocating that you choose to try Effexor right now. There is much to consider. However, if you get "stuck", you might reach the point at which the higher probability treatments would be using one of the older MAOIs or Effexor or Effexor + Remeron.
I am not a salesman for Effexor.
:-)
- ScottFrom Medline:
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Br J Psychiatry. 2001 Mar;178:234-41. Related Articles, Links
Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors.Thase ME, Entsuah AR, Rudolph RL.
University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213-2593, USA.
BACKGROUND: It had been suggested that the antidepressant venlafaxine, which inhibits reuptake of both serotonin and (at higher doses) noradrenaline, may result in better outcomes than treatment with selective serotonin reuptake inhibitors (SSRIs). AIMS: To compare remission rates during treatment with SSRIs or venlafaxine. METHOD: Data from eight comparable randomised, double-blind studies of major depressive disorder were pooled to compare remission rates (Hamilton Rating Scale for Depression score < or = 7) during treatment with venlafaxine (n = 851), SSRIs (fluoxetine, paroxetine, fluvoxamine; n = 748) or placebo (four studies; n = 446). RESULTS: Remission rates were: venlafaxine, 45% (382/851); SSRIs, 35% (260/748); placebo, 25% (110/446) (P: < 0.001; odds ratio for remission is 1.50 (1.3-1.9), favouring venlafaxine v. SSRIs). The difference between venlafaxine and the SSRIs was significant at week 2, whereas the difference between SSRIs and placebo reached significance at week 4. Results were not dependent on any one study or the definition of remission. CONCLUSIONS: Remission rates were significantly higher with venlafaxine than with an SSRI.
Publication Types:
Meta-AnalysisPMID: 11230034 [PubMed - indexed for MEDLINE]
J Clin Psychiatry. 1999;60 Suppl 22:7-11. Related Articles, Links
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Evolution of remission as the new standard in the treatment of depression.Nierenberg AA, Wright EC.
Depression Clinical and Research Program, Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston 02114, USA.
Epidemiologic and clinical data support the goal of treating depressed patients to wellness or full remission. Many patients improve but fail to achieve full remission with antidepressant treatment and continue to have residual symptoms, which cause distress and dysfunction. These residual symptoms may meet criteria for subsyndromal and minor depression. Patients who have these milder syndromes after treatment have a greater risk of relapse and recurrence than do those who remain symptom-free. Clinical trials of antidepressants have shown lower rates of remission than of responses that fall short of remission, although some dual-acting antidepressants (e.g., serotonin-norepinephrine reuptake inhibitors) may have higher remission rates than other agents. Treatment with such robust dual-acting antidepressants may result in higher rates of remission and fewer residual symptoms than treatment with selective serotonin reuptake inhibitors.
Publication Types:
Review
Review, TutorialPMID: 10634349 [PubMed - indexed for MEDLINE]
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