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Venlafaxine Beats Selective Serotonin Reuptake Inhibitors in Remission of Depression: Presented at APA

By Bruce Sylvester

SAN FRANCISCO, CA -- May 22, 2003 -- Patients with major depressive disorder are more likely to have remission of symptoms with venlafaxine than with fluoxetine and, perhaps, with other selective serotonin reuptake inhibitors (SSRIs) as well.

Michael Thase, MD, a professor of psychiatry at University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, United States, reported the findings here May 20^th at the 2003 Annual Meeting of the American Psychiatric Association.

"The results of this largest-of-all comparative study of venlafaxine and other agents support the conclusions of other investigators that, compared with other SSRIs, venlafaxine helps patients achieve remission of symptoms at relatively higher rates," Dr. Thase said.

The investigators assessed patient records for remission-level scores of 7 or less on the Hamilton 17-item depression inventory (HAM-D17), based on a pooled analysis of data from 33 randomized, double-blind, comparative studies.

A total of 7,463 subjects diagnosed with major depressive disorder participated in the studies. Venlafaxine/venlafaxine XR patients accounted for 3,300 subjects and SSRIs accounted for 3,236 subjects (1,673 fluoxetine, 680 paroxetine, 652 sertraline, 197 citalopram, and 34 fluvoxamine). There were 927 placebo subjects.

Each of the 33 studies lasted 8 weeks.

Venlafaxine achieved remission by end point at a rate of 41%, SSRIs at a rate of 35%; and placebo at a rate of 24%.

Comparative outcomes were statistically significant for remission and for all 7 alternate measures of antidepressant efficacy (P<0.001).

Individual comparisons of venlafaxine to other agents showed greater remission rates for venlafaxine than for fluoxetine (42% vs 34%; P<0.001), paroxetine (44% vs 39%; P<0.001), and the other SSRIs (37% vs 32%; P<0.001).

The odds ratio favoring venlafaxine over SSRIs for remission was 1.309 (95% CI = 1.181-1.451). Individual odds ratios were 1.413 (95% CI = 1.221-1.635) for venlafaxine compared with fluoxetine, 1.203 (95% CI = 0.970-1.492) for venlafaxine compared with paroxetine, and 1.164 (95% CI = 0.925-1.464) for venlafaxine compared with sertraline.

'These are powerful results from a solid set of combined data," noted Dr. Thase.

This research was supported by Wyeth Research, of West Point, Pennsylvania.


[Study title: Venlafaxine and SSRIs: Pooled Remission Analysis. Abstract 263]

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