EFFECTIVENESS OF VENLAFAXINE IN PATIENTS HOSPITALIZED FOR MAJOR DEPRESSION AND MELANCHOLIA

Background: This study was undertaken to compare the antidepressant ef ficacy and shortterm safety of venlafaxine with those of placebo in ho spitalized patients with major depression and melancholia. Method: Nin ety-three inpatients with a minimum prestudy Montgomery-Asberg Depress ion Rating Scale (MADRS) score of 25 were treated for up to 4 weeks wi th either venlafaxine or placebo. Dosage averaged approximately 350 mg /day during Weeks 2 to 4. Efficacy and safety were assessed throughout the study. Efficacy was evaluated using the MADRS, the 21-item Hamilt on Rating Scale for Depression (HAM-D), and the Clinical Global Impres sions (CGI) scale. Recorded study events, vital signs and body weight measurements, laboratory determinations, physical examinations, and EC G recordings were used to assess safety. Results: Venlafaxine provided significantly greater improvement in the MADRS scores after 4 days an d in the HAM-D scores after I week than did placebo. Response rate (ba sed on a 50% decrease in MADRS scores) was 65% (30 of 46 patients) for venlafaxine and 28% (13 of 47 patients) for placebo. Significantly mo re placebo-treated patients (40%; N = 19) than venlafaxine-treated pat ients (9%; N = 4) discontinued treatment early because of lack of effi cacy. Nausea and sweating were the most common events, occurring at a significantly higher rate in the venlafaxine group. Conclusion: Venlaf axine is an effective and well-tolerated antidepressant in hospitalize d patients with major depression and melancholia.