THE CLINICAL EFFICACY OF VENLAFAXINE IN THE TREATMENT OF DEPRESSION

Venlafaxine, a new antidepressant drug, inhibits the synaptic reuptake of both serotonin and norepinephrine. As a result of this dual mechan ism of action, venlafaxine is effective against a broad range of depre ssive conditions, both mild-to-moderate and severe, whether occurring in inpatients or outpatients. The promise shown in preclinical studies was first supported by a series of open, noncomparative studies and t hen by placebo-controlled, double-blind trials. Venlafaxine was found to be significantly better than placebo in reducing depression, as mea sured on a variety of psychometric scales, and it was noted that in th is respect it was at least as effective as, and often more effective t han, comparator antidepressants, including imipramine, clomipramine, t razodone and fluoxetine. In longer-term treatment, venlafaxine has bee n shown to reduce the frequency of relapses in comparison with placebo treatment. Also in long-term use, venlafaxine has been associated wit h a significantly greater percentage of responders than seen with imip ramine. A characteristic of venlafaxine is its early onset of action, a feature which may be related to its dual mode of action; efficacy ha s been reported within the first week of treatment when a rapid dose e scalation regimen was employed. The clinical efficacy of venlafaxine a ppears, on present evidence, not to be affected by the age or sex of t he patient, nor is it lessened by concomitant melancholia, psychomotor retardation or agitation, or anxiety. The drug appears equally effect ive against mild-to-moderate depressive illness and depression which i s severe, of long duration, and/or refractory to other antidepressant medications. It is concluded that venlafaxine is an effective antidepr essant agent with a possible short latency to onset of its clinical ac tion, which may be used in a wide range of depressive conditions.