Venlafaxine in the treatment of dysthymia: An open-label study

Background: Numerous studies have demonstrated the effectiveness of antidep ressant medications in the treatment of dysthymia, or chronic mild depressi on. Venlafaxine blocks reuptake of both serotonin and norepinephrine and ma y produce a more complete antidepressant response than do single-mechanism selective serotonin reuptake inhibitors. The purpose of this open label stu dy was to provide preliminary data on the tolerability and effectiveness of venlafaxine for patients with dysthymia. Method: Twenty-two dysthymic subjects (DSM-III-R criteria) were enrolled in this 10-week, open-label trial, and 5 dropped out prior to their second vi sit. Seventeen subjects (77.3%) received more than 1 week of medication. Results: Of these 17 subjects, 13 (76.5%) were treatment responders. Result s of paired sample t tests were highly significant, indicating that, on ave rage, there was significant improvement on all measures of symptomatology a nd functioning, with mean +/- SD scores on the Hamilton Rating Scale for De pression decreasing from 20.95 +/- 6.50 at baseline to 6.06 +/- 5.49 at wee k 10. The mean +/- SD final dose was 178.68 +/- 70.80 mg/day. Side effects were reported by 17 (85%) of the 20 subjects for whom tolerability was asse ssed (the most common were fatigue, dry mouth, and nausea); 5 (22.7%) of 22 patients discontinued treatment because of side effects, primarily nausea (N = 3). Conclusion: These findings suggest the benefit of venlafaxine in the treatm ent of chronic depression and the need for more rigorous studies.