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Venlafaxine and paroxetine in treatment-resistant depression

Double-blind, randomised comparison

Published online by Cambridge University Press:  03 January 2018

M.-F. Poirier*
Affiliation:
SHU–Centre Hospitalier Sainte-Anne, Paris
P. Boyer
Affiliation:
Hôpital de la Pitié-Salpêtrière, Paris
*
Dr Marie-France Poirier, SHU-Centre Hospitalier Sainte-Anne, I, rue Cabanis, 75674 Paris, France. Tel: (33 I) 45 65 81 79; Fax: (33 I) 45 65 81 60

Abstract

Background

About one-third of patients fail to respond to initial antidepressant therapy, which suggests a need for more effective drugs.

Aims

To compare the efficacy and safety of venlafaxine and paroxetine in 122 patients with non-chronic treatment-resistant depression.

Method

In-patients or out-patients satisfying DSM – III – R criteria for major depression in evolution for less than eight months, having a baseline HAM–D score 18 and a HAM – D Item 3 score < 3 were eligible. Patients were required to have a history of resistance to two previous antidepressant treatments and a CGI improvement score of 3 at the beginning of treatment. Doses were adjusted to 200–300 mg/day for venlafaxine and 30–40 mg/day for paroxetine.

Results

For the observed-case analysis, the response rate was 51.9% for venlafaxine and 32.7% for paroxetine (P=0.044), and a remission was achieved in 42.3% of venlafaxine-treated and 20.0% of paroxetine-treated patients (P=0.01). The incidence of adverse effects was comparable between treatment groups.

Conclusions

Venlafaxine showed some evidence of superiority to paroxetine in this difficult-to-treat patient population.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Supported by a grant from Wyeth-Lederle, Paris, France.

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