Effectiveness of venlafaxine extended release and conventional antidepressants in elderly patients with depressive disorder

Abstract

Objectives. To determine and compare effectiveness, tolerability and safety of venlafaxine extended release (VXR) and other conventional antidepressants, mainly selective serotonin reuptake inhibitors (SSRIs), for the treatment of elderly patients diagnosed of depressive disorder in an out-patient psychiatry setting.

Methods. Multicenter, naturalistic, randomized, openlabel study performed in elderly patients with depressive disorder (according to DSM-IV). Patients were randomized to 6 months of treatment with VXR or another conventional antidepressant (CA). Effectiveness was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Scale (HAM-A). Response was considered as a ≥ 50 % decrease and remission as a < 9 score in the MADRS.

Results. Sample of 120 patients older than 60 years; 68 received VXR and 52 CA (SSRI: 94.1 %). Most frequently used SSRI were citalopram (40.8 %), paroxetine (24.5 %) and sertraline (20.4 %). After 6 months of treatment, VXR achieved a higher response (75 %, VXR; 50 %, CA; p = 0.048) and remission (50 %, VXR; 28.9 %, CA; p = 0.048) and a higher decrease in the HAM-A score (–14.77, VXR; –10.84, CA). There were no significant differences in compliance rates (67.6, VXR; 71.1 %, CA) and adverse reactions (14.7 %, VXR; 13.46 %, CA) between both treatment groups. Blood pressure and heart rate remained within normal limits in both treatment groups.

Conclusions. In this study, venlafaxine extended release shows higher effectiveness than other conventional antidepressants, mainly SSRIs, in the treatment of depressive elderly patients in the out-patient psychiatry setting.