Shelton Charles, Entsuah Richard, Padmanabhan S Krishna, Vinall Phillip E
University of Kentucky, Lexington, Kentucky, USA.
Int Clin Psychopharmacol. 2005 Jul;20(4):233-8. doi: 10.1097/00004850-200507000-00007.
The combined serotonin-norepinephrine reuptake inhibitor, venlafaxine XR, has demonstrated significant response and remission in patients diagnosed with depression when measured with the Hamilton Depression Rating Scale (HAM-D). This pooled analysis of data from five studies compared the sustained remission of depressive symptoms in patients treated with venlafaxine XR, the selective serotonin reuptake inhibitors (SSRIs) fluoxetine or paroxetine, or placebo. Data from 1391 subjects enrolled in five active and placebo-controlled studies who met the DSM-III-R or DSM-IV criteria for major depressive disorder were analysed. Three treatment groups were compared: venlafaxine XR (n = 560), fluoxetine/paroxetine (n = 298) and placebo (n = 496). Mean treatment duration was 8 weeks. Responders were defined as those patients whose HAM-D-21 score decreased by > or = 50% from baseline. Remission was defined as a HAM-D-17 score < or = 7. Sustained remission was defined as maintenance of remission through week 8 or the end of treatment (if before week 8) and for > or = 2 weeks. Between-group rate comparisons in outcome measures were carried out using Fisher's exact and log-rank tests. Venlafaxine XR produced significantly higher rates of sustained remission in depressed patients compared to fluoxetine/paroxetine or placebo over this 8-week treatment period. As early as week 2, a significantly greater proportion of patients treated with venlafaxine achieved improved depression scores (remission and response). A significantly greater rate of remission and sustained remission occurred with venlafaxine compared to placebo. Remission was achieved earlier with venlafaxine and lasted throughout the remainder of the study. These results demonstrate that venlafaxine XR is more effective than fluoxetine/paroxetine for sustaining remission of depressive symptoms.
5-羟色胺-去甲肾上腺素再摄取抑制剂文拉法辛缓释剂，通过汉密尔顿抑郁量表（HAM-D）测量，已证实对被诊断为抑郁症的患者有显著疗效和缓解作用。这项对五项研究数据的汇总分析，比较了接受文拉法辛缓释剂、选择性5-羟色胺再摄取抑制剂（SSRI）氟西汀或帕罗西汀或安慰剂治疗的患者中抑郁症状的持续缓解情况。分析了1391名符合DSM-III-R或DSM-IV重性抑郁症标准、纳入五项活性药物和安慰剂对照研究的受试者的数据。比较了三个治疗组：文拉法辛缓释剂组（n = 560）、氟西汀/帕罗西汀组（n = 298）和安慰剂组（n = 496）。平均治疗持续时间为8周。缓解者定义为HAM-D-21评分较基线降低≥50%的患者。缓解定义为HAM-D-17评分≤7。持续缓解定义为在第8周或治疗结束时（如果在第8周之前）维持缓解且持续≥2周。使用Fisher精确检验和对数秩检验对各治疗组间的结局指标发生率进行比较。在这8周的治疗期内，与氟西汀/帕罗西汀或安慰剂相比，文拉法辛缓释剂使抑郁症患者的持续缓解率显著更高。早在第2周，接受文拉法辛治疗的患者中抑郁评分改善（缓解和有反应）的比例就显著更高。与安慰剂相比，文拉法辛的缓解率和持续缓解率显著更高。文拉法辛更早达到缓解，且在研究的剩余时间内持续存在。这些结果表明，在维持抑郁症状缓解方面，文拉法辛缓释剂比氟西汀/帕罗西汀更有效。
