Kornstein Susan G, Kocsis James H, Ahmed Saeeduddin, Thase Michael, Friedman Edward S, Dunlop Boadie W, Yan Bing, Pedersen Ron, Ninan Philip T, Li Thomas, Keller Martin
Virginia Commonwealth University, Richmond, Virginia.
Int Clin Psychopharmacol. 2008 Nov;23(6):357-63. doi: 10.1097/YIC.0b013e328314e2cb.
The objective of this study was to evaluate the long-term efficacy of venlafaxine extended release (ER) < or =225 mg/day in patients with recurrent major depressive disorder (MDD). In this double-blind trial, outpatients with recurrent MDD (N=1096) were randomized to 10 weeks of acute-phase treatment with venlafaxine ER (75-300 mg/day) or fluoxetine (20-60 mg/day) followed by a 6-month continuation phase and two consecutive 12-month maintenance phases. At the start of each maintenance period, venlafaxine ER responders were randomized to double-blind venlafaxine ER or placebo. In this analysis, data from responders to acute and continuation treatment were analyzed during the combined maintenance phases while receiving venlafaxine ER < or =225 mg/day. Failure to maintain response was defined as an increase in maintenance dose to 300 mg/day or recurrence. Differences were calculated using Kaplan-Meier methods and compared using log-rank tests. Continuation-phase responders (n=114) receiving venlafaxine ER < or =225 mg/day comprised the analysis population (venlafaxine ER: n=55; placebo: n=59). The estimated probability for remaining well across 24 months of maintenance treatment was 67% for venlafaxine ER and 41% for placebo (P=0.007). Venlafaxine ER effectively maintained response at doses < or =225 mg/day for up to 2.5 years in patients with recurrent MDD. The findings are consistent with those of the full data set.
本研究的目的是评估文拉法辛缓释剂(ER)剂量≤225mg/天对复发性重度抑郁症(MDD)患者的长期疗效。在这项双盲试验中,复发性MDD门诊患者(N = 1096)被随机分配接受为期10周的急性期治疗,治疗药物为文拉法辛ER(75 - 300mg/天)或氟西汀(20 - 60mg/天),随后是6个月的延续期和两个连续的12个月维持期。在每个维持期开始时,对急性期治疗有反应的文拉法辛ER患者被随机分配接受双盲文拉法辛ER或安慰剂治疗。在本分析中,对急性期和延续期治疗有反应的数据在联合维持期进行分析,此时患者接受的文拉法辛ER剂量≤225mg/天。未能维持反应被定义为维持剂量增加至300mg/天或复发。使用Kaplan - Meier方法计算差异,并使用对数秩检验进行比较。接受文拉法辛ER剂量≤225mg/天的延续期有反应者(n = 114)构成分析人群(文拉法辛ER:n = 55;安慰剂:n = 59)。在24个月的维持治疗中,文拉法辛ER组保持良好状态的估计概率为67%,安慰剂组为41%(P = 0.007)。对于复发性MDD患者,文拉法辛ER在剂量≤225mg/天时可有效维持反应长达2.5年。这些发现与完整数据集的结果一致。