Joffe R T, Marshall A M, Lee D K
Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
J Clin Psychiatry. 1998 Oct;59(10):515-20. doi: 10.4088/jcp.v59n1004.
Studies to date suggest that venlafaxine is effective, well tolerated, and safe in a broad spectrum of patients. We examined the clinical utility and tolerability of venlafaxine in patients treated by community-based psychiatrists and family physicians in a naturalistic clinical setting.
Nineteen physicians each recruited 10 to 20 physicians to enroll 5 patients each maximum, diagnosed with DSM-IV major depression or dysthymia. The patients were at least moderately ill (Clinical Global Impressions) with a score of at least 32 on the Zung Self-Rating Depression Scale. After baseline clinical and laboratory assessments, each patient received 37.5 mg of venlafaxine b.i.d., with adjustments possible at the 5 visits during the next 8 weeks.
Of the 880 patients at baseline, 682 completed the 8-week study. The daily doses of venlafaxine ranged between 18.75 mg and 375 mg, with 80% receiving between 75 and 150 mg/day by 8 weeks. The intent-to-treat analysis revealed that at 8 weeks, 62% (522 of 843) of patients were either much or very much improved. Nausea was the most frequent side effect, followed by somnolence, headache, and dry mouth.
Venlafaxine has good clinical utility and tolerability in a community-based sample of a broad spectrum of depressed outpatients.
迄今为止的研究表明，文拉法辛在广泛的患者群体中有效、耐受性良好且安全。我们在自然临床环境中，研究了文拉法辛在社区精神科医生和家庭医生治疗的患者中的临床效用和耐受性。
19名医生每人招募10至20名医生，每位医生最多招募5名被诊断为DSM-IV重度抑郁症或心境恶劣的患者。患者病情至少为中度（临床总体印象），在zung自评抑郁量表上的得分至少为32分。在进行基线临床和实验室评估后，每位患者每天两次服用37.5毫克文拉法辛，在接下来的8周内的5次就诊时可进行调整。
在基线时的880名患者中，682名完成了为期8周的研究。文拉法辛的日剂量在18.75毫克至375毫克之间，到8周时，80%的患者每天服用75至150毫克。意向性分析显示，在8周时，62%（843名患者中的522名）的患者病情有很大或非常大的改善。恶心是最常见的副作用，其次是嗜睡、头痛和口干。
在广泛的社区门诊抑郁症患者样本中，文拉法辛具有良好的临床效用和耐受性。
