Venlafaxine Improves Patients Depression-Free Days Compared To Selective Serotonin Reuptake Inhibitors, Placebo

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Venlafaxine Improves Patients Depression-Free Days Compared To Selective

Serotonin Reuptake Inhibitors, Placebo

By Ed Susman

Special to DG News

NEW ORLEANS, LA -- May 10, 2001 -- Researchers say they have a new tool that

can give clinicians clues as to how well antidepressant medications are

working.

Scientists say patients receiving venlafaxine (Effexor, American Home

Products) had nearly 19 depression-free days compared with 14

depression-free days for selective serotonin reuptake inhibitors (SSRIs) and

seven depression free days among placebo patients in pooled data from eight

clinical trials.

The study, by Rajiv Mallick, PhD, director of global health outcomes

assessment at Wyeth-Ayerst Research, Radnor, Pennsylvania, was reported

yesterday (May 9) at the 154th annual meeting of the American Psychiatric

Association.

" Depression-free days is an approximation of the time that patients were

without symptoms during an eight-week study, " Dr. Mallick said.

The differences between venlafaxine and the SSRIs-fluoxetine, paroxetine and

fluvoxamine-were statistically significant, he said. The differences between

placebo and active medications were also significant he said.

Pooled data included 2,046 patients from five studies in Europe, two in the

United States and one in Canada.

Dr. Mallick said depression-free days-a marker postulated by researchers in

1996-provides an estimate of sustained remission of depression.

" The difference between SSRIs and venlafaxine is five days, " noted Wayne

Brunell, MD, clinical instructor in psychiatry at Harvard Medical School,

Boston, Massachusetts. " It is an important finding. Naturally, I would like

to have five extra depression-free days, too. "

Dr. Brunell said the issue of " depression free days " could become a useful

marker in determining remission rather than just response in patients.

" However, we have no data on how this marker will work in long-term

treatment of patients. We will have to wait for that data before we can

determine how to use this marker. "

An antidepressant's efficacy traditionally has been measured by its ability

to reduce depressive symptoms by 50 percent. Yet remission-or the virtual

elimination of all symptoms of depression-is gaining recognition as a high

standard of efficacy measurement, Dr. Brunell said. When patients achieve

remission they are less likely to relapse, and are more likely to be

restored to normal functioning.

" If physicians embrace the concept of depression free days, they may be

better equipped to choose the best treatment option and assess their

patients' resulting recovery, " said Alan Schatzberg, MD, Professor and

Chairman, Stanford University School of Medicine, Stanford, California.

" Furthermore, physicians can use depression free days to engage patients in

their therapy, establish realistic expectations for treatment, and motivate

patients to stick with their treatment to overcome the disease. "

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