BACKGROUND: 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.
METHOD: 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.
RESULTS: 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.
CONCLUSION: Venlafaxine has good clinical
utility and tolerability in a community-based sample of a broad spectrum of
depressed outpatients.