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RESEARCH PRODUCT

Is There an Advantage to Venlafaxine in Comparison with Other Antidepressants?

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The purpose of this article is to compare and contrast the benefits and limitations of antidepressant drugs. Several different classes of antidepressants are available for treatment of major depressive disorder, each with its own benefits and limitations as a result of its pharmacological profile. Tricyclic antidepressants (TCAs) and monoamine oxidase (MAO) inhibitors are effective in a large proportion of depressed patients, but their use is often limited by short- and long-term safety/tolerability problems. Selective serotonin reuptake inhibitors (SSRIs) exhibit comparable efficacy to TCAs in most patients, but may be less effective in certain patients. Additionally, SSRI use may by impacted by clinically significant drug interactions. Venlafaxine is a selective serotonin-noradrenaline reuptake inhibitor (SNRI) with unique pharmacological properties that may enhance its efficacy as well as its safety profile. In clinical trials, venlafaxine exhibits antidepressant activity in a broad range of patients with major depression, including those with melancholia, agitated or retarded symptoms, anxiety symptoms, and refractory or resistant depression. Venlafaxine has shown potential for an early onset of action and offers dose flexibility that may allow recruitment of additional responders at higher dosages. Because of its lack of affinity for muscarinic cholinergic, histaminergic, and alpha1-adrenergic receptors, venlafaxine has a safety profile that is superior to that of TCAs. Venlafaxine also is devoid of the drug interactions characteristic of SSRIs. © 1997 John Wiley & Sons, Ltd.