Category Archives: Depressive disorder

Meta-analysis of venlafaxine: DISCUSSION(3)

Song and colleagues published the first meta-analysis comparing SSRIs with TCAs. They examined efficacy and discontinuation rates and found no difference between the two drug classes. That study, however, was complicated by the use of a variety of different definitions for response and by the inclusion ofatypical agents (eg, bicyclics) in the analysis along with the TCAs. On the other hand, the meta-analysis conducted by Moller and associates compared imipramine with newer agents including SSRIs and atypical agents, which were pooled despite differences in chemical classes. As with the former analysis by Song et al, groups had similar efficacies. Those results are similar to those that we found in that differences among groups were not statistically significant. asthma inhalers

Continue reading

Meta-analysis of venlafaxine: DISCUSSION(2)

Meta-analysis of venlafaxine: DISCUSSION(2)

It should be noted that the rates reported are for efficacy rather than effectiveness because they were all produced from RCTs. Interpretation ofthese data and translation into clinical situations require accounting for noncompliance other than that due to ADRs or perceived lack of effect. Other types of noncompliance include (but are not limited to) forgetting to take medication, loss or misplacement of drugs, intentional omission due to fear, perceived lack of need or other personal reasons.

Continue reading

Meta-analysis of venlafaxine: DISCUSSION(1)

Despite a great volume of literature on the subject, we were able to locate only a small number of RCTs for the antidepressant classes of interest. Notably absent were studies examining desipramine (a single out-patient study) and nortriptyline (no published RCTs found), cheap drugs with reputedly lower rates of ADRs, particularly of the anticholinergic variety. No supporting evidence was found. Such studies should be published, especially if ADRs are of interest. Nonetheless, we were able to retrieve information on nearly 3000 patients, which is a reasonably large sample to provide estimates.

Continue reading

Meta-analysis of venlafaxine: RESULTS

Meta-analysis of venlafaxine: RESULTS

A total of 234 studies were identified in the literature search for the meta-analysis of efficacy rates. Of those studies, 187 (79.9%) were excluded for the reasons listed in Table 1. As a result, 37 RCTs yielding 56 study arms were used in the analysis of efficacy rates. Inter-rater agreement for study selection yielded a kappa of 0.81 (P<0.05), and data were extracted by full consensus (100%). flovent inhaler

Continue reading

Meta-analysis of venlafaxine: MATERIALS AND METHODS(3)

Data were combined for all antidepressant classes, ie, SNRIs, SSRIs and TCAs. It was assumed that all Canadian drugs within a class are essentially the same and, in equipotent doses used continuously over several weeks, act similarly. Subgroup analyseswere done forindividualdrugswhenever possible.

Continue reading

Meta-analysis of venlafaxine: MATERIALS AND METHODS(2)

Meta-analysis of venlafaxine: MATERIALS AND METHODS(2)

Studies that evaluated patients 18 years of age or older who were diagnosed with a major depressive episode, defined by a standard, accepted scale (eg, Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases-9) as either endogenous or unipolar depression, were eligible. Patients must have scored 15 or greater on the Hamilton Depression (HAMD) scale (any version), or 18 or greater on the Montgomery-Asberg (MADRS) scale . Patients could not have been taking any concomitant antidepressants, lithium or thyroid, nor have any concomitant diseases (especially metabolic, endocrine or psychiatric). They could, however, have been taking other drugs such as tranquilizers or hypnotics.

Continue reading

Meta-analysis of venlafaxine: MATERIALS AND METHODS(1)

The research was carried out by an independent group of academic researchers at the University of Toronto who had no direct affiliation with the sponsor. The project was, however, sponsored by Wyeth-Ayerst Canada, but the investigators retained the right to publish results regardless of findings.

Continue reading

Meta-analysis of venlafaxine, SSRIs and TCAs in the treatment of major depressive disorder

Meta-analysis of venlafaxine

Depression, also referred to as major depressive disorder (MDD), is a major health problem. A number of agents from several chemical classes of drugs are available to treat MDD. Tricyclic antidepressants (TCAs) have been the mainstay of drug therapy for depression since their introduction in the 1960s. However, many patients experience a wide variety of adverse events with these drugs. buy asthma inhaler

Continue reading