Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors

Background It had been suggested that the antidepressant venlafaxine, which inhibits reuptake of both serotonin and (at higher doses) noradrenaline, may result in better outcomes than treatment with selective serotonin reuptake inhibitors (SSRIs). Aims To compare remission rates during treatment with SSRIs or venlafaxine. Method Data from eight comparable randomised, double-blind studies of major depressive disorder were pooled to compare remission rates (Hamilton Rating Scale for Depression score less than or equal to7) during treatment with venlafaxine (n=851), SSRIs (fluoxetine, paroxetine, fluvoxamine; n=748) or placebo (four studies; n=446). Results Remission rates were: venlafaxine, 45% (382/851); SSRIs, 35% (260/748); placebo, 25% (110/446) (P < 0.001; odds ratio for remission is 1.50 ( 1.3-1.9), favouring venlafaxine v. SSRIs). The difference between venlafaxine and the SSRIs was significant at week 2, whereas the difference between SSRIs and placebo reached significance at week 4. Results were not dependent on any one study or the definition of remission. Conclusions Remission rates were significantly higher with venlafaxine than with an SSRI. Declaration of interest M.E.T. is a paid consultant to Wyeth -Ayerst Laboratories, the employer of A.R.E, and R.L.R.