Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T06:41:52.873Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical measures of rapid onset of action

Published online by Cambridge University Press:  16 April 2020

SA Montgomery
SA Montgomery*
Affiliation:
Department of Pharmacology, Imperial College School of Medicine at St Mary's, Norfolk Place, London, W2 1NY, UK
Get access

Summary

The benefits of an antidepressant with an early or rapid onset of action include a more rapid resolution of the debilitating symptoms of depression, a potential reduction in the risk of suicide and cost savings associated with a reduction in hospitalization. While these benefits are valuable, this promise has yet to be fulfilled by any antidepressant. Venlafaxine is a unique serotonin-noradrenaline reuptake inhibitor (SNRI) which produces rapid and prolonged desensitization of β-adrenergic receptors in preclinical studies after both acute and chronic administration of venlafaxine. Results from placebo-controlled and active comparator clinical studies provide evidence that venlafaxine may have an early onset of activity which is most apparent at higher dosages. The early onset is most apparent with rapid escalation of the venlafaxine dosage, and the incidence, therefore, of side effects tends to be higher early after initiating therapy with venlafaxine. Thus, venlafaxine may fill the long awaited need for an antidepressant with an early onset of action.

Keywords

antidepressantsvenlafaxineserotonin-noradrenaline reuptake inhibitorclinical pharmacologyonset of action
Type
Research Article
Information
European Psychiatry , Volume 12 , Issue S4 , 1997 , pp. 295s - 300s
Copyright
Copyright © Elsevier, Paris 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baron, BM, Ogden, A-M, Siegel, BWet al.Rapid down regulation of β-adrenoceptors by co-administration of desipramine and fluoxetine. Eur J Pharmacol 1988; 154: 125–134CrossRefGoogle ScholarPubMed
Benkert, O, Gründer, G, Wetzel, H, Hackett, DA randomized, double-blind comparison of a rapidly escalating dose of venlafaxine and imipramine in inpatients with major depression and melancholia. J Psychiatr Res 1996; 30: 441–451CrossRefGoogle ScholarPubMed
Clerc, GE, Ruimy, P, Verdeau-Paillès, JA double-blind comparison of venlafaxine and fluoxetine in patients hospitalized for major depression and melancholia. Int Clin Psychopharmacol 1994; 9: 139–143CrossRefGoogle ScholarPubMed
Dierick, M, Ravizza, L, Realini, R, Martin, AA double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients. Prog Neuropsychopharmacol Biol Psychiatry 1996; 20: 57–71CrossRefGoogle ScholarPubMed
Dunbar, GC, Cohn, JB, Fabre, LFet al.A comparison of paroxetine, imipramine and placebo in depressed out-patients. Br J Psychiatry 1991; 159: 394–398CrossRefGoogle ScholarPubMed
Greenberg, PE, Stiglin, LE, Finkelstein, SN, Berndt, ERThe economic burden of depression in 1990. J Clin Psychiatry 1993; 54: 405–418Google ScholarPubMed
Guelfi, JD, White, C, Hackett, Det al.Effectiveness of venlafaxine in patients hospitalized with major depression and melancholia. J Clin Psychiatry 1995; 56: 450–458Google ScholarPubMed
Jönsson, B, Bebbington, PEWhat price depression? The cost of depression and the cost-effectiveness of pharmacological treatment. Br J Psychiatry 1994; 164: 665–673CrossRefGoogle ScholarPubMed
Montgomery, SARapid onset of action of venlafaxine. Int Clin Psychopharmacol 10 (suppl 2) 1995 21–27CrossRefGoogle ScholarPubMed
Moyer, JA, Andree, TH, Haskins, JTet al.The preclinical pharmacological profile of venlafaxine: a novel antidepressant agent (abstract). Clin Neuropharmacol 15(suppl 1, Pt B) 1994 435BCrossRefGoogle Scholar
Muth, EA, Haskins, JT, Moyer, JAet al.Antidepressant biochemical profile of the novel bicyclic compound Wy-45,030, an ethyl cyclohexanol derivative. Biochem Pharmacol 1986; 35: 4493–4497CrossRefGoogle ScholarPubMed
Muth, EA, Moyer, JA, Haskins, JTet al.Biochemical, neurophysiological, and behavioral effects of Wy-45,233 and other identified metabolites of the antidepressant venlafaxine. Drug Dev Res 1991; 23: 191–199CrossRefGoogle Scholar
Nelson, JC, Mazure, CM, Bowers, MB, Jatlow, PIA preliminary, open study of the combination of fluoxetine and desipramine for rapid treatment of major depression. Arch Gen Psychiatry 1991; 48: 303–307CrossRefGoogle ScholarPubMed
Preskorn, SHAntidepressant drug selection: criteria and options. J Clin Psychiatry 55suppl A1994 6–22Google ScholarPubMed
Rudolph, RL, Fabre, L, Feighner, J, Rickels, K A randomized, placebo-controlled, dose-response trial of venlafaxine hydrochloride in the treatment of major depression J Clin Psychiatry 1997 (in press)CrossRefGoogle Scholar
Shrivastava, RK, Cohn, C, Crowder, Jet al.Long-term safety and clinical acceptability of venlafaxine and imipramine in outpatients with major depression. J Clin Psychopharmacol 1994; 14: 322–329CrossRefGoogle ScholarPubMed
Stark, P, Hardison, CDA review of multicenter controlled studies of fluoxetine vs. imipramine and placebo in outpatients with major depressive disorder. J Clin Psychiatry 1985; 46: 53–58Google ScholarPubMed
Stassen, HH, Delini-Stula, A, Angst, JTime course of improvement under antidepressant treatment: a survival-analytical approach. Eur Neuropsychopharmacol 1993; 3: 127–135CrossRefGoogle ScholarPubMed
Stassen, HH, Angst, J, Delini-Stula, ASeverity at baseline and onset of improvement in depression. Meta-analysis of imipramine and moclobemide versus placebo. Eur Psychiatry 1994; 9: 129–136CrossRefGoogle Scholar
Stoudemire, A, Frank, R, Hedemark, Net al.The economic burden of depression. Gen Hosp Psychiatry 1986; 8: 387–394CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.