Venlafaxine versus SSRI therapy for major depression. Results of comparative efficacy trials

Although any effective antidepressant will produce a therapeutic response in 50% to 60% of patients with major depression, this means that the needs of the remaining 40% to 50% of patients go unmet. Consequently, selection of optimal antidepressant therapy for major depression should entail the consideration of drugs that have the greatest potential to induce a therapeutic response, remissions and, ultimately, long-term recovery. According to findings from various clinical studies, antidepressants with multiple mechanisms of action (eg, venlafaxine, clomipramine) yielded higher response rates than did other antidepressants (eg, paroxetine, citalopram). Moreover, results of placebo-controlled and active drug-controlled clinical studies have demonstrated that compared with the SSRIs, the combined-action antidepressant venlafaxine exhibited a more robust efficacy in that it consistently produced higher response and remission rates.