Effectiveness of venlafaxine in patients hospitalized for major depression and melancholia

This study was undertaken to compare the antidepressant efficacy and short-term safety of venlafaxine with those of placebo in hospitalized patients with major depression and melancholia.

Ninety-three inpatients with a minimum prestudy Montgomery-Asberg Depression Rating Scale (MADRS) score of 25 were treated for up to 4 weeks with either venlafaxine or placebo. Dosage averaged approximately 350 mg/day during Weeks 2 to 4. Efficacy and safety were assessed throughout the study. Efficacy was evaluated using the MADRS, the 21-item Hamilton Rating Scale for Depression (HAM-D), and the Clinical Global Impressions (CGI) scale. Recorded study events, vital signs and body weight measurements, laboratory determinations, physical examinations, and ECG recordings were used to assess safety.

Venlafaxine provided significantly greater improvement in the MADRS scores after 4 days and in the HAM-D scores after 1 week than did placebo. Response rate (based on a 50% decrease in MADRS scores) was 65% (30 of 46 patients) for venlafaxine and 28% (13 of 47 patients) for placebo. Significantly more placebo-treated patients (40%; N = 19) than venlafaxine-treated patients (9%; N = 4) discontinued treatment early because of lack of efficacy. Nausea and sweating were the most common events, occurring at a significantly higher rate in the venlafaxine group.

Venlafaxine is an effective and well-tolerated antidepressant in hospitalized patients with major depression and melancholia.