Expanding Role Of Venlafaxine

Wyeth-Ayerst's dual action antidepressant, Effexor (venlafaxine), a serotonin-norepinephrine reuptake inhibitor, may be of value in other clinical indications including psychiatric and non-pychiatric disorders, according to results presented by Robert Priest, head of the Department of Psychiatry at the University of London, at the 8th Congress of the Association of European Psychiatrists, held in London on July 8.

In eight social phobic patients, six showed an improvement with venlafaxine (56.25mg to 300mg per day), after failing to respond to treatment with selective serotonin reuptake inhibitors. A significant improvement was also found in 39 patients with borderline personality disorder, with a dose titration of 200mg to 400mg per day over 12 weeks. It was noted that the incidence of sexual dysfunction was low in this study, compared to similar ones using SSRIs.

In attention deficit disorder, a condition widely treated with psychostimulants, eg methylphenidate, which are associated with side effects such as insomnia and decreased appetite, 12 of the 16 patients who tolerated treatment with venlafaxine (25mg to 225mg per day), with or without psychostimulant, had a 50% reduction in ADD symptoms. In a second study with 20 ADD diagnosed adults, 12 were able to tolerate doses ranging from 50mg to 1500mg per day, and eight of these showed significant improvement. A third study compared the use of velafaxine alone to psychostimulants, and a combination of the two. 80% of patients demonstrated a reponse on venlafaxine alone, compared to 88% using a combination of venlafaxine and psychostimulants, and 33% using only stimulants.