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Moving from serotonin to serotonin-norepinephrine enhancement with increasing venlafaxine dose: clinical implications and strategies for a successful outcome in major depressive disorder.
- Source :
-
Expert opinion on pharmacotherapy [Expert Opin Pharmacother] 2023 Sep-Dec; Vol. 24 (15), pp. 1715-1723. Date of Electronic Publication: 2023 Aug 07. - Publication Year :
- 2023
-
Abstract
- Introduction: Mental health disorders, especially depressive and anxiety disorders, are associated with substantial health-related burden. While the second-generation antidepressants are widely accepted as first-line pharmacological treatment for major depressive disorder (MDD), patient response to such treatment is variable, with more than half failing to achieve complete remission, and residual symptoms are frequently present.<br />Areas Covered: Here, the pharmacodynamics of venlafaxine XR are reviewed in relation to its role as both a selective serotonin reuptake inhibitor (SSRI) and a serotonin-norepinephrine-reuptake inhibitor (SNRI), and we look at how these pharmacodynamic properties can be harnessed to guide clinical practice, asking the question 'is it possible to develop a symptom-cluster-based approach to the treatment of MDD with comorbid anxiety utilizing venlafaxine XR?.' Additionally, three illustrative clinical cases provide practical examples of the utility of venlafaxine-XR in real-world clinical practice. The place of venlafaxine XR in managing fatigue/low energy, a frequent residual symptom in MDD, is explored using pooled data from clinical trials of venlafaxine XR.<br />Expert Opinion: Venlafaxine XR should be considered as a first-line treatment for MDD with or without comorbid anxiety, and there are clear pharmacodynamic signals supporting a symptom cluster-based treatment paradigm for venlafaxine XR.
- Subjects :
- Humans
Venlafaxine Hydrochloride therapeutic use
Serotonin therapeutic use
Norepinephrine therapeutic use
Selective Serotonin Reuptake Inhibitors therapeutic use
Cyclohexanols therapeutic use
Treatment Outcome
Delayed-Action Preparations
Depressive Disorder, Major drug therapy
Antidepressive Agents, Second-Generation therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1744-7666
- Volume :
- 24
- Issue :
- 15
- Database :
- MEDLINE
- Journal :
- Expert opinion on pharmacotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 37501324
- Full Text :
- https://doi.org/10.1080/14656566.2023.2242264