Efficacy of venlafaxine in geriatric depression

Jeffrey P. Staab, Dwight L. Evans

Research output: Contribution to journalReview article

33 Scopus citations

Abstract

Geriatric patients with major depression present clinical challenges not encountered in younger individuals, including a greater incidence of medical comorbidity, higher rates of multiple medication use, changes in drug metabolism due to age or physical illness, and increased sensitivity to antidepressant side effects. Nevertheless, successful treatment of depressive disorders in the elderly improves mental and physical functioning, decreases morbidity and perhaps mortality, and enhances quality of life. Recent research indicates that newer antidepressants are effective for late life depression and safer for older individuals. Among newer antidepressants, venlafaxine has a pharmacological profile that makes it an attractive choice for geriatric patients. It has limited potential to interact with other medications because it only weakly inhibits the cytochrome P450 system and binds to plasma proteins at a low level. Dosing may have to be adjusted for patients with renal failure, but typically not for those with liver disease or other medical conditions. Data from three double-blind and four open clinical trials support the safety and efficacy of venlafaxine for geriatric depression. Patients may experience transient, generally tolerable side effects such as insomnia, nausea, agitation, or dry mouth early in treatment, but more serious problems such as falls or cardiac rhythm disturbances seem to be rare. Treatment emergent hypertension occurs in a small percentage of older patients, generally at doses above 150 mg/day. Finally, emerging data suggest that venlafaxine may be effective for conditions such as stroke, anxiety, and neuropathic pain that frequently accompany depressive disorders in the elderly. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish (US)
Pages (from-to)63-68
Number of pages6
JournalDepression and Anxiety
Volume12
Issue numberSUPPL. 1
DOIs
StatePublished - 2000

Keywords

  • Antidepressive agent
  • Clinical trials
  • Comorbidity
  • Elderly
  • Geriatric psychiatry
  • Human
  • Major depression
  • Norepinephrine
  • Review
  • Serotonin

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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