Venlafaxine vs. fluoxetine in postmenopausal women with majo
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Postmenopausal women are at significant risk for depression with studies showing that about 5.7% of women are diagnosed with major depressive disorder (MDD) after menopause. The trial published in the BMC Psychiatry shows that venlafaxine was well-tolerated and compared to fluoxetine, it led to a greater improvement.

The aim of this study was to compare the efficacy and safety of venlafaxine vs. fluoxetine in the treatment of postmenopausal MDD.

This was an 8-week, multicenter, randomized, single-blind, active-controlled trial conducted at a psychiatric hospital and a general hospital. The primary outcome measure was improving depressive symptoms (Hamilton Depression Rating Scale (HAMD-24) score). The secondary outcomes included the change of HAMD-24 anxiety/somatization factor score and Clinical Global Impressions-Improvement (CGI-I) response rate.

Safety was assessed by treatment-emergent adverse events (TEAEs) and laboratory tests. Efficacy was analyzed by using the full analysis set (FAS) following the modified intention-to-treat (mITT) principle. The primary endpoint measurements were analyzed using a mixed-effect model for repeated measures (MMRM) model with patients as a random-effect factor, treatment group as the independent variable, time as a repeated measure, and baseline covariates, using a first-order ante dependence covariance matrix.

A total of 184 women were randomized. The full analysis set (FAS) included 172 patients.

--Over the 8-week study period, the reduction in HAMD-24 scores was significant in both groups, while a significantly greater decline from baseline was observed in the venlafaxine group compared with the fluoxetine group.

--The baseline-to-week-8 least-squares mean change of the anxiety/somatization factor scores, CGI-I response rate were greater in the venlafaxine group than in the fluoxetine group.

--The most frequent TEAEs in both groups were nausea, somnolence, dizziness, headache, and dry mouth. There was no significant difference in the incidence of adverse events between the two groups.

Conclusively, venlafaxine was well tolerated and compared to fluoxetine, it led to a greater improvement in the treatment of postmenopausal MDD.

Source: https://doi.org/10.1186/s12888-021-03253-8
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