Evaluating the relationship of high-dose venlafaxine prescribing to treatment-resistant depression

  • Thomas A
  • Taylor D
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Aims and method: Prescribing of venlafaxine in The South London and Maudsley NHS Trust was found to account for over 50% of the antidepressant costs, but only 15% of the prescriptions. There is evidence to suggests that higher doses of venlafaxine may be effective in treating treatment-refractory depression. We aimed to discover if higher doses of venlafaxine used in the trust were related to prior failure to respond to antidepressant treatment. Hospital in-patients being treated with venlafaxine during a 1-week period in October 2001 were identified and cases notes were reviewed to determine patient demographic data and prior history of antidepressant therapy. Results: There were 38 patients identified as being prescribed venlafaxine (18 of whom had a primary diagnosis of depression). Twenty-five were classed as non-treatment-resistant and 13 were classed as treatment-resistant. Doses of venlafaxine were statistically significantly higher in patients considered treatment-resistant (245 mg v. 180 mg daily, P=0.03). All other recorded patient characteristics were similar. Clinical implications: Higher doses of venlafaxine were prescribed to patients who were retrospective defined as treatment-refractory. Further studies should address the reasons for this prescribing practice




Thomas, A., & Taylor, D. (2018). Evaluating the relationship of high-dose venlafaxine prescribing to treatment-resistant depression. Psychiatric Bulletin, 27(03), 93–95. https://doi.org/10.1192/s0955603600001604

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