FULL TEXT (全文ー英語のみ)


Berger D, ADDITIONAL ECNP DATA (Letter), Psychiatric Times, 21:9, August, p.14; 2004.

In the february 2004 Psychiatric Times Supplement "Optimizing Outcomes in the treatment of Anxiety and Depression", Dr. Bowes described a pooled remission analysis poster presented at the 2003 European College of Neuropsychopharmacology (ECNP) in Prague that showed venlafaxine having higher rates of symptom remission vs SSRIs or placebo (the Supplement was sponsored by the maker of venlafaxine).

I had gone to the ECNP meeting and there was also a presentation of a titrated fixed-dose double-blind direct comparison of the SSRI escitalopram (20mg/day; N=98) vs venlafaxine (225mg/day; N=100) showing escitalopram superior for severe depression and better tolerated that Dr. Bowes did not discuss.

The results of this study go against the idea of dual action antidepressants (e.g. SNRIs) being superior to a single action SSRI in terms of efficacy, and the non-selectivity of venlafaxine may have been assoicated with worse tolerability. Direct comparisons are also a more reliable study methodology than retrospective pooled analyses.

The study presented was: "A Double Blind Comparison of Escitalopram with Venlafaxine XR in the Treatment of Major Depressive Disorder" Bielski, et al. Our information sources must be careful to eschew any possibility of unbalanced reporting of conference presentations or of the literature.

Doug Berger, M.D., Tokyo, Japan

Dr. Berger is in private practice in Tokyo and he consults on clinical drug development for pharmaceutical companies in Japan.