A randomized, double-blind, active-control study of sertraline versus venlafaxine XR in major depressive disorder

Richard C. Shelton, Kirsten L. Haman, Mark H. Rapaport, Ari Kiev, Ward T. Smith, Robert M A Hirschfeld, R. Bruce Lydiard, John M. Zajecka, David L. Dunner

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: Sertraline may produce dual neurotransmitter effects similar to the serotonin-norepinephrine reuptake inhibitors (SNRIs); however, it has been tested against an SNRI in only 1 previous study, and never at an optimal dose. The objective of the current multisite study was to compare relatively higher doses of sertraline (i.e., 150 mg/day) and venlafaxine extended release (XR) (225 mg/day) in outpatients with major depressive disorder. Method: Subjects with DSM-IV major depressive disorder were randomly assigned to 8 weeks of double-blind treatment with sertraline (N = 82) or venlafaxine XR (N = 78). The study ran from January 2002 through January 2003. The primary outcome measure was the Quality of Life Enjoyment and Satisfaction Questionnaire; secondary outcome variables included the 17-item Hamilton Rating Scale for Depression. Results: Both treatments led to significant improvement in depressive symptoms and quality-of-life measures. No significant differences were noted between treatment groups for final scores on the primary or secondary measures. The treatment groups did not differ significantly in the percentage of responders (sertraline = 55%, venlafaxine XR = 65%; intent-to-treat [ITT] sample) or remitters (sertraline = 38%, venlafaxine XR = 49%; ITT sample), although the proportions are similar to those found in earlier selective serotonin reuptake inhibitor (SSRI) vs. venlafaxine meta-analyses. In patients who achieved the maximum dose of drug and maintained it for 3 weeks, response rates were similar to those found at lower doses (sertraline = 59%, venlafaxine XR = 70%); however, remission rates for this sample were comparable for both drug groups (sertraline = 48%, venlafaxine XR = 50%). Conclusions: The efficacies of sertraline and venlafaxine XR were comparable. Although response and remission rates did not differ statistically, the rates were analogous to those reported in previous meta-analyses. However, at clinically relevant higher doses, the remission rates were very similar.

Original languageEnglish (US)
Pages (from-to)1674-1681
Number of pages8
JournalJournal of Clinical Psychiatry
Volume67
Issue number11
StatePublished - Nov 2006

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Sertraline
Major Depressive Disorder
Meta-Analysis
Quality of Life
Depression
Venlafaxine Hydrochloride
Serotonin Uptake Inhibitors
Therapeutics
Diagnostic and Statistical Manual of Mental Disorders
Pharmaceutical Preparations
Neurotransmitter Agents
Outpatients
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Shelton, R. C., Haman, K. L., Rapaport, M. H., Kiev, A., Smith, W. T., Hirschfeld, R. M. A., ... Dunner, D. L. (2006). A randomized, double-blind, active-control study of sertraline versus venlafaxine XR in major depressive disorder. Journal of Clinical Psychiatry, 67(11), 1674-1681.

A randomized, double-blind, active-control study of sertraline versus venlafaxine XR in major depressive disorder. / Shelton, Richard C.; Haman, Kirsten L.; Rapaport, Mark H.; Kiev, Ari; Smith, Ward T.; Hirschfeld, Robert M A; Lydiard, R. Bruce; Zajecka, John M.; Dunner, David L.

In: Journal of Clinical Psychiatry, Vol. 67, No. 11, 11.2006, p. 1674-1681.

Research output: Contribution to journalArticle

Shelton, RC, Haman, KL, Rapaport, MH, Kiev, A, Smith, WT, Hirschfeld, RMA, Lydiard, RB, Zajecka, JM & Dunner, DL 2006, 'A randomized, double-blind, active-control study of sertraline versus venlafaxine XR in major depressive disorder', Journal of Clinical Psychiatry, vol. 67, no. 11, pp. 1674-1681.
Shelton RC, Haman KL, Rapaport MH, Kiev A, Smith WT, Hirschfeld RMA et al. A randomized, double-blind, active-control study of sertraline versus venlafaxine XR in major depressive disorder. Journal of Clinical Psychiatry. 2006 Nov;67(11):1674-1681.
Shelton, Richard C. ; Haman, Kirsten L. ; Rapaport, Mark H. ; Kiev, Ari ; Smith, Ward T. ; Hirschfeld, Robert M A ; Lydiard, R. Bruce ; Zajecka, John M. ; Dunner, David L. / A randomized, double-blind, active-control study of sertraline versus venlafaxine XR in major depressive disorder. In: Journal of Clinical Psychiatry. 2006 ; Vol. 67, No. 11. pp. 1674-1681.
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abstract = "Objective: Sertraline may produce dual neurotransmitter effects similar to the serotonin-norepinephrine reuptake inhibitors (SNRIs); however, it has been tested against an SNRI in only 1 previous study, and never at an optimal dose. The objective of the current multisite study was to compare relatively higher doses of sertraline (i.e., 150 mg/day) and venlafaxine extended release (XR) (225 mg/day) in outpatients with major depressive disorder. Method: Subjects with DSM-IV major depressive disorder were randomly assigned to 8 weeks of double-blind treatment with sertraline (N = 82) or venlafaxine XR (N = 78). The study ran from January 2002 through January 2003. The primary outcome measure was the Quality of Life Enjoyment and Satisfaction Questionnaire; secondary outcome variables included the 17-item Hamilton Rating Scale for Depression. Results: Both treatments led to significant improvement in depressive symptoms and quality-of-life measures. No significant differences were noted between treatment groups for final scores on the primary or secondary measures. The treatment groups did not differ significantly in the percentage of responders (sertraline = 55{\%}, venlafaxine XR = 65{\%}; intent-to-treat [ITT] sample) or remitters (sertraline = 38{\%}, venlafaxine XR = 49{\%}; ITT sample), although the proportions are similar to those found in earlier selective serotonin reuptake inhibitor (SSRI) vs. venlafaxine meta-analyses. In patients who achieved the maximum dose of drug and maintained it for 3 weeks, response rates were similar to those found at lower doses (sertraline = 59{\%}, venlafaxine XR = 70{\%}); however, remission rates for this sample were comparable for both drug groups (sertraline = 48{\%}, venlafaxine XR = 50{\%}). Conclusions: The efficacies of sertraline and venlafaxine XR were comparable. Although response and remission rates did not differ statistically, the rates were analogous to those reported in previous meta-analyses. However, at clinically relevant higher doses, the remission rates were very similar.",
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AU - Kiev, Ari

AU - Smith, Ward T.

AU - Hirschfeld, Robert M A

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N2 - Objective: Sertraline may produce dual neurotransmitter effects similar to the serotonin-norepinephrine reuptake inhibitors (SNRIs); however, it has been tested against an SNRI in only 1 previous study, and never at an optimal dose. The objective of the current multisite study was to compare relatively higher doses of sertraline (i.e., 150 mg/day) and venlafaxine extended release (XR) (225 mg/day) in outpatients with major depressive disorder. Method: Subjects with DSM-IV major depressive disorder were randomly assigned to 8 weeks of double-blind treatment with sertraline (N = 82) or venlafaxine XR (N = 78). The study ran from January 2002 through January 2003. The primary outcome measure was the Quality of Life Enjoyment and Satisfaction Questionnaire; secondary outcome variables included the 17-item Hamilton Rating Scale for Depression. Results: Both treatments led to significant improvement in depressive symptoms and quality-of-life measures. No significant differences were noted between treatment groups for final scores on the primary or secondary measures. The treatment groups did not differ significantly in the percentage of responders (sertraline = 55%, venlafaxine XR = 65%; intent-to-treat [ITT] sample) or remitters (sertraline = 38%, venlafaxine XR = 49%; ITT sample), although the proportions are similar to those found in earlier selective serotonin reuptake inhibitor (SSRI) vs. venlafaxine meta-analyses. In patients who achieved the maximum dose of drug and maintained it for 3 weeks, response rates were similar to those found at lower doses (sertraline = 59%, venlafaxine XR = 70%); however, remission rates for this sample were comparable for both drug groups (sertraline = 48%, venlafaxine XR = 50%). Conclusions: The efficacies of sertraline and venlafaxine XR were comparable. Although response and remission rates did not differ statistically, the rates were analogous to those reported in previous meta-analyses. However, at clinically relevant higher doses, the remission rates were very similar.

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