Does adding noradrenaline reuptake inhibition to selective serotonin reuptake inhibition improve efficacy in patients with depression? A systematic review of meta-analyses and large randomised pragmatic trials.

Selective serotonin reuptake inhibitors (SSRIs) are recommended as first-line pharmacological treatment for depression and are the most commonly prescribed class of antidepressants. However, there is substantial evidence that noradrenaline has a role in the pathogenesis and treatment of depression. This review aims to examine the evidence of including noradrenaline reuptake inhibition with serotonin reuptake inhibition with respect to increasing efficacy in the treatment of depression.

Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor.

Findings from the National Institute of Mental Health's Sequenced Treatment Alternatives to Relieve Depression trial indicate that approximately 50% of patients with major depressive disorder do not experience a treatment response after adequate first-line treatment with a selective serotonin reuptake inhibitor (SSRI). This study was designed to test the hypothesis that, after treatment failure with an SSRI, switching to venlafaxine extended release (ER) would offer advantages over switching to another SSRI, citalopram. The objectives of this trial were to compare the efficacy and safety of venlafaxine ER and citalopram in the treatment of moderate-to-severe depression in patients who did not experience a treatment response to an SSRI other than citalopram and to investigate the effects of severity of depression by categorizing treatment groups according to baseline severity.

A double-blind, randomised, placebo controlled study of venlafaxine XL in patients with generalised anxiety disorder in primary care.

Background: Generalised anxiety disorder (GAD) is one of the commonest anxiety disorders and is treated almost entirely in primary care. Most recent studies performed in GAD have excluded depression for regulatory reasons. As GAD is usually a co-morbid disease, often co-existing with depression, the results from recent studies have only limited relevance to the naturalistic population.