Profiles of patients who may benefit from high-dose venlafaxine therapy Review article
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Abstract
Venlafaxine is a reuptake inhibitor of serotonin, noradrenaline and, to a lesser extent, dopamine. The dose-dependence of the drug’s mechanism of action is clinically important. In lower doses, it inhibits serotonin reuptake, increasing the daily dose of the drug allows the activation of the noradrenergic mechanism, and in the highest therapeutic doses, additionally the dopaminergic mechanism. Therefore, the use of various doses allows for improvement in a wide spectrum of clinical symptoms of depression, and venlafaxine has a number of registered indications. The drug – especially in higher doses – is particularly useful in the treatment of depression and apathy, anergy, fatigue, drug-resistant depression or depression with coexisting chronic pain.
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References
2. Nutt DJ. Relationship of neurotransmitters to the symptoms of major depressive disorder. J Clin Psychiatry. 2008; 69(Suppl E1): 4-7.
3. Jiang Y, Zou D, Li Y et al. Monoamine neurotransmitters control basic emotions and affect major depressive disorders. Pharmaceuticals. 2022; 15(10): 1203.
4. Fagiolini A, Cardonerb N, Pirildarc S et al. Moving from serotonin to serotonin-norepinephrine enhancement with increasing venlafaxine dose: clinical implications and strategies for a successful outcome in major depressive disorder Expert Opin Pharmacother. 2023; 24(15): 1715-23.
5. Perahia DG, Quail D, Desaiah D et al. Switching to duloxetine from selective serotonin reuptake inhibitor antidepressants: a multicenter trial comparing 2 switching techniques. J Clin Psychiatry. 2008; 69(1): 95-105.
6. Wysokiński A. Wenlafaksyna w warsztacie psychiatry od niemal 18 lat. Psychiatra. 2017; jesień: 49-52.
7. Gałecki P, Bliźniewska-Kowalska K. Treatment-resistant depression – Recommendations of the National Consultant in the field of psychiatry. Psychiatria Polska. 2021; 55: 7-21.
8. Furukawa TA, Cipriani A, Cowen PJ et al. Optimal dose of selective serotonin reuptake inhibitors, venlafaxine, and mirtazapine in major depression: a systematic review and dose-response meta-analysis. Lancet Psychiatry. 2019; 6: 601-9.
9. Lenox-Smith AJ, Jiang Q. Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor. Int Clin Psychopharmacol. 2008; 23(3): 113-9.
10. Israel JA. The impact of residual symptoms in major depression. Pharmaceuticals. 2010; 3(8): 2426-40.
11. Nil R, Lütolf S, Seifritz E. Residual symptoms and functionality in depressed outpatients: A one-year observational study in Switzerland with escitalopram. J Affect Disord. 2016; 197: 245-50.
12. Thase M, Asami Y, Wajsbrot D et al. A meta-analysis of the efficacy of venlafaxine extended release 75-225 mg/day for the treatment of major depressive disorder. Curr Med Res Opin. 2017; 33(2): 317-26.
13. Dudek D, Krupa AJ. Objawy bólowe w depresji. In: Ból i depresja. Dudek D, Siwek M, Woroń J (eds.). Termedia, Poznań 2021: 49-64.
14. Markowitz JS, Patrick KS. Venlafaxine-tramadol similarities. Med Hypotheses. 1998; 51: 167-8.
15. Wichniak A. Leczenie bólu przewlekłego z perspektywy lekarza psychiatry. Psychiatra. 2018; jesień: 59-62.
16. Rowbotham MC, Goli V, Kunz NR et al. Venlafaxine extended release in the treatment of painful diabetic neuropathy: a double-blind, placebo-controlled study. Pain. 2004; 110: 697-706.