Venlafaxine for major depression

doi:10.1136/bmj.39098.457720.BE

BMJ 2007;334:215-216 (3 February), doi:10.1136/bmj.39098.457720.BE

Editorials

Venlafaxine for major depression

More evidence that risks outweigh benefits for most patients?

The first 150 words of the full text of this article appear below.

In this week's BMJ Rubino and colleagues providenew evidence that informs the debate about whether antidepressantsincrease the risk of suicide.¹ The study, a retrospective observationalanalysis of the General Practice Research Database, found thatpatients prescribed venlafaxine were more likely to attemptor complete suicide than patients prescribed citalopram, fluoxetine,or dothiepin. Adjustment for possible confounders, however,greatly reduced the excess risk.

Venlafaxine is a serotoninergic and noradrenergicreuptake inhibitor, and it may be more effective than selectiveserotonin inhibitors for major depression.² ³ However, patients often discontinue treatment because ofside effects.⁴

The database analysed is the world's largestcomputerised database of anonymised longitudinal medical recordsfrom primary care (more than 3.4 million active patients, about13 million in total since 1987, from around 450 primary carepractices throughout the United Kingdom; www.gprd.com). Thedatabase has been used extensively for pharmacoepidemiologicalresearch, including previous studies examining the . . . [Full text of this article]

Andrea Cipriani, lecturer in psychiatry¹, John R Geddes, professor of epidemiological psychiatry², Corrado Barbui, lecturer in psychiatry³

¹ Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, 37134 Verona, Italy, ² Department of Psychiatry, University of Oxford, Oxford OX3 7JX, ³ Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona

andrea.cipriani@univr.it

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