Antidepressant Effexor Good Choice for Older Women
Aug. 7, 2001 -- What do you give the menopausal depressed woman who's tried everything? Effexor, according to a study presented recently at the World Assembly for Mental Health in Vancouver.
Effexor, an antidepressant that acts on two different brain chemicals, appears to be particularly helpful for middle-aged or older women, say researchers, who designed a study to compare the drug to the selective serotonin reuptake inhibitors. Also known as SSRIs, this class of very commonly prescribed antidepressants includes Prozac, Paxil, and Zoloft. Effexor appeared to be more effective than SSRIs in both older and younger women -- but especially so in older women.
It's important that patients get completely better when you treat depression, not that they just get some response to the antidepressant, says Alan Lipshitz, MD, director of clinical affairs, neuroscience, at Wyeth-Ayerst Pharmaceutical, the company that makes Effexor and funded the research. In a group of women aged 50 and over, who were not taking estrogen replacement, venlafaxine was found to be better than both SSRIs and placebo at making women feel better, he says.
This research suggests that Effexor, which works on two brain chemicals, serotonin and norepinephrine, may be more effective at making someone better that the SSRIs, which work on serotonin only.
"We know SSRIs have helped a lot of people. Finding out which medication is best for which individuals is always a hard question," says Andrew Leuchter, MD.
However, notes Leuchter, Effexor only has this effect at higher dosage levels. At lower dosage levels, its effects are similar to an SSRI. In addition, both SSRIs and venlafaxine take awhile to kick in. Once a patient is receiving an appropriate dose, it takes two to four weeks of treatment until the patient experiences the effect.
"We should be using [Effexor] at least as much as we use any other antidepressant -- and at present, we aren't," says Leuchter, director of the division of adult psychiatry at UCLA Neuropsychiatric Institute and Hospital and professor in the department of psychiatry and biobehavioral sciences at UCLA School of Medicine.
SSRIs are considered very good antidepressants for all people, including women, says Vivien K. Burt, MD, PhD.
"However, one of the nice things about [Effexor] is that it is excellent for treatment of depression, [anxiety], and anxious depression. Since middle-aged and older women are more likely to experience anxious depression, particularly around the transition of menopause, it is likely to be a useful agent to try for these patients," says Burt, professor of psychiatry at UCLA school of Medicine and director of the Women's Life Center at UCLA Neuropsychiatric Institute.