A double-blind randomized study comparing plasma level-targeted dose imipramine and high-dose venlafaxine in depressed inpatients

Marlijn Vermeiden, PG Mulder, W.W. van den Broek, Jan Bruijn, T.K. Birkenhager

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Abstract

Objective: To compare the efficacy of plasma level-targeted dose imipramine and high-dose venlafaxine in depressed inpatients in a randomized double-blind study. Methods: The study included 85 patients with a diagnosis of major depressive episode according to the DSM IV criteria and a 17-item Hamilton Rating Scale for Depression (HAM-D) score >= 17. Patients were randomized to imipramine or venlafaxine. The dose of imipramine was adjusted for each patient to a predefined blood level of 200-300 ng/ml. The dose of venlafaxine was increased gradually to 300-375 mg/day. Efficacy was evaluated after 7 weeks of treatment. Results: The mean age of the study group was 54.5 (range 29-82) years. There was no significant difference according to the primary outcome criterion of a >= 50% reduction on the HAM-D score: 17 of 43 (39.5%) patients on imipramine were responders compared to 21 of 42 (50%) patients on venlafaxine. When considering remission as outcome criterion (HAM-D score <= 7), 10 of 43 (23.3%) patients on imipramine were remitters compared to 15 of 42 (35.7%) patients on venlafaxine; again, no significant d Conclusions: The present study used optimal doses in depressed inpatients and showed that venlafaxine is at least equal in efficacy to imipramine. The results in the subgroup without psychotic features indicate a possible superiority of venlafaxine. (C) 2013 Elsevier Ltd. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)1337-1342
Number of pages6
JournalJournal of Psychiatric Research
Volume47
Issue number10
DOIs
Publication statusPublished - 2013

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