Remission from depression
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REVIEW ARTICLE
© 2005 Adis Data Information BV. All rights reserved.
Remission from Depression A Review of Venlafaxine Clinical and Economic Evidence Donald Han1 and Edward C.Y. Wang2 1 2
Wyeth Pharmaceuticals, Markham, Ontario, Canada Cephalon, Inc., Frazer, Pennsylvania, USA
Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567 1. Burden of Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569 2. Treatment Goal of Remission of Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 570 3. Economic Benefits of Treating to Remission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 571 4. Strategies to Achieving Full Remission: Differentiating Antidepressant Therapies . . . . . . . . . . . . . . . . . 572 5. Clinical Review of Venlafaxine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 572 5.1 Remission of Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 572 5.2 Somatic Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573 6. Economic Review of Venlafaxine in Major Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574 6.1 Cost and Effectiveness of Venlafaxine versus Selective Serotonin Receptor Inhibitors . . . . . . . 574 6.2 Effect on Venlafaxine and the Functional Burden of Depression . . . . . . . . . . . . . . . . . . . . . . . . . . 576 6.3 Effect on Venlafaxine and the Economic Burden of Depression . . . . . . . . . . . . . . . . . . . . . . . . . . 576 7. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 577 8. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 579
Abstract
Worldwide, major depression is the leading cause of years lived with a disability, and the fourth cause of disability-adjusted life years. Depression is second only to hypertension as the most common chronic condition encountered in general medical practice. Unfortunately, despite the high prevalence of depression, under-recognition and under-treatment are common. Historically, clinicians have assessed the short-term effectiveness of antidepressants by response rates, often defined as a 50% reduction in depressive symptoms. However, this usually does not reflect true clinical remission, and residual symptoms are common. Persistence of residual symptoms appears to be a common link to rela
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