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Br J Psychiatry. 1999 Jul;175:12-6.

Venlafaxine and paroxetine in treatment-resistant depression. Double-blind, randomised comparison.

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  • 1SHU-Centre Hospitalier Sainte-Anne, Paris.

Erratum in

  • Br J Psychiatry 1999 Oct;175:394.



About one-third of patients fail to respond to initial antidepressant therapy, which suggests a need for more effective drugs.


To compare the efficacy and safety of venlafaxine and paroxetine in 122 patients with non-chronic treatment-resistant depression.


In-patients or out-patients satisfying DSM-III-R criteria for major depression in evolution for less than eight months, having a baseline HAM-D score > or = 18 and a HAM-D Item 3 score < 3 were eligible. Patients were required to have a history of resistance to two previous antidepressant treatments and a CGI improvement score of 3 at the beginning of treatment. Doses were adjusted to 200-300 mg/day for venlafaxine and 30-40 mg/day for paroxetine.


For the observed-case analysis, the response rate was 51.9% for venlafaxine and 32.7% for paroxetine (P = 0.044), and a remission was achieved in 42.3% of venlafaxine-treated and 20.0% of paroxetine-treated patients (P = 0.01). The incidence of adverse effects was comparable between treatment groups.


Venlafaxine showed some evidence of superiority to paroxetine in this difficult-to-treat patient population.

[PubMed - indexed for MEDLINE]
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