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Cardiovascular changes associated with venlafaxine in the treatment of late-life depression.
- Source :
-
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2006 Sep; Vol. 14 (9), pp. 796-802. - Publication Year :
- 2006
-
Abstract
- Background: Potential cardiovascular side effects from venlafaxine-XR must be considered when prescribing this medication, especially in geriatric patients, who often present with comorbid medical conditions.<br />Methods: Participants age 60 and older with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of a major depressive episode without psychotic features were treated openly with venlafaxine-XR for 12 weeks during which venlafaxine-XR was titrated based on tolerability and response according to predefined guidelines. Sitting and standing blood pressures and heart rates were measured. A 12-lead electrocardiogram was obtained at baseline and at week 12.<br />Results: Sixty-two participants started treatment; 59 completed at least two weeks of the 12-week study. The mean final dose of venlafaxine-XR was 195.5 mg/day (standard deviation: 72.2). Twenty-four percent (95% confidence interval [CI]: 7.3%-40.7%) of initially normotensive participants and 54% (95% CI: 34.3%-74%) of those with preexisting hypertension experienced an increase in blood pressure. Twenty-nine percent (95% CI: 14.6%-43.4%) of participants developed orthostatic hypotension. Two participants experienced a clinically significant increase in QTc interval. One participant reported new-onset mild dizziness, whereas four participants reported new-onset tachycardia or palpitation. Overall, 17 unique participants (28.8%; 95% CI: 17.3%-40.4%) experienced a new-onset cardiovascular problem, potentially related to the study medication.<br />Conclusion: Overall, venlafaxine-XR was well tolerated. However, similar to previous reports, venlafaxine-XR was associated with some undesirable cardiovascular effects in some of the participants. Systematic monitoring of cardiovascular parameters during treatment with venlafaxine-XR should be strongly recommended, especially in the elderly.
- Subjects :
- Age of Onset
Aged
Arrhythmias, Cardiac chemically induced
Arrhythmias, Cardiac epidemiology
Cardiovascular Diseases physiopathology
Cognition Disorders diagnosis
Cognition Disorders epidemiology
Comorbidity
Cyclohexanols therapeutic use
Depressive Disorder, Major diagnosis
Diagnostic and Statistical Manual of Mental Disorders
Drug Administration Schedule
Drug Monitoring methods
Electrocardiography
Female
Guidelines as Topic
Heart Rate physiology
Humans
Hypertension chemically induced
Hypertension epidemiology
Hypotension, Orthostatic chemically induced
Hypotension, Orthostatic epidemiology
Male
Neuropsychological Tests
Selective Serotonin Reuptake Inhibitors therapeutic use
Severity of Illness Index
Tachycardia chemically induced
Tachycardia epidemiology
Venlafaxine Hydrochloride
Cardiovascular Diseases chemically induced
Cardiovascular Diseases epidemiology
Cyclohexanols adverse effects
Depressive Disorder, Major drug therapy
Depressive Disorder, Major epidemiology
Selective Serotonin Reuptake Inhibitors adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1064-7481
- Volume :
- 14
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 16943176
- Full Text :
- https://doi.org/10.1097/01.JGP.0000204328.50105.b3