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Objective:To investigate the efficacy of venlafaxine combined with transcranial direct current stimulation in the treatment of postpartum depression and its effects on neurological function.Methods:A total of 135 patients with postpartum depression who were admitted to Wenzhou Seventh People's Hospital from November 2019 to October 2021 were included in this study. They were randomly divided into observation ( n = 70) and control ( n = 65) groups. The control group was treated with venlafaxine alone, and the observation group was treated with an IS200 intelligent electrical stimulator based on the treatment used in the control group. The two groups were treated for 4 weeks. Clinical efficacy and neurological function were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group (98.57% vs. 89.23%, χ2 = 7.61, P < 0.05). After treatment, the scores of Edinburgh Postnatal Depression Scale and Hamilton Depression Scale in the observation group were (8.03 ± 0.79) points and (9.03 ± 3.98) points, respectively, which were significantly lower than (11.74 ± 0.98) points and (14.68 ± 3.79) points in the control group ( t = 3.28, 4.65, both P < 0.05). Standard deviation of heart rate variability, root mean square of successive differences between adjacent NN intervals, ratio of low frequency to high frequency, activity of the autonomic nervous system in the observation group were (32.38 ± 0.93) ms, (27.86 ± 0.78) ms, 1.79 ± 0.19, (86.65 ± 1.21) points, respectively, which were significantly higher than (27.84 ± 0.88) ms, (25.79 ± 0.81) ms, 1.38 ± 0.14, (82.94 ± 1.19) points in the control group ( t = 4.09, 3.72, 2.98, 4.09, all P < 0.05). Conclusion:Venlafaxine combined with transcranial direct current stimulation for treatment of postpartum depression can enhance clinical efficacy and remarkably improve patient's neurological function.
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OBJECTIVE@#To explore the effectiveness and safety of the combined treatment with acupuncture and venlafaxine hydrochloride on depression in terms of the microstructure change of white matter fiber tracts of brain based on diffusion tensor imaging technology (DTI).@*METHODS@#The prospective study design was adopted. All of 60 patients with depression were randomized into an acupuncture-medication group and a medication group, 30 cases in each one. In the medication group, venlafaxine hydrochloride was used, 75 mg per day in the 1st week, 150 mg per day in the 2nd week and 225 mg per day from the 3rd to 6th week. In the acupuncture-medication group, on the base of the treatment in the medication group, acupuncture was combined. Baihui (GV 20) and Yintang (GV 29) were the main acupoints. The supplementary acupoints were selected according to the clinical symptoms of individuals. The needles were retained for 30 min. Acupuncture was provided once every 2 days, 3 times a week. The consecutive 12 weeks of treatment were required in the two groups. Additionally, a normal group was prepared with 30 healthy volunteers. Separately, before treatment, in 2, 8 and 12 weeks of treatment, Hamilton's depression scale (HAMD-17), Beck depression inventory scale (BDI) and the antidepressant side effect scale (SERS) were adopted to evaluate the effectiveness and safety of the two groups. Moreover, before and after 12 weeks of treatment, DTI was adopted to detect the fractional anisotropy score (FA) of each brain region in the patients.@*RESULTS@#After treatment, the scores of HAMD-17 and BDI were all reduced in the two groups (0.05). Compared with the healthy volunteers, FA scores in 6 brain regions changed obviously in the patients with depression, including the white matter of bilateral frontal lobes, splenium of corpus callosum, left cingulated gyrus, white matter of bilateral inferior temporal gyrus, white matter of bilateral inferior parietal lobe and white matter of bilateral deep temporal occipital region separately. Before treatment, the differences in FA scores of these 6 brain regions were not significant statistically between the two groups (>0.05). After treatment, FA scores in the white matter of bilateral frontal lobes, white matter of bilateral inferior temporal gyrus and white matter of bilateral deep temporal occipital region in the acupuncture-medication group were all higher than those in the medication group (<0.05).@*CONCLUSION@#Acupuncture repairs the brain white matter fiber tracts in some brain regions to certain extent and the therapeutic effects are enhanced with the adjuvant medication of venlafaxine hydrochloride.
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Humans , Acupuncture Therapy , Brain , Depression , Therapeutics , Diffusion Tensor Imaging , Prospective Studies , Venlafaxine HydrochlorideABSTRACT
Objective To investigate the clinical effect of sodium valproate tablets combined with venlafaxine hydrochloride sustained-release tablets in female patients with schizophrenia complicated with affective disorders and its influence on the recurrence time.Methods From January 2013 to July 2016,98 female patients with schizophrenia complicated by affective disorder in Taiyuan Mental Hospital were selected and randomly divided into single group (n =49) and combination group (n =49) according to the digital table.The single drug group was treated with sodium valproate tablets,and the combination group was treated with venlafaxine hydrochloride sustained-release tablets on the basis of a single drug group.The clinical efficacy and recurrence time of the two groups were compared.Results The scores of withdrawal symptoms [(4.39 ± 0.94) points],positive symptoms [(11.55 ± 4.30) points],negative symptoms [(11.09 ± 1.21) points] and psychiatric symptoms [(12.01 ±2.16) points] in the combination group were all significantly lower than those at 1 month after treatment[(10.98 ±1.43) points,(16.74 ± 3.89) points,(18.43 ± 2.05) points,(19.83 ± 3.44) points] (t =12.957,18.471,all P ＜0.05).The incubation period and amplitude of the P300 potentials in the combination group were (314.55 ± 9.21) s,(4.05 ± 1.76)s,respectively,which were both higher than those of the single drug group [(341.60 ± 25.87)s,(2.58 ± 2.30)s] (t =18.251,15.738,all P ＜ 0.05).The eye movements of the combination group 12 weeks after operaion were (27.30 ± 1.41) s and (6.15 ± 0.98) s,respectively,which were higher than those of the single drug group[(25.10 ± 2.93) s and (5.10 ± 1.20) s] (t =13.992,15.836,all P ＜ 0.05).The recurrence rate of the combined group was 8.16％,which was lower than 18.37％ of the single drug group(x2 =6.893,P ＜ 0.05).The hospitalization duration [(14.83 ± 4.61)d],symptom improvement time [(34.94 ± 7.85)d] of the combined group were shorter than those of the single drug group [(27.91 ± 7.49) d,(59.81 ± 10.94) d] (t =18.946,21.461,all P ＜ 0.05).The recurrence time at 12 weeks after treatment of the combination group was (148.48 ± 33.19)d,which was longer than (109.46 ±28.88)d of the single drug group(t =16.893,P ＜0.05).Conclusion The combination of sodium valproate tablets and venlafaxine hydrochloride sustained-release tablets in.patients with schizophrenia complicated with affective disorders can improve the clinical effect,shorten the recurrence time and improve the cognitive function of patients,which is worth popularizing and applying.
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Venlafaxine is a serotonergic and noradrenergic reuptake inhibitor which is used for the treatment of depression. We report a case of galactorrhea in a patient with major depressive disorder after starting treatment with venlafaxine. In particular, we discuss the course of hyper and normoprolactinemic galactorrhea. We managed this side effect initially by dose reduction and further by switching to essitalopram. Physicians should be aware of endocrinologic side effects such as galactorrhea during the serotonin and noradrenaline reuptake inhibitor treatment.
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Female , Humans , Pregnancy , Depression , Depressive Disorder, Major , Galactorrhea , Norepinephrine , Prolactin , Serotonin , Venlafaxine HydrochlorideABSTRACT
OBJECTIVE:To prepare Venlafaxine hydrochloride sustained-release tablets,and to investigate the characteristics of drug release. METHODS:Using glyceryl behenate as lipidic matrix material and HPMC as hydrophilic matrix material,the kind and dosage of excipients were screened by single factor experiment. Using 4,8,24 h accumulative release rate and the deviation summation of ideal values as index,the viscosity of HPMC,the amounts of HPMC K15M and glyceryl behenate were optimized by orthogonal test. The dissolution curves were fitted by different equations. RESULTS:The optimal formulation was as follows as venlafaxine hydrochloride 8.5 kg,HPMC K15M 15 kg,glyceryl behenate 26 kg,magnesium stearate 0.5 kg. 4,8,24 h accumula-tive release rates of prepared matrix sustained-release tablets were 34.3%,63.9% and 99.2%,respectively. The releases profiles of hydrophilic and lipidic matrix sustained release tablets followed first-order equation in vitro mainly through matrix erosion. CON-CLUSIONS:Venlafaxine hydrochloride hydrophilic and lipidic matrix sustained-release tablets with good sustained-release effect have been prepared successfully.
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Objective To optimize the formulations of venlafaxine hydrochloride ( VH ) emulsions by using central composite design-response surface methodology. Methods The effect of amounts of Arlacel P135, VH, PEG-400, and NaCl on the emulsion viscosity, centrifugation breakage, and mean diameter was systemically investigated, respectively. The desirable formulation that combining these three response variables was constructed. Linear equations and a second-order polynomial equation were fitted to the data, and the outcome equation was used to predict the responses in the optimal region. Results There was a quantitative relationship between 4 factors and 3 evaluation indexes and evaluation the “desirability” . The optimal formulation of the VH emulsion were as follows:taking 0. 48 g of Arlacel P135, 0. 40 g of VH, 0. 26 g of PEG-400, and 0. 025 g of NaCl. The experimental values of the response variables were highly closed to the predict values. Conclusion The model presents good prediction and can be used to optimize the preparation of VH emulsion, which obtaining stable W/O emulsion.
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OBJECTIVE: During the transition to menopause, various symptoms including vasomotor symptoms and depressed mood lead to low quality of life. We investigated the effect of low-dose venlafaxine hydrochloride extended release on depressed mood and vasomotor symptoms of perimenopausal women. METHODS: 33 perimenopausal women fulfilling Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for a depressive episode were enrolled between January 2014 and May 2014. Subjects were prescribed 37.5 mg/day or 75 mg/day venlafaxine hydrochloride according to clinician's judgement, and the dosages were maintained for 8 weeks. Depressed mood and other psychological difficulties were evaluated by using Hamilton Rating Scale for Depression (HAMD), Hamilton Rating Scale for Anxiety (HAMA), Clinical Global Impression-Severity. Climacteric symptoms including vasomotor symptoms were evaluated by using Greene Climacteric Scale (GCS). For statistical analysis, paired t-test was used. RESULTS: Significant decreases in HAMD, HAMA, GCS scores were observed after 2 weeks of treatment and the trends continued until the end of the study. The scores of HAMD significantly decreased, 28 of them reached remission (HAMD < or =7). The scores on vasomotor symptoms of GCS after 8 week treatment significantly decreased compared to baseline (13.1+/-5.0, p<0.01). CONCLUSION: These results suggest that venlafaxine hydrochloride is effective and tolerable treatment option for vasomotor symptoms and depressed mood in perimenopausal women. To validate our results, furthur studies with double-blind, placebo controlled will be needed.
Subject(s)
Female , Humans , Anxiety , Climacteric , Depression , Diagnostic and Statistical Manual of Mental Disorders , Menopause , Quality of Life , Venlafaxine HydrochlorideABSTRACT
OBJECTIVE: To establish a liquid chromatography tandem mass spectrometry (LC-MS-MS) method for simultaneous determination of venlafaxine (Ven) and its active metabolite, O-desmethylvenlafaxine (ODV), in human plasma, and to investigate the pharmacokinetics and bioequivalence of Ven and ODV in venlafaxine hydrochloride capsules in Chinese healthy volunteers. METHODS: Twenty-two volunteers took a single oral dose (50 mg) of venlafaxine hydrochloride capsules by 2-way crossover design. The concentrations of Ven and ODV in plasma were determined by HPLC-MS-MS. The pharmacokinetic parameters were calculated by BAPP software. RESULTS: Blood samples were deproteinized . The calibration curves of Ven and ODV were linear in the range from 1.99 to 510 μg · L-1 (r=0.9997) and 1.96 to 501 μg · L-1 (r=0.9999), respectively. The relative recovery was 92.2%-105.9%. The intra-day and inter-day RSDs were less than 10.5%. The pharmacokinetic parameters of test and reference capsules of Ven were as follows: ρmax were (68.90 ± 23.8) and (69.81 ± 23.73) μg · L-1, tmax were (2.2 ± 0.7) and (1.9 ± 0.8) h, t1/2 were (5.0 ± 1.1) and (4.9 ± 1.6) h, AUC0-24 were (547.91 ± 288.66) and (592.70 ± 330.70) μg · h · L-1, respectively; the pharmacokinetic parameters of test and reference capsules of ODV were as follows; ρmax were (73.88 ± 21.18) and (73.96 ± 22.09) μg · L-1, tmax were (3.8 ± 1.8) and (4.0 ± 1.6) h, t1/2 were (8.7 ± 1.8) and (8.9 ± 1.9) h, AUC0-48 were (1 224.41 ± 239.46) and (1243.53 ± 287.19) μg · h · L-1, respectively. The relative bioavalabilities of Ven and ODV in the test capsules were (107.8 ± 22.0)% and (99.6 ± 10.7)%, respectively. CONCLUSION: The HPLC-MS-MS method for simultaneous determination of Ven and ODV in plasma is proved to be sensitive, accurate and convenient. The reference and test capsules are bioequivalent. Copyright 2012 by the Chinese Pharmaceutical Association.