Anxiety Disorders

Venlafaxine XR Safe, Effective in Treating Generalized Anxiety Disorder

Laurel Ranger
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People near the middle of social hierarchies suffer higher rates of depression and anxiety
People near the middle of social hierarchies suffer higher rates of depression and anxiety
The previous study of venlafaxine XR had a small sample size and was unable to estimate safety or tolerability.

Results of a meta-analysis published in PLOS ONE demonstrate that venlafaxine extended release (XR) is an effective and well-tolerated treatment option in adults with generalized anxiety disorder (GAD). 

Xinyuan Li of the department of neurology, Neuroscience Centre, the First Teaching Hospital of Jilin University, Changchun, China, and colleagues conducted a literature search that included Pubmed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science. From these sources, 10 eligible articles that included 14 randomized double-blind, placebo-controlled multicenter clinical trials were ultimately selected and the data extracted. 

The meta-analysis included a combined population of 3622 patients with moderately severe GAD. Venlafaxine XR was significantly more effective than placebo in mean change in the Hamilton Rating Scale for Anxiety total score (mean difference=3.31; P =.0005), response rate (odds ratio [OR] = 1.83; P <.00001), and remission (OR=2.55; P =.003). The most common adverse effects were nausea, dry mouth, dizziness, insomnia, somnolence, and headache. 

The discontinuation rate due to any cause was comparable between the venlafaxine XR and placebo groups. However, the discontinuation rate due to adverse events was statistically higher in the venlafaxine XR group (OR=2.80; P <.00001), while discontinuation due to lack of effectiveness was significantly lower in the venlafaxine XR group than the placebo group (OR=0.26; P <.00001).

 The large sample size offered sufficient data to study the safety and tolerability of Venlafaxine XR and provided additional evidence of its therapeutic benefit. This meta-analysis demonstrates that venlafaxine XR may be an effective treatment option for GAD, a common disorder with an estimated lifetime prevalence of 4.3% to 5.9%.

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Limitations included the lack of restriction on fixed or flexible dose, which may have increased heterogeneity and the potential for selection and reporting bias.

Reference

Li X, Zhu L, Su Y, Fang S. Short-term efficacy and tolerability of venlafaxine extended release in adults with generalized anxiety disorder without depression: a meta-analysis. PLOS ONE. 2017;12(10):e0185865.