Venlafaxine XR matches paroxetine for panic disorder: equal efficacy, tolerability

OB/GYN News,  Oct 15, 2003  by Bruce Jancin

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SAN FRANCISCO -- The serotonin-norepinephrine reuptake inhibitor venlafaxine is as effective as paroxetine in the treatment of panic disorder, Dr. Mark Pollack reported at the annual meeting of the American Psychiatric Association.

Venlafaxine extended-release (Effexor XR) achieves remission faster than paroxetine (Paxil), a selective serotonin reuptake inhibitor with a Food and Drug Administration-approved indication for treatment of panic disorder. But after 12 weeks of therapy, the proportion of patients who are panic-free is virtually identical with the two drugs. Side effect profiles are quite similar, too, with the exception of significantly more somnolence with paroxetine, added Dr. Pollack of Massachusetts General Hospital, Boston.

He reported on 634 patients with panic disorder who participated in a 12-week, multicenter, randomized, double-blind head-to-head comparison of venlafaxine XR at 75 mg/day, venlafaxine XR at 150 mg/day, paroxetine at 40 mg/day, or placebo. The trial was funded by Wyeth Research, which markets Effexor XR.

The remission rate in the venlafaxine group was significantly better than that of placebo-group patients by week 4. Paroxetine-treated patients were ahead in remission rates by week 6.

After 12 weeks, 54% of those on venlafaxine XR 75 mg/day were panic-free, as were 61% on venlafaxine XR 150 mg/day, 60% on paroxetine, and 34% on placebo. Rates of remission, defined as being panic-free and having a Clinical Global Impression-Improvement score of 1, were 45% and 47% on 75 and 150 mg/day of venlafaxine XR, 46% on paroxetine, and 27% on placebo.

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