Analysis of Symptoms in Patients With Major Depressive Disorder Treated With Desvenlafaxine or Placebo

Background: The aim of this study was to evaluate the impact of desvenlafaxine on a broad range of major depressive disorder (MDD) symptoms. Methods: Data were pooled from 9 double-blind, randomized, placebo-controlled, 8-week studies of desvenlafaxine in adult outpatients with MDD. Intent-to-treat participants received fixed- (50, 100, 200, or 400 mg/d; n = 1342) or flexible-dose (100 to 400 mg/d, n = 463) desvenlafaxine or placebo (n = 1108). Final on-therapy scores for individual items of the 17-item Hamilton Rating Scale for Depression (HAM-D17) and the Montgomery Åsberg Depression Rating Scale (MADRS) were compared between groups using analysis of covariance. Efficacy at different doses was examined using the subset of fixed-dose studies. Results: Based on differences in adjusted mean changes from baseline (desvenlafaxine vs placebo), statistically significant advantages with desvenlafaxine (50 to 400 mg/d, all doses pooled) vs placebo were seen for 10 of the 17 HAM-D17 items: depressed mood (0.4; P < 0.001), feelings of guilt (0.2; P < 0.001), suicide (0.1; P < 0.001), late insomnia (0.1; P < 0.001), work and activities (0.2; P < 0.001), psychomotor retardation (0.1; P < 0.001), agitation (0.1; P < 0.001), psychic anxiety (0.3; P < 0.001), general somatic symptoms (0.2; P 0.05). Symptom relief was similar with all desvenlafaxine doses examined, including 50 mg/d. Conclusions: Short-term desvenlafaxine therapy (50 to 400 mg/d) improved a broad range of emotional and physical symptoms in outpatients with MDD. Psychopharmacology Bulletin. 2009;42(3):21–35.