Assessing the Efficacy of Desvenlafaxine for Improving Functioning and Well-Being Outcome Measures in Patients With Major Depressive Disorder

Nov 13, 2009The Journal of clinical psychiatry

Desvenlafaxine's effects on daily functioning and well-being in major depression: combined results from 9 clinical trials

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Abstract

Desvenlafaxine therapy resulted in a 2.0 point improvement in total Sheehan Disability Scale scores compared with placebo.

Significant improvements were observed in individual Sheehan Disability Scale items related to work (-0.6), social life/leisure activities (-0.8), and family life/home responsibilities (-0.7; P < .001 for all).
Desvenlafaxine therapy led to a 1.7 point increase in the total World Health Organization Well-Being Index score, with notable improvements in individual aspects such as good spirits (0.4) and feeling calm/relaxed (0.4; P < .001 for all).
Improvements in the Hamilton Depression Rating Scale work/activities item (-0.2; P < .001) and the Montgomery-Asberg Depression Rating Scale lassitude item (-0.3; P < .001) were also significant compared to placebo.
All individual fixed-dose groups showed significant differences across all outcomes (P < .05), although no dose-response relationship was evident.

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OBJECTIVE: To evaluate the effects of desvenlafaxine therapy on functioning and well-being in major depressive disorder (MDD).

METHOD: Total and individual item Sheehan Disability Scale (SDS) and 5-item World Health Organization Well-Being Index (WHO-5) scores from 8 double-blind, placebo-controlled, 8-week desvenlafaxine clinical trials were pooled. Scores on the 17-item Hamilton Depression Rating Scale (HDRS(17)) work/activities and Montgomery-Asberg Depression Rating Scale (MADRS) lassitude items were pooled from 9 studies. Outpatients with DSM-IV MDD were randomly assigned to fixed (5 studies; 50, 100, 200, or 400 mg/d; n = 1,342) or flexible (4 studies, 100-400 mg/d; n = 463) doses of desvenlafaxine or placebo (n = 1,108). Data from each patient's final evaluation were analyzed for the total population and for individual dose groups from the fixed-dose studies and were compared between groups using analysis of covariance.

RESULTS: Compared with placebo, desvenlafaxine therapy resulted in significantly greater improvements in SDS total score (-2.0) and individual items regarding work (-0.6), social life/leisure activities (-0.8), and family life/home responsibilities (-0.7; P < .001 for all comparisons), as well as WHO-5 total score (1.7) and individual items (good spirits [0.4], calm/relaxed [0.4], active/vigorous [0.3], fresh/rested [0.3], and interest [0.3]; P < .001 for all comparisons). Desvenlafaxine treatment resulted in significant improvements on the HDRS(17) work/activities (-0.2; P < .001) and MADRS lassitude (-0.3; P < .001) items compared with placebo. Significant differences were observed for the individual fixed-dose groups on all outcomes (P < .05); there was no evidence of a dose-response relationship.

CONCLUSIONS: Desvenlafaxine therapy resulted in significant improvements in the functioning and well-being among MDD patients.

Assessing the Efficacy of Desvenlafaxine for Improving Functioning and Well-Being Outcome Measures in Patients With Major Depressive Disorder

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