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Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Venlafaxine, Desvenlafaxine, Duloxetine, Milnacipran, Levomilnacipran

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NeuroPsychopharmacotherapy

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Abstract

Approved members of the selective serotonin (5-HT) and norepinephrine (NE) reuptake inhibitor (SNRI) class so long are venlafaxine, desvenlafaxine, duloxetine, milnacipran, and levomilnacipran. They differ regarding binding affinity to 5-HT/NE-transporter binding and uptake inhibition, pharmacokinetic properties (half-life, metabolism), and clinical profile (e.g., analgesic properties). Numerous randomized placebo-controlled clinical studies (RCTs) and non-interventional studies have shown efficacy and effectiveness. Some studies reported higher efficacy compared to serotonin selective antidepressants (SSRIs) proposing these drugs for severe and so-called therapy-resistant depressions. Typical side effects are nausea, trouble sleeping, and sexual dysfunction.

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References

  • Acuna C. Duloxetine for the treatment of fibromyalgia. Drugs Today. 2008;44:725–34.

    Article  CAS  Google Scholar 

  • Allgulander C, Hackett D, Salinas E. Venlafaxine extended release (ER) in the treatment of generalized anxiety disorder: twenty-four-week placebo-controlled dose-ranging study. Br J Psychiatry. 2001;179:15–22.

    Article  CAS  PubMed  Google Scholar 

  • Ansseau M, von Frenckell R, Mertens C, de Wilde J, et al. Controlled comparison of two doses of milnacipran (F 2207) and amitriptyline in major depressive inpatients. Psychopharmacology. 1989;98:163–8.

    Article  CAS  PubMed  Google Scholar 

  • Ansseau M, Papart P, Troisfontaines B, Bartholome F, et al. Controlled comparison of milnacipran and fluoxetine in major depression. Psychopharmacology. 1994;114:131–7.

    Article  CAS  PubMed  Google Scholar 

  • Asnis GM, Bose A, Gommoll CP, Chen C, Greenberg WM. Efficacy and safety of levomilnacipran sustained release 40 mg, 80 mg, or 120 mg in major depressive disorder: a phase 3, randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2013;74:242–8.

    Article  CAS  PubMed  Google Scholar 

  • Asnis GM, Henderson MA. Levomilnacipran for the treatment of major depressive disorder: a review. Neuropsychiatr Dis Treat. 2015;11:125–35.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ballus C, Quiros G, De Flores T, et al. The efficacy and tolerability of venlafaxine and paroxetine in outpatients with depressive disorders or dysthymia. Int Clin Psychopharmacol. 2000;15:43–8.

    Article  CAS  PubMed  Google Scholar 

  • Bérard A, Sheehy O, Zhao JP, Vinet É, et al. SSRI and SNRI use during pregnancy and the risk of persistent pulmonary hypertension of the newborn. Br J Clin Pharmacol. 2017;83:1126–33.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bielski RJ, Ventura D, Chang CC. A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. J Clin Psychiatry. 2004;65:1190–6.

    Article  CAS  PubMed  Google Scholar 

  • Brent DA. Antidepressants and suicidality. Psychiatr Clin North Am. 2016;39:503–12.

    Article  PubMed  Google Scholar 

  • Buckley NA, McManus PR. Fatal toxicity of serotonergic and other antidepressant drugs: analysis of United Kingdom mortality data. Br Med J. 2002;325:1332–3.

    Article  Google Scholar 

  • Bymaster FP, Dreshfield-Ahmad LJ, Threlkeld PG, Shaw JL. Comparative affinity of duloxetine and venlafaxine for serotonin and norepinephrine transporters in vitro and in vivo, human serotonin receptor subtypes, and other neuronal receptors. Neuropsychopharmacology. 2001;25:871–80.

    Article  CAS  PubMed  Google Scholar 

  • Carrasco JL, Kornstein SG, McIntyre RS, et al. An integrated analysis of the efficacy and safety of desvenlafaxine in the treatment of major depressive disorder. Int Clin Psychopharmacol. 2016;31:134–46.

    Article  PubMed  Google Scholar 

  • Carter NJ, McCormack PL. Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23:523–41.

    Article  CAS  PubMed  Google Scholar 

  • Cipriani A, Furukawa TA, Salanti G, Chaimani A, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391:1357–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cipriani A, Koesters M, Furukawa TA, Nosè M, et al. Duloxetine versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2012;10:CD006533.

    PubMed  Google Scholar 

  • Citrome L. Levomilnacipran for major depressive disorder: a systematic review of the efficacy and safety profile for this newly approved antidepressant—what is the number needed to treat, number needed to harm and likelihood to be helped or harmed? Int J Clin Pract. 2013;67:1089–104.

    Article  CAS  PubMed  Google Scholar 

  • Clayton AH, Pradko JF, Croft HA, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002;63:357–66.

    Article  PubMed  Google Scholar 

  • Clerc G. Antidepressant efficacy and tolerability of milnacipran, a dual serotonin and noradrenaline reuptake inhibitor: a comparison with fluvoxamine. Int Clin Psychopharmacol. 2001;16:145–51.

    Article  CAS  PubMed  Google Scholar 

  • Clerc GE, Ruimy P, Verdeau-Palles J. A double-blind comparison of venlafaxine and fluoxetine in patients hospitalized for major depression and melancholia. The Venlafaxine French Inpatient Study Group. Int Clin Psychopharmacol. 1994;9:139–43.

    Article  CAS  PubMed  Google Scholar 

  • Coleman KA, Xavier VY. An indirect comparison of the efficacy and safety of desvenlafaxine and venlafaxine using placebo as the common comparator. CNS Spectr. 2012;17:131–41.

    Article  PubMed  Google Scholar 

  • Cording M, Derry S, Phillips T, Moore RA, Wiffen PJ. Milnacipran for pain in fibromyalgia in adults. Cochrane Database Syst Rev. 2015;10:CD008244.

    Google Scholar 

  • Costa e Silva J. Randomized, double-blind comparison of venlafaxine and fluoxetine in outpatients with major depression. J Clin Psychiatry. 1998;59:352–7.

    Article  PubMed  Google Scholar 

  • Cunningham LA, Borison RL, Carman JS, Chouinard G, et al. A comparison of venlafaxine, trazodone, and placebo in major depression. J Clin Psychopharmacol. 1994;14:99–106.

    Article  CAS  PubMed  Google Scholar 

  • Cusack B, Nelson A, Richelson E. Binding of antidepressants to human brain receptors: focus on newer generation compounds. Psychopharmacology. 1994;114:559–65.

    Article  CAS  PubMed  Google Scholar 

  • Davidson JRT, Wittchen HU, Llorca PM, et al. Duloxetine treatment for relapse prevention in adults with generalized anxiety disorder: a double-blind placebo-controlled trial. Eur Neuropsychopharmacol. 2008;18:673–81.

    Article  CAS  PubMed  Google Scholar 

  • Davies J, Read J. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: are guidelines evidence-based? Addict behaviors. 2019;97:111–21.

    Article  Google Scholar 

  • Delini-Stula A. Milnacipran: an antidepressant with dual selectivity of action on noradrenaline and serotonin uptake. Hum Psychopharmacol. 2000;15:255–60.

    Article  CAS  PubMed  Google Scholar 

  • De Vries C, Gadzhanova S, Sykes MJ, Ward M, Roughead E. A systematic review and meta-analysis considering the risk for congenital heart defects of antidepressant classes and individual antidepressants. Drug Saf. 2021;44:291–312.

    Article  PubMed  Google Scholar 

  • Dueñas H, Brnabic AJ, Lee A, Montejo AL. Treatment-emergent sexual dysfunction with SSRIs and duloxetine: effectiveness and functional outcomes over a 6-month observational period. Int J Psychiatry Clin Pract. 2011;15:242–54.

    Article  PubMed  Google Scholar 

  • Eckert L, Lançon C. Duloxetine compared with fluoxetine and venlafaxine: use of meta-regression analysis for indirect comparisons. BMC Psychiatry. 2006;6:30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Einarson TR, Arikian SR, Casciano J, Doyle JJ. Comparison of extended-release venlafaxine, selective serotonin reuptake inhibitors, and tricyclic antidepressants in the treatment of depression: a meta-analysis of randomized controlled trials. Clin Ther. 1999;21:296–308.

    Article  CAS  PubMed  Google Scholar 

  • Einarson A, Fatoye B, Sarkar M, et al. Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study. Am J Psychiatry. 2001;158:1728–30.

    Article  CAS  PubMed  Google Scholar 

  • Entsuah AR, Rudolph RL, Hackett D, Miska S. Efficacy of venlafaxine and placebo during long-term treatment of depression: a pooled analysis of relapse rates. Int Clin Psychopharmacol. 1996;11:137–45.

    CAS  PubMed  Google Scholar 

  • Entsuah R, Gorman JM. Global benefit-risk assessment of antidepressants: venlafaxine XR and fluoxetine. J Psychiatr Res. 2002;36:111–8.

    Article  PubMed  Google Scholar 

  • Ereshefsky L, Dugan D. Review of the pharmacokinetics, pharmacogenetics, and drug interaction potential of antidepressants: focus on venlafaxine. Depress Anxiety. 2000;12(Suppl 1):30–44.

    Article  PubMed  Google Scholar 

  • Fagiolini A, Albert U, Ferrando L, Herman E. A randomized, double-blind study comparing the efficacy and safety of trazodone once-a-day and venlafaxine extended-release for the treatment of patients with major depressive disorder. Int Clin Psychopharmacol. 2020;35:137–46.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fava M. Somatic symptoms, depression, and antidepressant treatment. J Clin Psychiatry. 2002;63:305–7.

    Article  CAS  PubMed  Google Scholar 

  • Fava GA, Benasi G, Lucente M, Offidani E, Cosci F, Guidi J. Withdrawal symptoms after serotonin-noradrenaline reuptake inhibitor discontinuation: systematic review. Psychother Psychosom. 2018;87:195–203.

    Article  PubMed  Google Scholar 

  • Feighner JP. Cardiovascular safety in depressed patients: focus on venlafaxine. J Clin Psychiatry. 1995;56:574–9.

    CAS  PubMed  Google Scholar 

  • Feighner JP, Entsuah AR, McPherson MK. Efficacy of once-daily venlafaxine extended release (XR) for symptoms of anxiety in depressed outpatients. J Affect Disord. 1998;47:55–62.

    Article  CAS  PubMed  Google Scholar 

  • Fric M, Pfuhlmann B, Laux G, Riederer P, et al. The influence of smoking on the serum level of duloxetine. Pharmacopsychiatry. 2008;41:151–5.

    Article  CAS  PubMed  Google Scholar 

  • Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ 2017;189:E747.

    Google Scholar 

  • Gallagher HC, Gallagher RM, Butler M, Buggy DJ, Henman MC. Venlafaxine for neuropathic pain in adults. Cochrane Database Syst Rev. 2015;8:CD011091.

    Google Scholar 

  • Gelenberg AJ, Lydiard RB, Rudolph RL, et al. Efficacy of venlafaxine extended-release capsules in nondepressed outpatients with generalized anxiety disorders. 6-month randomized controlled trial. JAMA. 2000;283:3082–8.

    Article  CAS  PubMed  Google Scholar 

  • Ghaemi NS. Clinical psychopharmacology. Oxford; 2019.

    Google Scholar 

  • Gibbons RD, Brown CH, Hur K, Davis J, Mann JJ. Suicidal thoughts and behavior with antidepressant treatment: reanalysis of the randomized placebo-controlled studies of fluoxetine and venlafaxine. Arch Gen Psychiatry. 2012;69:580–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Goldstein DJ, Lu Y, Detke MJ, et al. Duloxetine in the treatment of depression: a double-blind placebo-controlled comparison with paroxetine. J Clin Psychopharmacol. 2004;24:389–99.

    Article  CAS  PubMed  Google Scholar 

  • Guelfi JD, Ansseau M, Corruble E, Samuelian JC, Tournoux A, Pletan Y. A double-blind comparison of the efficacy and safety of milnacipran and fluoxetine in depressed patients. Int Clin Psychopharmacol. 1998;3:121–8.

    Article  Google Scholar 

  • Harvey AT, Rudolph RL, Preskorn SH. Evidence of the dual mechanisms of action of venlafaxine. Arch Gen Psychiatry. 2000;57:503–9.

    Article  CAS  PubMed  Google Scholar 

  • Hayes RM, Wu P, Shelton RC, Cooper WO, et al. Maternal antidepressant use and adverse outcomes: a cohort study of 228,876 pregnancies. Am J Obstet Gynecol. 2012;207:49.e41–9.

    Article  Google Scholar 

  • Hiemke C, Bergemann N, Clement HW, Conca A, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry. 2018;51:9–62.

    Article  CAS  PubMed  Google Scholar 

  • Kasper S, Pletan Y, Solles A, Tournoux A. Comparative studies with milnacipran and tricyclic antidepressants in the treatment of patients with major depression: a summary of clinical trial results. Int Clin Psychopharmacol. 1996;11(Suppl 4):35–9.

    Article  PubMed  Google Scholar 

  • Keller MB, Trivedi MH, Thase ME, Shelton RC, et al. The prevention of recurrent episodes of depression with venlafaxine for two years (PREVENT) study: outcomes from the 2-year and combined maintenance phases. J Clin Psychiatry. 2007;68:1246–56.

    Article  CAS  PubMed  Google Scholar 

  • Khan A, Fabre LF, Rudolph R. Venlafaxine in depressed outpatients. Psychopharmacol Bull. 1991;27:141–4.

    CAS  PubMed  Google Scholar 

  • Knadler MP, Lobo E, Chappell J, Bergstrom R. Duloxetine: clinical pharmacokinetics and drug interactions. Clin Pharmacokinetics. 2011;50:281–94.

    Article  CAS  Google Scholar 

  • Kocsis JH, Thase ME, Trivedi MH, Shelton RC, et al. Prevention of recurrent episodes of depression with venlafaxine ER in a 1-year maintenance phase from the PREVENT study. J Clin Psychiatry. 2007;68:1014–23.

    Article  CAS  PubMed  Google Scholar 

  • Kornstein SG, Kocsis JH, Ahmed S et al. Assessing the efficacy of 2 years of maintenance treatment with venlafaxine extended release in patients with recurrent major depression: a secondary analysis of data from the prevent study. Int Clin Psychopharmacol 2008;23:357–63.

    Google Scholar 

  • Laoutidis ZG, Kioulos KT. Desvenlafaxine for the acute treatment of depression: a systematic review and meta-analysis. Pharmacopsychiatry. 2015;48:187–99.

    Article  CAS  PubMed  Google Scholar 

  • Lecrubier Y. Milnacipran: the clinical properties of a selective serotonin and noradrenaline reuptake inhibitor (SNRI). Hum Psychopharmacol. 1997;12:127–34.

    Article  Google Scholar 

  • Leinonen E, Leopola U, Mehtonen H, Rimon O-P. Long-term efficacy and safety of milnacipran compared to clomipramine in patients with major depression. Acta Psychiatr Scand. 1997;96:497–504.

    Article  CAS  PubMed  Google Scholar 

  • Liebowitz MR, Gelenberg AJ, Munjack D. Venlafaxine extended release vs placebo and paroxetine in social anxiety disorder. Arch Gen Psychiatry. 2005;62:190–8.

    Article  CAS  PubMed  Google Scholar 

  • Lopez-Ibor J, Guelfi JD, Pletan Y, Tournoux A, Prost JF. Milnacipran and selective serotonin reuptake inhibitors in major depression. Int Clin Psychopharmacol. 1996;11(Suppl 4):41–6.

    Article  PubMed  Google Scholar 

  • Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014;1:CD007115.

    Google Scholar 

  • Macher JP, Sichel JP, Serre C, von Frenckell R, Huck JC, Demares JP. Double-blind placebo-controlled study of milnacipran in hospitalized patients with major depressive disorders. Neuropsychobiology. 1989;22:77–82.

    Article  CAS  PubMed  Google Scholar 

  • Magni LR, Purgato M, Gastaldon C, Papola D, et al. Fluoxetine versus other types of pharmacotherapy for depression. Cochrane Database Syst Rev. 2013;17:CD004185.

    Google Scholar 

  • Mehtonen OP, Sogaard J, Roponen P, Behnke K. Randomized, double-blind comparison of venlafaxine and sertraline in outpatients with major depressive disorder. Venlafaxine 631 Study Group. J Clin Psychiatry. 2000;61:95–100.

    Article  CAS  PubMed  Google Scholar 

  • Montgomery SA, Entsuah R, Hackett D, Kunz NR, Rudolph RL. Venlafaxine versus placebo in the preventive treatment of recurrent major depression. J Clin Psychiatry. 2004;65:328–36.

    Article  CAS  PubMed  Google Scholar 

  • Montgomery SA, Mansuy L, Ruth A, Bose A, et al. Efficacy and safety of levomilnacipran sustained release in moderate to severe major depressive disorder: a randomized, double-blind, placebo-controlled, proof-of-concept study. J Clin Psychiatry. 2013;74:363–9.

    Article  CAS  PubMed  Google Scholar 

  • Nakagawa A, Watanabe N, Omori IM, Barbui C, et al. Efficacy and tolerability of milnacipran in the treatment of major depression in comparison with other antidepressants: a systematic review and meta-analysis. CNS Drugs. 2008;22:587–602.

    Article  CAS  PubMed  Google Scholar 

  • Nakagawa A, Watanabe N, Omori IM, Barbui C, et al. Milnacipran versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2009;8:CD006529.

    Google Scholar 

  • Nelson JC. Safety and tolerability of the new antidepressants. J Clin Psychiatry. 1997;58(6):26–31.

    Google Scholar 

  • Nelson JC, Lu Pritchett Y, Martynov O, Yu JY, Mallinckrodt CH, Detke MJ. The safety and tolerability of duloxetine compared with paroxetine and placebo: a pooled analysis of 4 clinical trials. Prim Care Companion J Clin Psychiatry. 2006;8:212–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nelson JC, Wohlreich MM, Mallinckrodt CH, Detke MJ, et al. Duloxetine for the treatment of major depressive disorder in older patients. Am J Geriatr Psychiatry. 2005;13:227–35.

    Article  PubMed  Google Scholar 

  • Nemeroff CB, Entsuah R, Benattia I, et al. Comprehensive analysis of remission (COMPARE) with venlafaxine versus SSRIs. Biol Psychiatry. 2008;63:424–34.

    Article  CAS  PubMed  Google Scholar 

  • Nierenberg AA, Feighner JP, Rudolph R, Cole J, Sullivan J. Venlafaxine for treatment-resistant depression. J Clin Psychopharmacol. 1994;14:419–23.

    Article  CAS  PubMed  Google Scholar 

  • Oakes TM, Katona C, Liu P, Robinson M, et al. Safety and tolerability of duloxetine in elderly patients with major depressive disorder: a pooled analysis of two placebo-controlled studies. Int Clin Psychopharmacol. 2013;28:1–11.

    Article  PubMed  Google Scholar 

  • Olie JP, Gourion D, Montagne A, Rostin M, Poirier MF. Milnacipran and venlafaxine at flexible doses (up to 200 mg/day) in the outpatient treatment of adults with moderate-to-severe major depressive disorder: a 24-week randomized, double-blind exploratory study. Neuropsychiatr Dis Treat. 2010;6:71–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Papakostas GI, Fava M. A meta-analysis of clinical trials comparing milnacipran, a serotonin—norepinephrine reuptake inhibitor, with a selective serotonin reuptake inhibitor for the treatment of major depressive disorder. Eur Neuropsychopharmacol. 2007;17:32–6.

    Article  CAS  PubMed  Google Scholar 

  • Papakostas GI, Thase ME, Fava M, Nelson JC, Shelton RC. Are antidepressant drugs that combine serotonergic and noradrenergic mechanisms of action more effective than the selective serotonin reuptake inhibitors in treating major depressive disorder? A meta-analysis of studies of newer agents. Biol Psychiatry. 2007;62:1217–27.

    Article  CAS  PubMed  Google Scholar 

  • Perahia DGS, Wang F, Mallinckrodt CH, Walker DJ, Detke MJ. Duloxetine in the treatment of major depressive disorder: a placebo- and paroxetine-controlled trial. Eur Psychiatry. 2006a;21:367–78.

    Google Scholar 

  • Perahia DGS, Pritchett YL, Desaiah D, Raskin J. Efficacy of duloxetine in painful symptoms: an analgesic or antidepressant effect? Int Clin Psychopharmacol 2006b;21:311–7.

    Google Scholar 

  • Perahia DGS, Maina G, Thase ME, et al. Duloxetine in the prevention of depressive recurrences: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2009;70:706–16.

    Article  CAS  PubMed  Google Scholar 

  • Poirier MF, Boyer F. Venlafaxine and paroxetine in treatment-resistant depression: double-blind, randomized comparison. Br J Psychiatry. 1999;175:12–6.

    Article  CAS  PubMed  Google Scholar 

  • Pollack MH, Worthington JJ, Otto MW, et al. Venlafaxine for panic disorder: results from a double-blind, placebo-controlled study. Psychopharmacol Bull. 1996;32:667–70.

    CAS  PubMed  Google Scholar 

  • Preskorn SH. Comparison of the tolerability of bupropion, fluoxetine, imipramine, nefazodone, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry. 1995;56:12–21.

    PubMed  Google Scholar 

  • Puech A, Montgomery SA, Prost JF, Solles A, Briley M. Milnacipran, a new serotonin and norepinephrine reuptake inhibitor: an overview of its antidepressant activity and clinical tolerability. Int Clin Psychopharmacol. 1997;12:99–108.

    Article  CAS  PubMed  Google Scholar 

  • Puozzo C, Panconi E, Deprez D. Pharmacology and pharmacokinetics of milnacipran. Int Clin Psychopharmacology. 2002;17(Suppl 1):S25–35.

    Article  Google Scholar 

  • Richelson E. The clinical relevance of antidepressant interaction with neurotransmitter transporters and receptors. Psychopharmacol Bull. 2002;36:133–50.

    PubMed  Google Scholar 

  • Rickels K, Pollack MH, Sheehan DV, Haskins JT. Efficacy of extended-release venlafaxine in nondepressed outpatients with generalized anxiety disorder. Am J Psychiatry. 2000;157:968–74.

    Article  CAS  PubMed  Google Scholar 

  • Robinson M, Oakes TM, Raskin J, et al. Acute and long-term treatment of late-life major depressive disorder: duloxetine versus placebo. Am J Geriatr Psychiatry. 2014;22:34–45.

    Article  PubMed  Google Scholar 

  • Rouillon F, Warner B, Pezous N, Bisserbe JC. Milnacipran efficacy in the prevention of recurrent depression: a 12-month placebo-controlled study. Int Clin Psychopharmacol. 2000;15:133–40.

    Article  CAS  PubMed  Google Scholar 

  • Rudolph RL, Derivan AT. The safety and tolerability of venlafaxine hydrochloride: analysis of the clinical trials database. J Clin Psychopharmacol. 1996;16(suppl 2):54S–9S.

    Article  CAS  PubMed  Google Scholar 

  • Rudolph RL, Feiger AD. A double-blind, randomized, placebo-controlled trial of once-daily venlafaxine extended release (XR) and fluoxetine for the treatment of depression. J Affect Disord. 1999;56:171–81.

    Article  CAS  PubMed  Google Scholar 

  • Sambunaris A, Bose A, Gommoll CP, Chen C, et al. A phase III, double-blind, placebo-controlled, flexible-dose study of levomilnacipran extended-release in patients with major depressive disorder. J Clin Psychopharmacol. 2014;34:47–56.

    Article  CAS  PubMed  Google Scholar 

  • Samuelian JC, Hackett D. A randomized, double-blind, parallel-group comparison of venlafaxine and clomipramine in outpatients with major depression. J Psychopharmacol. 1998;12:273–8.

    Article  CAS  PubMed  Google Scholar 

  • Sansone RA, Sansone LA. Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison. Innov Clin Neurosci. 2014;11:37–42.

    PubMed  PubMed Central  Google Scholar 

  • Sauer H, Huppertz-Helmhold S, Dierkes W. Efficacy and safety of venlafaxine ER vs. amitriptyline ER in patients with major depression of moderate severity. Pharmacopsychiatry. 2003;36:169–75.

    Article  CAS  PubMed  Google Scholar 

  • Schueler YB, Koesters M, Wieseler B, Grouven U, et al. A systematic review of duloxetine and venlafaxine in major depression, including unpublished data. Acta Psychiatr Scand. 2011;123:247–65.

    Article  CAS  PubMed  Google Scholar 

  • Schweizer E, Feighner J, Mandos LA, Rickels K. Comparison of venlafaxine and imipramine in the acute treatment of major depression in outpatients. J Clin Psychiatry. 1994;55:104–8.

    CAS  PubMed  Google Scholar 

  • Schweizer E, Weise C, Clary C, Fox I, Rickels K. Placebo-controlled trial of venlafaxine for the treatment of major depression. J Clin Psychopharmacol. 1991;11:233–6.

    Article  CAS  PubMed  Google Scholar 

  • Sechter D, Vandel P, Weiller E, Pezous N, Cabanac F, Tournoux A. A comparative study of milnacipran and paroxetine in outpatients with major depression. J Affect Disord. 2004;83:233–6.

    Article  CAS  PubMed  Google Scholar 

  • Shelton RC. Serotonin norepinephrine reuptake inhibitors. In: Macaluso M, Preskorn SH, editors. Antidepressants. Handbook of experimental pharmacology, vol. 250. Springer Nature; 2018.

    Google Scholar 

  • Smith D, Dempster C, Glanville J, Freemantle N, Anderson I. Efficacy and tolerability of venlafaxine compared with selective serotonin reuptake inhibitors and other antidepressants: a meta-analysis. Br J Psychiatry. 2002;180:396–404.

    Article  PubMed  Google Scholar 

  • Spencer CM, Wilde MI. Milnacipran. A review of its use in depression. Drugs. 1998;56:405–27.

    Article  CAS  PubMed  Google Scholar 

  • Stahl S. Essential psychopharmacology. The prescriber’s guide. Antidepressants. 6th ed. Cambridge: Cambridge University Press; 2017.

    Google Scholar 

  • Stahl SM, Entsuah R, Rudolph RL. Comparative efficacy between venlafaxine and SSRIs: a pooled analysis of patients with depression. Biol Psychiatry. 2002;52:1166–74.

    Article  CAS  PubMed  Google Scholar 

  • Steen A, Den Bour JA. A double-blind, six-month comparative study of milnacipran and clomipramine in major depressive disorder. Int Clin Pharmacol. 1997;12:269–81.

    CAS  Google Scholar 

  • Sultan A, Gaskell H, Derry S, Moore RA. Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials. BMC Neurol. 2008;8:29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tatsumi M, Groshan K, Blakely RD, Richelson E. Pharmacological profile of antidepressants and related compounds at human monoamine transporters. Eur J Pharmacol. 1997;340:249–58.

    Article  CAS  PubMed  Google Scholar 

  • Thase ME. Efficacy and tolerability of once-daily venlafaxine extended release (XR) in outpatients with major depression. The Venlafaxine XR 209 Study Group. J Clin Psychiatry. 1997;58:393–8.

    Article  CAS  PubMed  Google Scholar 

  • Thase ME. Effects of venlafaxine on blood pressure: a meta-analysis of original data from 3744 depressed patients. J Clin Psychiatry. 1998;59:502–8.

    Article  CAS  PubMed  Google Scholar 

  • Thase ME, Entsuah AR, Rudolph RL. Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors. Br J Psychiatry. 2001;178:234–41.

    Article  CAS  PubMed  Google Scholar 

  • Thase ME, Clayton AH, Haight BR, Thompson AH, et al. A double-blind comparison between bupropion XL and venlafaxine XR: sexual functioning, antidepressant efficacy, and tolerability. J Clin Psychopharmacol. 2006;26:482–8.

    Article  CAS  PubMed  Google Scholar 

  • Thase ME, Kornstein SG, Germain JM, Jiang Q, et al. An integrated analysis of the efficacy of desvenlafaxine compared with placebo in patients with major depressive disorder. CNS Spectr. 2009;14:144–54.

    Article  PubMed  Google Scholar 

  • Thase ME, Gelenberg A, Kornstein SG, Kocsis JH, et al. Comparing venlafaxine extended release and fluoxetine for preventing the recurrence of major depression: results from the PREVENT study. J Psychiatr Res. 2011;45:412–20.

    Article  PubMed  Google Scholar 

  • Thase ME, Asami Y, Wajsbrot D, Dorries K, et al. A meta-analysis of the efficacy of venlafaxine extended release 75–225 mg/day for the treatment of major depressive disorder. Curr Med Res Opin. 2016;33:317–26.

    Article  PubMed  Google Scholar 

  • Tignol J, Pujol-Domenech J, Chartres JP, Leger JM, et al. Double-blind study of the efficacy and safety of milnacipran and imipramine in elderly patients with major depressive episode. Acta Psychiatr Scand. 1998;97:157–65.

    Article  CAS  PubMed  Google Scholar 

  • Tzanakaki M, Guazelli M, Nimatoudis I, et al. Increased remission rates with venlafaxine compared with fluoxetine in hospitalized patients with major depression and melancholia. Int Clin Psychopharmacol. 2000;15:29–34.

    Article  CAS  PubMed  Google Scholar 

  • Van Amerongen AP, Ferrey G, Tournoux A. A randomized, double-blind comparison of milnacipran and imipramine in the treatment of depression. J Affect Disord. 2002;72:21–31.

    Article  PubMed  Google Scholar 

  • Weinmann S, Becker T, Koesters M. Re-evaluation of the efficacy and tolerability of venlafaxine vs SSRI: meta-analysis. Psychopharmacology. 2008;196:511–20.

    Article  CAS  PubMed  Google Scholar 

  • White N, Litovitz T, Clancy C. Suicidal antidepressant overdoses: a comparative analysis by antidepressant type. J Med Toxicol. 2008;4:238–50.

    Article  PubMed  PubMed Central  Google Scholar 

  • Williams T, McCaul M, Guido Schwarzer G, et al. Pharmacological treatments for social anxiety disorder in adults: a systematic review and network meta-analysis. Acta Neuropsychiatr. 2020;32:169–76.

    Article  PubMed  Google Scholar 

  • Wong MC, Chung JW, Wong TK. Effects of treatments for symptoms of painful diabetic neuropathy: systematic review. BMJ. 2007;335(7610):87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  2. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU), Munich, Germany

    Gerd Laux

  3. Vitos Waldkrankenhaus Köppern, Friedrichsdorf, Germany

    Ansgar Klimke

Authors
  1. Gerd Laux
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  2. Ansgar Klimke
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Correspondence to Gerd Laux .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Bayern, Germany

    Christian Riederer

Section Editor information

  1. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux Dipl.-Psych.

  2. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU), Munich, Germany

    Gerd Laux Dipl.-Psych.

  3. Department of Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany

    Hans-Jürgen Möller

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Laux, G., Klimke, A. (2022). Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Venlafaxine, Desvenlafaxine, Duloxetine, Milnacipran, Levomilnacipran. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_414-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_414-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

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