The International Journal of Neuropsychopharmacology

Venlafaxine compared with fluoxetine in outpatients with depression and concomitant anxiety 1

Andre  De Nayer  a1, Stefaan  Geerts  a2, Leo  Ruelens  a3, Michel  Schittecatte  a4, Eugeen  De Bleeker  a5, Ignace  Van Eeckhoutte  a6, Jean-Luc  Evrard  a7, Paul  Linkowski  a8, Pierre  Fossion  a9, Sophie  Leyman  a10 and Annick  Mignon  a10 c1
a1 Hôpital Ste Thérèse, Montignies sur Sambre, Belgium
a2 Sint Lucas Hospital, Assebroek, Belgium
a3 St Andries Hospital, Tielt, Belgium
a4 Centre Hospitalier Universitaire de Charleroi, Marchienne au Pont, Belgium
a5 St Lucia Hospital, Sint Niklaas, Belgium
a6 Psychiatrisch centrum Heilig Hart, Ieper, Belgium
a7 CHR Val de Sambre, Chatelet, Belgium
a8 Cliniques Universitaires de Bruxelles, Hôpital Erasme, Brussels, Belgium
a9 Cliniques Universitaires de Bruxelles, Hôpital Brugmann, Brussels, Belgium
a10 Wyeth Lederle Belgium, Louvain-la-Neuve, Belgium


The aim of this double-blind study was to compare the efficacy and safety of venlafaxine vs. fluoxetine in the treatment of patients with depression and anxiety. A total of 146 moderately depressed patients with associated anxiety were randomized to receive 75 mg/d venlafaxine or 20 mg/d fluoxetine for 12 wk. Dose increases were permitted after 2 wk of treatment, to 150 mg/d venlafaxine and 40 mg/d fluoxetine, to optimize response. At the final visit, a statistically significantly greater efficacy of venlafaxine over fluoxetine was observed on depressive symptoms and concomitant anxiety, and 75·0 and 50·7% of patients administered venlafaxine and fluoxetine, respectively, showed an overall response. A sustained response (for at least 2 wk), present at the end of the study was achieved in 57·8 and 43·3% of patients in the venlafaxine and fluoxetine groups, respectively, and at the final visit, 59·4 and 40·3% of patients, respectively, were in remission (virtually asymptomatic). Dose increases were required by a greater percentage of patients in the fluoxetine group (52·9%), than in the venlafaxine group (37·1%), and in those patients whose dose was increased, a higher efficacy was again observed with venlafaxine. Venlafaxine and fluoxetine were well tolerated, with the most frequently experienced adverse events being nausea and headache. Fewer patients in the venlafaxine group than in the fluoxetine group reported at least one adverse event (55·7 and 67·1% patients, respectively). Venlafaxine therefore proved to be significantly more effective than fluoxetine in improving depressive symptoms and concomitant anxiety.

(Received July 22 2001)
(Reviewed September 12 2001)
(Revised December 4 2001)
(Accepted December 7 2001)

Key Words: Concomitant anxiety; depression; fluoxetine; venlafaxine.

c1 Address for correspondence: A. Mignon, Medical Department, Wyeth Lederle Belgium, rue du Bosquet 15, B-1348 Louvain-la-Neuve, Belgium. Tel.: +32 (0) 10 494 854 Fax: +32 (0) 10 494 650 E-mail:


1 This article was presented in part at the XI World Congress of Psychiatry, Hamburg, Germany, 6–11 August 1999, and at the 12th European College of Neuropsychopharmacology Congress, London, 21–25 September 1999.