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Efficacy and Safety of Venlafaxine-ECT Combination in Treatment-Resistant Depression

Received November 20, 2000; revised February 10, 2001; accepted February 22, 2001. From Hospital Santiago Apostol, Department of Psychiatry, Vitoria, Spain (A.G.-P., M.G., N.G., E.E., J.L.P.H.), and the Department of Neuroscience, Neuropsychopharmacology Unit, Faculty of Medicine, University of Cádiz, Spain (J.A.M.). Address correspondence to Dr. Gonzalez-Pinto, Hospital Santiago Apostol, Department of Psychiatry, Olaguibel 29, Vitoria, Basque Country, Spain. E-mail: agonzalez{at}sscc.osakidetza.net

ABSTRACT

Thirteen patients with treatment-resistant major depression were given venlafaxine, at doses ranging from 150 mg to 375 mg, combined with ECT. Propofol was used as an anesthetic. Ten of 13 (76.9%) were considered responsive to combined ECT-venlafaxine treatment, and positive responses were not associated with venlafaxine doses. An asystole episode was observed in 4 patients; these patients had received significantly higher doses of venlafaxine (P<0.01). Treatment seems to be safe at venlafaxine doses <300 mg/day. At higher doses, with propofol used as anesthetic, the possibility of asystole cannot be ruled out. A possible additive effect of high-dose venlafaxine and propofol-blocking sodium channels are discussed.

Key Words: Venlafaxine • ECT • Depression

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