Predictors of Treatment with Duloxetine or Venlafaxine XR among Adult Patients Treated for Depression in Primary Care Practices in the United Kingdom.

Nianwen Shi,Emily Durden,Zhun Cao,Michael Happich,Amelito Torres

doi:10.1155/2012/815363

Abstract

Background. Knowledge about real-world use of duloxetine and venlafaxine XR to treat depression in the UK is limited. Aims. To identify predictors of duloxetine or venlafaxine XR initiation. Method. Adult depressed patients who initiated duloxetine or venlafaxine XR between January 1, 2006 and September 30, 2007 were identified in the UK's General Practice Research Database. Demographic and clinical predictors of treatment initiation with duloxetine and venlafaxine XR were identified using logistic regression. Results. Patients initiating duloxetine (n = 909) were 4 years older than venlafaxine XR recipients (n = 1286). Older age, preexisting unexplained pain, respiratory disease, and pre-period use of anticonvulsants, opioids, and antihyperlipidemics were associated with increased odds of initiating duloxetine compared to venlafaxine XR. Pre-period anxiety disorder was associated with decreased odds of receiving duloxetine. Conclusion. Initial treatment choice with duloxetine versus venlafaxine XR was primarily driven by patient-specific mental and medical health characteristics. General practitioners in the UK favor duloxetine over venlafaxine XR when pain conditions coexist with depression.

Highlights

Major depressive disorder (MDD) is a mood disorder characterized by persistent feelings of sadness, a pervasive low mood, diminished ability to experience pleasure, and cognitive symptoms such as difficulty concentrating and impaired memory
Women were overrepresented in both treatment cohorts, but no significant difference was observed in the gender distribution between groups (67.7%/duloxetine, 64.5%/venlafaxine XR, P = 0.120)
Patients treated with duloxetine were 4 years older than patients treated with venlafaxine XR (49.6 ± 16.5 years versus 45.5 ± 16.1 years; P < 0.001)

Summary

Introduction

Major depressive disorder (MDD) is a mood disorder characterized by persistent feelings of sadness, a pervasive low mood, diminished ability to experience pleasure, and cognitive symptoms such as difficulty concentrating and impaired memory. Introduced in 1995 in the UK, venlafaxine XR is a SNRI indicated for major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder. Duloxetine, marketed in 2005, is approved for treatment of major depressive disorder, diabetic peripheral neuropathic pain, and generalized anxiety disorder. To identify predictors of duloxetine or venlafaxine XR initiation. Adult depressed patients who initiated duloxetine or venlafaxine XR between January 1, 2006 and September 30, 2007 were identified in the UK’s General Practice Research Database. Demographic and clinical predictors of treatment initiation with duloxetine and venlafaxine XR were identified using logistic regression. Older age, preexisting unexplained pain, respiratory disease, and pre-period use of anticonvulsants, opioids, and antihyperlipidemics were associated with increased odds of initiating duloxetine compared to venlafaxine XR. Initial treatment choice with duloxetine versus venlafaxine XR was primarily driven by patient-specific mental and medical health characteristics. General practitioners in the UK favor duloxetine over venlafaxine XR when pain conditions coexist with depression

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