Efficacy of venlafaxine extended release in major depressive disorder patients: effect of baseline anxiety symptom severity

Effects of baseline anxiety on the efficacy of venlafaxine extended release versus placebo were examined in a post hoc pooled subgroup analysis of 1573 patients enrolled in eight short-term studies of major depressive disorder. Anxiety subgroups were defined based on baseline 17-item Hamilton Rating Scale for Depression Item 10 score <3 (low) versus ≥3 (high). Change from baseline to final visit in Montgomery–Åsberg Depression Rating Scale total score and Montgomery–Åsberg Depression Rating Scale response and remission rates were analyzed. Change from baseline in Montgomery–Åsberg Depression Rating Scale total score and response and remission rates was significantly greater for venlafaxine extended release versus placebo in both low and high anxiety subgroups (all P < 0.0001). A statistically significant baseline anxiety by treatment interaction was observed for Montgomery–Åsberg Depression Rating Scale total score only (P = 0.0152). The adjusted mean change from baseline in Montgomery–Åsberg Depression Rating Scale total score was significantly greater in the high anxiety subgroup versus low anxiety subgroup for patients treated with venlafaxine extended release (−6.27 versus −3.89; P = 0.0440) but not placebo. These results support the efficacy of venlafaxine extended release for major depressive disorder treatment in patients with anxiety symptoms.