Ö.Ayhan KALYONCU, Devran TAN, Hasan MIRSAL, Özkan PEKTAŞ, Mansur BEYAZYÜREK

The efficacy of venlafaxine on depressive symtoms of patients diagnosed with both alcohol use disorder and major depressive disorder

Amaç: Bu çalışmanın amacı alkol kullanım bozukluğu ve majör depresif bozukluk tanısı olan hastalardaki depresyon belirtileri üzerine venlafaksinin etkinliğini belirlemektir. Yöntem: Çalışmaya; DSM IV tanı ölçütlerine göre hem alkol kullanım bozukluğu hem de majör depresif bozukluk tanısı alan, başlangıçta Hamilton Depresyon Ölçeği (HDÖ) puanı en az 14 olan, en az iki haftadan bu yana alkol almayan 18-65 yaşları arasındaki hastalar alınmıştır. Çalışmanın ilk haftasında hastalara 75 mg/gün venlafaksin verilmiştir. İkinci haftada doz çalışmanın tedavi dozu olan 150 mg/güne çıkılmıştır. Hastalara; Hamilton Anksiyete Ölçeği (HAÖ), HDÖ, Klinik Global Izlem (KGI) ölçeği, Belirti Tarama Listesi 90-R (BTL 90-) uygulanmıştır. Hastalar tedavi öncesi ve tedavinin 1., 8., 15., 22., 29., 43., 57. günlerinde değerlendirilmiştir. Bulgular: Çalışmaya 61 hasta alınmıştır. İki hasta çalışma dışı kalmış ilk görüşmeye 59 hasta alınmış 4 hasta çalışmayı bırakmıştır. Çalışmayı bırakma nedenleri; iki olguda depresif belirtilerin artış göstermesi, bir olguda manik aşamaya geçiş ve bir olguda alkol kullanımıdır. Tedavi süreci içinde HDÖ, HAÖ ve BTL 90-R puanlarında istatiksel olarak da anlamlı azalma saptanmıştır. Sonuç: Bulgularımız, hem alkol kullanım bozukluğu hem de majör depresif bozukluk tanısı olan hastalarda venlafaksin tedavisi ile depresyon ve anksiyete belirtilerinde belirgin iyileşme olduğuna işaret etmektedir.

Alkol kullanım bozukluğu ve majör depresif bozukluk tanısı olan hastalardaki depresyon belirtileri üzerine venlafaksinin etkinliği

Objective: The aim of our study was to determine the efficacy of venlafaxine on depressive symptoms of patients diagnosed with both alcohol use disorder and major depressive disorder. Method: Patients with a diagnosis of both alcohol use disorder and MDD (Major Depressive Disorder) according to DSM-IV criteria, baseline Hamilton Depression Scale (HAM-D) scores of minimum 14 at first evaluation, abstinence from alcohol for at least 2 weeks and an age between 18 – 65 years were enrolled to the study. In the first week of the study, venlafaxine XR was administered at 75 mg/day. In the second week the dosage was increased to 150 mg/day which was the accepted treatment dosage. Hamilton Anxiety Scale (HAM-A), HAM-D, Clinical Glogal Impression Scale (CGI) and Symptom Check List (SCL-90-R) tests were applied to the patients. The patients were evaluated prior to study and on days –1, 8, 15, 22, 29, 43 and 57 of drug treatment. Results: A total of 61 patients were screened for the study. As a result, 59 patients were included in the first visit and 4 of these patients discontinued the study. The reasons for discontinuation were: increase of depressive symptoms in two cases; one case manic shift; resumption of alcohol use in one case. HAM-D, HAM-A and SCL-90-R total scores decreased during the treatment period and this decrease was also statistically significant. Conclusion: Our results suggest significant improvement in depression and anxiety symptoms during venlafaxine XR treatment in patients diagnosed with both alcohol use disorder and major depressive disorder.

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