Review of duloxetine and venlafaxine in depression

Canadian Pharmacists Journal

Volumn 142, Issue 3, 2009, Pages 144-152

  Zerjav, Sylvia ^a,b   Tse, Gordon ^c   Scott, Michael J W ^d  

^a British Columbia Mental Health and Substance Use Services   (Canada)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^c FRASER HEALTH AUTHORITY   (Canada)

^d Prince George Regional Hospital   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ACENOCOUMAROL; ANTIHISTAMINIC AGENT; CLOZAPINE; CORTICOSTEROID; CYTOCHROME P450 2D6; DESVENLAFAXINE; DEXAMETHASONE; DULOXETINE; ESCITALOPRAM; FLUOXETINE; FLUVOXAMINE; LITHIUM; MONOAMINE OXIDASE INHIBITOR; NEUROLEPTIC AGENT; NORADRENALIN; PARACETAMOL; PAROXETINE; PIMOZIDE; PLACEBO; QUINOLINE DERIVED ANTIINFECTIVE AGENT; RISPERIDONE; SEROTONIN; SEROTONIN UPTAKE INHIBITOR; TRAMADOL; TRICYCLIC ANTIDEPRESSANT AGENT; TRIPTAN DERIVATIVE; UNINDEXED DRUG; VENLAFAXINE; WARFARIN; ZIPRASIDONE;

ABDOMINAL PAIN; AGITATION; ALANINE AMINOTRANSFERASE BLOOD LEVEL; ALCOHOL CONSUMPTION; ALKALINE PHOSPHATASE BLOOD LEVEL; AMINOTRANSFERASE BLOOD LEVEL; ANOREXIA; ANORGASMIA; ANTICHOLINERGIC SYNDROME; AREA UNDER THE CURVE; ASPARTATE AMINOTRANSFERASE BLOOD LEVEL; ASTHENIA; ATAXIA; BILE DUCT OBSTRUCTION; BILIRUBIN BLOOD LEVEL; BLOOD PRESSURE; BLURRED VISION; CARDIOVASCULAR DISEASE; CHOLESTASIS; CIGARETTE SMOKING; CLINICAL TRIAL; CONFUSION; CONSTIPATION; CONVULSION; DELIRIUM; DEPRESSION; DIAPHORESIS; DIASTOLIC BLOOD PRESSURE; DIZZINESS; DOSE RESPONSE; DRUG ABSORPTION; DRUG ANTAGONISM; DRUG BLOOD LEVEL; DRUG CLEARANCE; DRUG COST; DRUG DISTRIBUTION; DRUG DOSE INCREASE; DRUG DOSE REDUCTION; DRUG DOSE TITRATION; DRUG EFFICACY; DRUG ELIMINATION; DRUG FATALITY; DRUG FORMULATION; DRUG HALF LIFE; DRUG MECHANISM; DRUG MEGADOSE; DRUG METABOLISM; DRUG POTENTIATION; DRUG PROTEIN BINDING; DRUG SAFETY; DRUG TOLERABILITY; DRUG URINE LEVEL; DRUG WITHDRAWAL; ENDOCRINE DISEASE; ERECTILE DYSFUNCTION; EVENING DOSAGE; FATIGUE; FLUSHING; FOOD; FOOD DRUG INTERACTION; GASTROINTESTINAL SYMPTOM; GERIATRIC PATIENT; GLUCOSE BLOOD LEVEL; HALLUCINATION; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HEART MUSCLE CONDUCTION DISTURBANCE; HEART RATE; HEPATITIS; HEPATOMEGALY; HUMAN; HYDROCORTISONE BLOOD LEVEL; HYPERGLYCEMIA; HYPERTENSION; HYPERTENSIVE CRISIS; HYPONATREMIA; HYPOTENSION; INAPPROPRIATE VASOPRESSIN SECRETION; INSOMNIA; IRRITABILITY; JAUNDICE; KIDNEY DYSFUNCTION; LIBIDO DISORDER; LIVER CELL DAMAGE; LIVER DISEASE; LIVER INJURY; LIVER TOXICITY; MAJOR DEPRESSION; METABOLIC DISORDER; MORNING DOSAGE; MYDRIASIS; NAUSEA; NAUSEA AND VOMITING; NEUROLOGIC DISEASE; ORTHOSTATIC HYPOTENSION; PATIENT COMPLIANCE; PR INTERVAL; PRURITUS; QRS COMPLEX; QT PROLONGATION; RASH; RECOMMENDED DRUG DOSE; REM SLEEP; REM SLEEP DEPRIVATION; REVIEW; RHINITIS; SEDATION; SEIZURE; SEROTONIN SYNDROME; SEXUAL AROUSAL DISORDER; SEXUAL DYSFUNCTION; SIDE EFFECT; SINGLE DRUG DOSE; SINUS TACHYCARDIA; SKIN DISEASE; SLOW WAVE SLEEP; SOMNOLENCE; SUICIDAL IDEATION; SWEATING; SYNCOPE; SYSTEMATIC REVIEW; SYSTOLIC BLOOD PRESSURE; URINE INCONTINENCE; URINE RETENTION; VOMITING; WEIGHT GAIN; WEIGHT REDUCTION; XEROSTOMIA; YAWNING;

EID: 68349112817     PISSN: 17151635     EISSN: None     Source Type: Journal    
DOI: 10.3821/1913-701X-142.3.144     Document Type: Review

References (103)

1. Preskorn SH. Milnacipran: a dual norepinephrine and serotonin reuptake pump inhibitor. J Psychiatr Pract 2004;10:57-63.
2. Sibutramine. In: Repchinsky C, editor. Compendium of pharmaceuticals and specialties 2007. Ottawa (ON): Canadian Pharmacists Association; 2007.
3. Wong DT, Robertson DW, Bymaster FP, et al. LY227942, an inhibitor of serotonin and norepinephrine uptake: biochemical pharmacology of a potential antidepressant drug. Life Sci 1988;43:2049-57.
4. Bymaster FP, Dreshfield-Ahmad LJ, Threlkeld PG, et al. Comparative affinity of duloxetine and venlafaxine for serotonin and norepinephrine transporters in vitro and in vivo, human serotonin receptor subtypes, and other neuronal receptors. Neuropsychopharmacology 2001;25:871-80.
5. Tran PV, Bymaster FP, McNamara RK, Potter W. Dual monoamine modulation for improved treatment of major depressive disorder. J Clin Psychopharmacol 2003;23:78-86.
6. Koch S, Hemrick-Luecke SK, Thompson LK, et al. Comparison of effects of dual transporter inhibitors on monoamine transporters and extracellular levels in rats. Neuropharmacology 2003;45(7):935-44.
7. Roseboom PH, Kalin NH. Neuropharmacology of venlafaxine. Depress Anxiety 2000;12 Suppl 1:20-9.
8. Richelson E. The clinical relevance of antidepressant interaction with neurotransmitter transporters and receptors. Psychopharmacol Bull 2002;36(4):133-50.
9. Iyengar S, Webster AA, Hemrick-Luecke SK, et al. Efficacy of duloxetine, a potent and balanced serotonin-norepinephrine reuptake inhibitor in persistent pain models in rats. J Pharmacol Exp Ther 2004;311:576-84.
10. Westanmo AD, Gayken J, Haight R. Duloxetine: a balanced selective norepinephrine- and serotonin-reuptake inhibitor. Am J Health Syst Pharm 2005;62:2481-90.
11. Wong DT, Bymaster FP. Dual serotonin and noradrenaline uptake inhibitor class of antidepressants: potential for greater efficacy or just hype? Prog Drug Res 2002;58:169-222.
12. Turcotte JE, Debonnel G, de Montigny C, et al. Assessment of the serotonin and norepinephrine reuptake blocking properties of duloxetine in healthy subjects. Neuropsychopharmacology 2001;24:511-21.
13. Chalon SA, Granier LA, Vendenhende FR, et al. Duloxetine increases serotonin and norepinephrine availability in healthy subjects: a double-blind, controlled study. Neuropsychopharmacology 2003;28:1685-93.
14. Lott RS, Baker DE. Duloxetine: a new antidepressant. Adv Pharm 2003;1(3):228-41.
15. Perahia DGS, Pritchett YL, Kajdasz DK, et al. A randomized, double-blind comparison of duloxetine and venlafaxine in the treatment of patients with major depressive disorder. J Psychiatr Res 2007;42:22-34.
16. Goldstein DJ, Mallinckrodt C, Lu Y, Demitrack MA. Duloxetine in the treatment of major depressive disorder: a double-blind clinical trial. J Clin Psychiatry 2002;63:225-31.
17. Detke MJ, Lu Y, Goldstein DJ, et al. Duloxetine, 60 mg once daily, for major depressive disorder: a randomized double-blind placebo-controlled trial. J Clin Psychiatry 2002;63:308-15.
18. Detke MJ, Lu Y, Goldstein DJ, et al. Duloxetine once daily dosing versus placebo in the acute management of major depression. J Psychiatr Res 2002;36:383-90.
19. Goldstein DJ, Lu Y, Detke MJ, et al. Duloxetine in the treatment of depression: a double-blind placebo-controlled comparison with paroxetine. J Clin Psychopharmacol 2004;24:389-99.
20. Detke MJ, Wiltse CG, Mallinckrodt CH, et al. Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo- and paroxetine-controlled trial. Eur Neuropsychopharmacol 2004;14:457-70.
21. Perahia DG, Gilaberte I, Wang F, et al. Duloxetine in the prevention of relapse of major depressive disorder: a double-blind placebo-controlled study. Br J Psychiatry 2006;188:346-53.
22. Pigott TA, Prakash A, Arnold LM, et al. Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder. Curr Med Res Opinion 2007;23(6):1303-18.
23. Khan A, Bose A, Alexopoulos GS, et al. Double-blind comparison of escitalopram and duloxetine in the acute treatment of major depressive disorder. Clin Drug Investig 2007;27(7):481-92.
24. Wade AG, Gembert K, Florea I. A comparative study of the efficacy of acute and continuation treatment with escitalopram versus duloxetine in patients with major depressive disorder. Curr Med Res Opinion 2007;23(3):1605-14.
25. Lantz RJ, Gillespie TA, Rash TJ, et al. Metabolism, excretion, and pharmacokinetics of duloxetine in healthy human subjects. Drug Metab Dispos 2003;31(9):1142-50.
26. Skinner MH, Kuan H-Y, Pan A, et al. Duloxetine is both an inhibitor and a substrate of cytochrome P4502D6 in healthy volunteers. Clin Pharmacol Ther 2003;73(3):170-7.
27. Eli Lilly and Co. Cymbalta (duloxetine): highlights of prescribing information. Available: http://pi.lilly.com/us/cymbaltapi.pdf (accessed March 15, 2007).
28. Klamerus KJ, Maloney K, Rudolph RL, et al. Introduction of a composite parameter to the pharmacokinetics of venlafaxine and its active O-desmethyl metabolite. J Clin Pharmacol 1992;32:716-24.
29. Ereshefsky L. Drug-drug interactions involving antidepressants: focus on venlafaxine. J Clin Psychopharmacol 1996;16(3 Suppl 2):37S-53S.
30. Ereshefsky L, Dugan D. Review of the pharmacokinetics, pharmacogenetics, and drug interaction potential of antidepressants: focus on venlafaxine. Depress Anxiety 2000;12 Suppl 1:30-44.
31. Rendic S. Summary of information on human CYP enzymes: human P450 metabolism data. Drug Metab Rev 2002; 34(1-2):83-448.
32. Hudson JI, Wohlreich MM, Kajdaz DK, et al. Safety and tolerability of duloxetine in the treatment of major depressive disorder: analysis of pooled data from eight placebo-controlled clinical trials. Hum Psychopharmacol Clin Exp 2005;20:327-41.
33. Venlafaxine (Effexor). In: Compendium of pharmaceuticals and specialties 2008. Ottawa (ON): Canadian Pharmacists Association; 2008. Available: https://www.e-therapeutics.ca/wps/portal/ut/p/.scr/ Login (accessed January 13, 2009).
34. Schweizer E, Clary C, Weise C, et al. An open-label, dose-finding study of WY-45,030: a novel bicyclic antidepressant. Psychopharmacol Bull 1988;24:195-7.
35. Clayton AH, Montejo AL. Major depressive disorder, antidepressants, and sexual function. J Clin Psychiatry 2006;67 Suppl 6:33-7.
36. Detke MJ, Lu Y, Goldstein DJ, et al. Duloxetine 60 mg once daily dosing versus placebo in the acute management of major depression. J Psychiatr Res 2002;36:383-90.
37. Clayton AH, Pradko F, Croft HA, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry 2002;63:357-66.
38. McGahuey CA, Gelenberg AJ, Laukes CA, et al. The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Marital Ther 2000;26:25-40.
39. Williams K, Reynolds MF. Sexual dysfunction in major depression. CNS Sectr 2006;11(8 Suppl 9):19-23.
40. Clayton A, Kornstein S, Prakash A, et al. Changes in sexual functioning associated with duloxetine, escitalopram, and placebo in the treatment of patients with major depressive disorder. J Sex Med 2007;4(4 Pt 1):917-29.
41. Kluge M, Schussler P, Steiger A. Duloxetine increases stage 3 sleep and suppresses rapid eye movement (REM) sleep in patients with major depression. Eur Neuropsychopharmacol 2007;17(8):527-31.
42. De Las Cuevas C, Sanz E. Duloxetine-induced excessive disturbing and disabling yawning [letter]. J Clin Psychopharmacol 2007;27(1):106-7.
43. Duloxetine (Cymbalta®). In: Compendium of pharmaceuticals and specialties 2008. Ottawa (ON): Canadian Pharmacists Association; 2008. Available: https://www.e-therapeutics.ca/wps/portal/!ut/p/.scr/ Login (accessed January 9, 2009).
44. White MC, Gailey RA, Levin GM, Smith T. Seizure resulting from venlafaxine overdose. Ann Pharmacother 1997;31:178-80.
45. Zhalkovsky B, Walker D, Bourgeois JA. Seizure activity and enzyme elevations after venlafaxine overdose [letter]. J Clin Psychopharmacol 1997;17:490-1.
46. Schlienger RG, Klink MH, Eggenberger C, Drewe J. Seizures associated with therapeutic doses of venlafaxine and trimipramine. Ann Pharmacother 2000;34:1402-5.
47. Thase ME, Tran PV, Wiltse C, et al. Cardiovascular profile of duloxetine, a dual reuptake inhibitor of serotonin and norepinephrine. J Clin Psychopharmacol 2005;25(2):132-40.
48. Zhang L, Chappell J, Gonzales CR, et al. Callaghan QT effects of duloxetine at supratherapeutic doses: a placebo and positive controlled study. J Cardiovasc Pharmacol 2007;49(3):146-53.
49. Colucci VJ, Berry BD. Heart failure worsening and exacerbation after venlafaxine and duloxetine therapy. Ann Pharmacother 2008; 42:882-7.
50. Feighner JP. Cardiovascular safety in depressed patients: focus on venlafaxine. J Clin Psychiatry 1995;56(12):574-9.
51. Wernicke J, Lledo A, Raskin J, et al. An evaluation of the cardiovascular safety profile of duloxetine: findings from 42 placebo-controlled studies. Drug Saf 2007;30(5):437-55.
52. Hanje AJ, Pell LJ, Votolato NA, et al. Case report: fulminant hepatic failure involving duloxetine hydrochloride. Clin Gastroenterol Hepatol 2006;4(7):912-7.
53. Duloxetine. In: American hospital formulary 2006. Bethesda (MD): Board of American Society of Health-System Pharmacists; 2006.
54. The Merck Manual's online medical library. Laboratory test. Available: www.merck.com/mmpe/sec03/ch023/ch023b.html (accessed January 9, 2009).
55. Cymbalta (duloxetine hydrochloride). Available: www.fda.gov/MEDwatch/ SAFETY/2004/sep_PI/Cymbalta_PI.pdf (accessed January 9, 2009).
56. Cardona X, Avila A, Castellanos P. Venlafaxine-associated hepatitis [letter]. Ann Intern Med 2000;132:417.
57. Horsmans Y, De Clereq M, Sempeux C. Venlafaxine-associated hepatitis [letter]. Ann Intern Med 1999;30:944
58. Sencan I, Sahin I, Ozcetin A. Low-dose venlafaxine-associated liver toxicity in chronic hepatitis [letter]. Ann Pharmacother 2004;38:352-3.
59. Phillips BB, Digmann RR, Beck MG. Hepatitis associated with low-dose venlafaxine for postmenopausal vasomotor symptoms. Ann Pharmacother 2006;40(2):323-7.
60. Lee WM. Drug-induced hepatotoxicity. N Engl J Med 2003;349:474-85.
61. Rudolph RL, Derivan AT. The safety and tolerability of venlafaxine hydrochloride: analysis of the clinical trials database. J Clin Psychopharmacol 1996;16 Suppl 2:54S-61S.
62. Ezzo DC, Patel PN. Facial flushing associated with duloxetine use. Am J Health Syst Pharm 2007;64(5):495-6.
63. Oulis P, Masdrakis V, Karakatsanis N. Duloxetine-induced cutaneous adverse reaction [letter]. J Clin Psychopharmacol 2008; 28(1):104-5.
64. Sternbach H. Venlafaxine-induced galactorrhea [letter]. J Clin Psychopharmacol 2003;23:109-10.
65. Ashton AK, Longdon MC. Hyperprolactinemia and galactorrhea induced by serotonin and norepinephrine reuptake inhibiting antidepressants [letter]. Am J Psychiatry 2007;164(7): 1121-2.
66. Maramattom BV. Duloxetine-induced syndrome of inappropriate antidiuretic hormone secretion and seizures. Neurology 2006;66(5):773-4.
67. Adverse Drug Reactions Advisory Committee. Venlafaxine: not just an SSRI? Aust Adv Drug React Bull 1998;7:2.
68. Adverse Drug Reactions Advisory Committee. Selective serotonin reuptake inhibitors and SIADH. Med J Aust 1996;164:562.
69. Anderson IK, Martin GR, Ramage AG. Central administration of 5-HT activates 5-HT1A receptors to cause sympathoexcitation and 5-HT2/5-HT1C receptors to release vasopressin in anaesthetized rats. Br J Pharmacol 1992;107:1020-8.
70. Brownfield MS, Greathouse H, Lorens SA, et al. Neuropharmacological characterization of serotoninergic stimulation of vasopressin secretion in conscious rats. Neuroendocrinology 1988;47:277-83.
71. Ledingham JGG. Water and sodium homeostasis. In: Weatherall DJ, Ledingham JGG, Warrell DA, editors. Oxford textbook of medicine. Vol 2. Oxford (England): Oxford University Press; 1987:18-29.
72. Spigset O, Hedenmalm K. Hyponatraemia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by psychotropic drugs. Drug Saf 1995;12:209-25.
73. Hardy T, Sachson R, Shen S, et al. Does treatment with duloxetine for neuropathic pain impact glycemic control? Diabetes Care 2007;30:21-6.
74. Nelson JC, Pritchett YL, Martynov O, et al. The safety and tolerability of duloxetine compared with paroxetine and placebo: a pooled analysis of 4 clinical trials. Prim Care Companion J Clin Psychiatry 2006;8:212-9.
75. Wise TN, Perahia GD, Pangallo BA, et al. Effects of the antidepressant duloxetine on body weight: analyses of 10 clinical studies. Prim Care Companion J Clin Psychiatry 2006:8:269-78.
76. Henequin JC. Cell biology of insulin secretion. In: Kahn C, Weir G, editors. Joslin's diabetes mellitus. 13th ed. Baltimore, (MD): Williams and Wilkins; 1994:56-80.
77. Lembo G, Capaldo B, Rendina V, et al. Acute noradrenergic activation induces insulin resistance in human skeletal muscle. Am J Physiol 1994;266:E242-7.
78. Silverstone PH, Ravidran A. Once-daily venlafaxine extended release (XR) compared with fluoxetine in outpatients with depression and anxiety. Venlafaxine XR 360 Study Group. J Clin Psychiatry 1999;60:22-8.
79. Bradwejn J, Ahokas A, Stein DJ, et al. Venlafaxine extended-release capsules in panic disorder: a flexible dose, double-blind, placebo-controlled study. Br J Psychiatry 2005;187:352-9.
80. Liebowitz MR, Mangano RM, Bradwejn J, Asnis G. A randomized controlled trial of venlafaxine extended release in generalized social anxiety disorder. J Clin Psychiatry 2005;66:238-47.
81. Daffner-Bugia C, Laakmann G, Voderholzer U, et al. The neuroendocrine effects on venlafaxine in healthy subjects. Hum Psychopharmacol 1996;11:1-9.
82. Parikh AR, Thatcher BT, Tamano EA, Liskow BI. Suicidal ideation associated with duloxetine use: a case series [letter]. J Clin Psychopharmacol 2008;28(1):101-2.
83. Schweizer E, Feighner J, Mandos LA, et al. Comparison of venlafaxine and imipramine in the acute treatment of major depression in outpatients. J Clin Psychiatry 1994;55:104-8.
84. Settle EC Jr. Antidepressant drugs: disturbing and potentially dangerous adverse effects. J Clin Psychiatry 1998;59 Suppl 16: 25-30.
85. Mazur JE, Doty JD, Krygiel AS. Fatality related to a 30 g venlafaxine overdose. Pharmacotherapy 2003;23:1668-72.
86. Health Canada endorsed important safety information on venlafaxine XR. Available: www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/ medeff/venlaflaxine_hpc-cps-eng.pdf (accessed January 9, 2009).
87. Shah R, Uren Z, Baker A, Majeed A. Deaths from antidepressants in England and Wales 1993-1997: analysis of a new national database. Psychol Med 2001;31:1203-1.
88. Cheeta S, Schifano F, Oyefeso A, et al. Antidepressant related deaths and antidepressant prescriptions in England and Wales, 1998-f2000. Brf J Psychiatry 2004;184:41-7.
89. Buckley NA, McManus PR. Fatal toxicity of serotonergic and other antidepressant drugs: analysis of United Kingdom mortality data. BMJ 2002;325:1332-3.
90. Morgan O, Griffiths C, Baker A, Majeed A. Fatal toxicity of antidepressants in England and Wales, 1993-2002. Health Stat Q 2004;23:18-24.
91. Glueck CJ, Khalil Q, Winiarska M, et al. Interaction of duloxetine and warfarin causing severe elevation of international normalized ratio. JAMA 2006;295(13):1517-8.
92. Monastero R, Camarda R, Camarda C. Potential drug-drug interaction between duloxetine and acenocoumarol in a patient with Alzheimer's disease. Clin Ther 2007;29(12):2706-9.
93. Thase ME. Effects of venlafaxine on blood pressure: a meta-analysis of original data from 3744 depressed patients. J Clin Psychiatry 1998;59:502-8.
94. Preskorn SH. Reproducibility of the in vivo effect of the selective serotonin reuptake inhibitors on the in vivo function of cytochrome P450 2D6: an update (part I). J Psychiatr Pract 2003;9:150-8.
95. Preskorn SH. Reproducibility of the in vivo effect of the selective serotonin reuptake inhibitors on the in vivo function of cytochrome P450 2D6: an update (part II). J Psychiatr Pract 2003;9:228-36.
96. Preskorn SH. Duloxetine. Psychopharmacology 2004;10(6): 375-85.
97. Dunner DL, Wohlreich MM, Mallinckrodt CH, et al. Clinical consequences of initial duloxetine dosing strategies: comparison of 30 and 60 mg QD doses. Curr Ther Res Clin Exp 2005;66(6): 522-40.
98. Von Moltke LL, Greenblatt DJ, Shader RI. Clinical pharmacokinetics of antidpressants in the elderly. Therapeutic implications. Clin Pharmacokinet 1993;24:141-60.
99. Skinner MH, Kuan HY, Skerjanec A, et al. Effect of age on the pharmacokinetics of duloxetine in women. Br J Clin Pharmacol 2004;57(1):54-61.
100. Raskin J, Wiltse CG, Siegal A, et al. Efficacy of duloxetine on cognition, depression, and pain in elderly patients with major depressive disorder: an 8-week, double-blind, placebo-controlled trial. Am J Psychiatry 2007;164:900-9.
101. Klamerus KJ, Parker VD, Rudolph RL, et al. Effects of age and gender on venlafaxine and O-desmethylvenlafaxine pharmacokinetics. Pharmacotherapy 1996;16:915-23.
102. European Medicines Agency. Duloxetine. Available: www.emea.europa.eu/ humandocs/PDFs/EPAR/cymbalta/H-572-PI-en.pdf (accessed January 16, 2009).
103. Troy SM, Schultz RW, Parker VD, et al. The effect of renal disease on the disposition of venlafaxine. Clin Pharmacol Ther 1994;56(1):14-21.