Therapy Effects on Working Ability by Venlafaxine Compared to Serotonin Reuptake Inhibitors in the Treatment of Major Depressive Disorder of Different Severity

Aim: By reducing the working ability depression causes a considerable financial burden to national economics. Drug therapies increase the rate of patients reaching remission and complete working ability. Here we compared the effects of venlafaxine and serotonin reuptake inhibitors (SSRIs) as a class on working ability of patients with major depressive disorder (MDD). Methods: Data from the work and activity item 7 of the Hamilton depression scale (HAM-D17) of 31 doubleblind, randomized studies with 6492 patients in total were used to measure working ability. The rate of patients reaching "full working ability" after week 8 was determined. Results: With item 7 significantly higher rates of "full working ability" were observed with venlafaxine compared to SSRIs in patients with a baseline HAM-D17 < 30 (LOCF 29.0 vs. 25.2%, p < 0.001; OC35.2 vs. 31.1%, p = 0.015). Within the group of severely depressed patients (baseline HAM-D17 > 30) the advantage of venlafaxine was even more pronounced (LOCF 27.8 vs. 17.6%, p = 0.002; OC33.8 vs. 23.8%, p = 0.032). Conclusion: This analysis emphasizes the clinical relevance of higher remission rates of venlafaxine demonstrated in meta-analyses; costs caused by decreased working ability of patients with depressive disorder can be reduced. Instruments for direct measurement of working ability could quantify more exactly the potential of venlafaxine in cost reduction.