@article{fa7de525910d416692576c456ae8031a,
title = "Hypertension and orthostatic hypotension with venlafaxine treatment in depressed older adults",
abstract = "Background: Venlafaxine, a serotonin–norepinephrine reuptake inhibitor, is often used as first- or second-line therapy for depression in older adults. It can be associated with adverse blood pressure (BP) effects. Methods: Adults ⩾60 years of age in a current major depressive episode were treated in a protocolized manner with venlafaxine XR; 429 participants were treated for 8–16 weeks with a daily dose up to 300 mg to achieve remission from depression. Cardiac measures included sitting and standing BP and heart rate. Results: Of participants who were normotensive at baseline, 6.5% were found to have elevated BP during the study (1.9% '225 mg/day; 9.8% ⩾225 mg/day). There was no significant change in mean BP in the overall sample, or in the subgroup treated with doses ⩾225 mg/day. Additionally, 20.1% of the participants who did not have orthostatic hypotension at baseline were found to have orthostatic hypotension (16.8% '225 mg/day; 22.4% ⩾225 mg/day). Participants with new-onset orthostatic hypotension were significantly more likely to fall than the other participants. Conclusion: A large proportion of older adults treated with venlafaxine experience orthostatic hypotension, putting them at risk for falls. A smaller proportion experience elevated BP. Older patients prescribed venlafaxine, particularly at high doses, should be advised and counseled about these adverse effects.",
keywords = "Depression, geriatric, hypertension, norepinephrine, orthostatic hypotension, reuptake inhibitor, serotonin, venlafaxine",
author = "Rafae Wathra and Mulsant, {Benoit H.} and Lauren Thomson and Goldberger, {Kyle W.} and Lenze, {Eric J.} and Karp, {Jordan F.} and Marcos Sanches and Reynolds, {Charles F.} and Blumberger, {Daniel M.}",
note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: R.W. receives research support from the Clinician Scientist Program through the Department of Psychiatry at the University of Toronto. B.H.M. currently receives research support from Brain Canada, the Canadian Institutes of Health Research, the CAMH Foundation, the Patient-Centered Outcomes Research Institute (PCORI), the US National Institute of Health (NIH), Capital Solution Design LLC (software used in a study founded by CAMH Foundation), and HAPPYneuron (software used in a study founded by Brain Canada). He directly own stocks of General Electric (<$5000). Within the past three years, he has also received research support from Eli Lilly (medications for a National Institutes of Health (NIH)-funded clinical trial) and Pfizer (medications for a NIH-funded clinical trial). E.J.L. receives research support from the US NIH, the Patient-Centered Outcomes Research Institute (PCORI), McKnight Brain Research Foundation, Takeda, and Lundbeck, and consulting fees (past) from Janssen and Jazz Pharmaceuticals. J.F.K. receives medication supplies for investigator-initiated studies from Pfizer and Indivior, and serves on the scientific advisory board of Aifred Health. C.F.R. has received research support from the NIH, PCORI, the Center for Medicare and Medicaid Services, the American Foundation for Suicide Prevention, the Brain and Behavior Research Foundation, and the Commonwealth of Pennsylvania. Bristol Meyers Squib and Pfizer have provided pharmaceutical supplies for his NIH-sponsored research. D.M.B. receives research support from the Canadian Institutes of Health Research (CIHR), US NIH, Weston Brain Institute, Brain Canada, and the Temerty Family through the CAMH Foundation and the Campbell Research Institute. He received research support and in-kind equipment support for an investigator-initiated study from Brainsway Ltd., and he is the site principal investigator for three sponsor-initiated studies for Brainsway Ltd. He received in-kind equipment support from Magventure for two investigator-initiated studies. He received medication supplies for an investigator-initiated trial from Indivior. He has participated in an advisory board for Janssen. L.T., K.W.G., and M.S. report no conflicting interests. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study was supported primarily by the National Institute of Mental Health (R01 MH083660 and P30 MH90333 to University of Pittsburgh, R01 MH083648 to Washington University, and R01 MH083643 to University of Toronto). Additional funding was provided by the UPMC Endowment in Geriatric Psychiatry, the Taylor Family Institute for Innovative Psychiatric Research (at Washington University), the Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences (NCATS), and the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto. Publisher Copyright: {\textcopyright} The Author(s) 2020.",
year = "2020",
month = oct,
day = "1",
doi = "10.1177/0269881120944154",
language = "English",
volume = "34",
pages = "1112--1118",
journal = "Journal of Psychopharmacology",
issn = "0269-8811",
number = "10",
}