TY - JOUR
T1 - The Effect of Venlafaxine on Electrocardiogram Intervals during Treatment for Depression in Older Adults
AU - Behlke, Lauren M.
AU - Lenze, Eric J.
AU - Pham, Vy
AU - Miller, J. Philip
AU - Smith, Timothy W.
AU - Saade, Yasmina
AU - Karp, Jordan F.
AU - Reynolds, Charles F.
AU - Blumberger, Daniel M.
AU - Stefan, Cristiana
AU - Mulsant, Benoit H.
N1 - Funding Information:
D.M.B. has received research support from CIHR, Brain Canada, and the Temerty Family through the CAMH Foundation and the Campbell Family Research Institute. He received research support and in-kind equipment support for an investigator-initiated study from Brainsway, Ltd. He is the site principal investigator for 3 sponsor-initiated studies for Brainsway, Ltd. He also receives in-kind equipment support from Magventure for 2 investigator-initiated studies. He received medication supplies for an investigator-initiated trial from Indivior.
Funding Information:
This study was supported by the National Institute of Mental Health, UPMC Endowment in Geriatric Psychiatry, Taylor Family Institute for Innovative Psychiatric Research, National Center for Advancing Translational Sciences, Center for Brain Research in Mood Disorders, and the Campbell Family Mental Health Research Institute. This study was supported mainly 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. Pfizer contributed venlafaxine XR capsules for this study.
Funding Information:
E.J.L. has received research support from Takeda, Lundbeck, Janssen, the Taylor Family Institute for Innovative Psychiatric Research, the Barnes-Jewish Foundation, the Patient-Centered Outcomes Research Institute, and the McKnight Brain Research Foundation. He has received consulting fees from Janssen and Jazz Pharmaceuticals.
Funding Information:
J.P.M. has received research support from the Patient-Centered Outcomes Research Institute.
Funding Information:
B.H.M. reports research financial support from Brain Canada, CAMH Foundation, Canadian Institutes for Health Research, and Patient Centered Outcomes Research Institute; nonfinancial support from Pfizer (medication for an NIH-funded trial), Eli Lilly (medication and matching placebo for an NIH-funded trial), Capital Solution Design LLC (software for a trial funded by the CAMH Foundation), and HAPPYneuron (software for a trial funded by Brain Canada). The other authors declare no conflicts of interest.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose/Background Venlafaxine is a commonly used antidepressant with both serotonergic and noradrenergic activity. There are concerns that it may prolong the corrected QT interval (QTc), and older adults may be at higher risk for this adverse effect, especially at higher dosages of the medication. Methods/Procedures In this secondary analysis of a prospective clinical trial, we measured changes in QTc and other electrocardiogram (ECG) parameters in 169 adults 60 years or older with a major depressive disorder treated acutely with venlafaxine extended release up to 300 mg daily. We examined the relationship of venlafaxine dosage and ECG parameters, as well as the relationship between serum levels of venlafaxine and ECG parameters. Findings/Results Venlafaxine exposure was not associated with an increase in QTc. Heart rate increased with venlafaxine treatment, whereas the PR interval shortened, and QRS width did not change significantly. The QTc change from baseline was not associated with venlafaxine dosages or serum concentrations. Age, sex, cardiovascular comorbidities, and depression remission status did not predict changes in QTc with venlafaxine. Implications/Conclusions Venlafaxine treatment did not prolong QTc or other ECG parameters, even in high dosages in older depressed adults. These findings indicate that venlafaxine does not significantly affect cardiac conduction in most older patients.
AB - Purpose/Background Venlafaxine is a commonly used antidepressant with both serotonergic and noradrenergic activity. There are concerns that it may prolong the corrected QT interval (QTc), and older adults may be at higher risk for this adverse effect, especially at higher dosages of the medication. Methods/Procedures In this secondary analysis of a prospective clinical trial, we measured changes in QTc and other electrocardiogram (ECG) parameters in 169 adults 60 years or older with a major depressive disorder treated acutely with venlafaxine extended release up to 300 mg daily. We examined the relationship of venlafaxine dosage and ECG parameters, as well as the relationship between serum levels of venlafaxine and ECG parameters. Findings/Results Venlafaxine exposure was not associated with an increase in QTc. Heart rate increased with venlafaxine treatment, whereas the PR interval shortened, and QRS width did not change significantly. The QTc change from baseline was not associated with venlafaxine dosages or serum concentrations. Age, sex, cardiovascular comorbidities, and depression remission status did not predict changes in QTc with venlafaxine. Implications/Conclusions Venlafaxine treatment did not prolong QTc or other ECG parameters, even in high dosages in older depressed adults. These findings indicate that venlafaxine does not significantly affect cardiac conduction in most older patients.
KW - ECG
KW - QTc
KW - late life depression
KW - serum levels
KW - venlafaxine
UR - http://www.scopus.com/inward/record.url?scp=85095461824&partnerID=8YFLogxK
U2 - 10.1097/JCP.0000000000001287
DO - 10.1097/JCP.0000000000001287
M3 - Article
C2 - 33044352
AN - SCOPUS:85095461824
SN - 0271-0749
VL - 40
SP - 553
EP - 559
JO - Journal of Clinical Psychopharmacology
JF - Journal of Clinical Psychopharmacology
IS - 6
ER -