Researchers at the Department of Psychiatry at the University of Washington and from several other institutions randomized 133 participants who were being treated at spinal cord injury centers to either a 12-week trial of extended-release venlafaxine or placebo using a flexible-dose algorithm. Participants were aged 18 to 64, at least one month after spinal cord injury, and diagnosed with major depressive disorder or dysthymic disorder.
Main outcome measure was score on the Hamilton Depression Rating Scale (HAM-D 17-item version and Maier subscale, which focuses on core depression symptoms and excludes somatic symptoms) over 12 weeks, and on the Sheehan Disability Scale.
Statistical analyses showed a significant difference between the venlafaxine and placebo groups in improvement on the Maier subscale but not on the HAM-D. Participants receiving venlafaxine reported significantly less disability related to spinal cord injury on the Sheehan Disability Scale at 12 weeks compared with placebo. Blurred vision was the only significantly more common new or worsening adverse effect in the venlafaxine group compared with the placebo group.
“Depression is prevalent and associated with negative outcomes in individuals with spinal cord injury,” the researchers stated. “Antidepressants are used routinely to treat depression, yet no placebo-controlled trials have been published in this population to our knowledge…. Further research is needed to determine the optimal treatment and measurement approaches for depression in chronic spinal cord injury.”
For more information, see "The Textbook of Psychosomatic Medicine: Psychiatric Care of the Medically Ill," published by American Psychiatric Publishing.