According to PsychCentral (03/03/11), researchers used data from 665 patients who were diagnosed with major depressive disorder. Those patients were then put into one of three groups: the first group took escitalopram (Lexapro) with a placebo, the second took escitalopram (Lexapro) with buproprion (Wellbutrin), and the third took extended-release venlafaxine (the generic version of Effexor) and mirtazapine (Remeron, a tetracyclic antidepressant).
Researchers found that all three groups had similar outcomes. Patients had remission rates of between 38 and 39 percent in each of the groups, while response rates were approximately 52 percent. Although the remission and response rates were similar, however, the group that was given venlafaxine and mirtazapine was found to have suffered more side effects than the other two groups.
The study, called Combining Medication to Enhance Depression Outcomes (CO-MED), is included in the American Journal of Psychiatry (published online 05/02/11). Researchers concluded, "The combination of extended-release venlafaxine plus mirtazapine may have a greater risk of adverse events [than a single antidepressant or than the other combination of antidepressants]."
Dr. Madhukar Trivedi, a researcher involved in the CO-MED study, was also involved in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) trial, which found that only approximately 30 percent of patients who take an SSRI (selective serotonin reuptake inhibitor) go into remission in the first 12 weeks of their treatment.
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Because Effexor is not an SSRI, it is not known if the results of that study are extended to the antidepressant. Effexor is in a class of drugs known as SNRIs, serotonin-norepinephrine reuptake inhibitors, a class that is similar to SSRIs but not identical.