Venlafaxine in adults with attention-deficit/hyperactivity disorder: An open clinical trial

Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio 44106, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 05/1996; 57(5):184-9.
Source: PubMed


It is becoming commonly recognized that adults suffer from attention-deficit/hyperactivity disorder (ADHD). Since medications used in the past of treat adults with ADHD may be ineffective or poorly tolerated by some patients, it is important to determine if newly available medications can safely ameliorate symptoms of ADHD in adults.
An open clinical trial was undertaken to examine whether venlafaxine was safe and effective in the treatment of adults with ADHD. Ten subjects who met DSM-IV criteria for ADHD were enrolled in this 8-week trial. Individuals were started on 37.5 mg of venlafaxine b.i.d. If moderate ADHD symptoms persisted at the end of Week 4, the dose of venlafaxine was increased to 75 mg b.i.d. Assessments of ADHD symptomatology included the ADHD Rating Scale, Self-Report Version (ARS) and the Clinical Global Impressions (CGI) scale.
Nine patients completed the study. At the end of the study, 7 patients were receiving 37.5 mg b.i.d. of venlafaxine. Repeated measures ANOVA demonstrated that treatment with venlafaxine was associated with significant reductions in ADHD symptomatology (p < .02 for the ARS; p < .005 for the CGI). Of the 9 subjects who completed the trial, 7 were considered responders. Venlafaxine was well tolerated, and most patients experienced only mild side effects.
Venlafaxine may be a promising agent for the treatment of ADHD in adults. Controlled clinical trials are needed to further examine this issue.

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    • "With a maximum recommended dosage of 375 mg, it is prescribed for a range of conditions, including major depression , generalized anxiety, social anxiety, and panic disorder (Bakish, 1999; Silverstone and Ravindran, 1999; Gorman et al., 2000; Thase et al., 2000; Thase et al., 2001; Anderson et al., 2008). Its off-label prescription has been reported as well in fibromyalgia (Sayar et al., 2003), tension-type headache (Zissis et al., 2007), migraine prophylaxis (Ozyalcin et al., 2005), cocaine dependence (McDowell et al., 2000), and a range of other conditions (Findling et al., 1996; Gelenberg et al., 2000; Freeman et al., 2001; Galvez et al., 2004; Rowbotham et al., 2004; Evans et al., 2005; Amsterdam et al., 2010). Venlafaxine is available either as an immediate-release (tablet) or as an extended-release formulation (venlafaxine XR capsule and tablet; Wellington and Perry, 2001). "
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    ABSTRACT: Introduction Venlafaxine is one of the most frequently prescribed antidepressants worldwide, despite its toxicity risk in overdose. Furthermore, the molecule has been recently identified at the EU-wide level as one of the novel psychoactive substances. This paper aims at investigating the potential of misuse, taking into account both the existing literature and the analysis of the misusers' experiences as described in venlafaxine misuse web reports. Methods A literature search was performed using PubMed, Embase, and Medline. Posts/threads relating to venlafaxine misuse issues were identified through Google® and Yahoo® English-language searches. Resulting websites' data were then qualitatively assessed, and information was collected on a range of issues, including dosage, drug intake modalities, untoward drug effects, and association with other recreational drugs. Results A few literature case reports focusing on venlafaxine as a misusing drug were here identified. The molecule was here typically ingested or snorted at dosages up to 10–15 times higher than those clinically advised, obtaining MDMA/amphetamine-like stimulant and psychedelic effects. Polydrug misuse was commonly reported. Venlafaxine appeared to be widely available online for sale. Conclusions Physicians should carefully evaluate patients for history of drug dependence and observe them for signs of venlafaxine misuse.
    No preview · Article · Jul 2015 · Human Psychopharmacology Clinical and Experimental
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    • "Three open studies involving 41 adults support this postulation. In these studies, 75% of adults who tolerated venlafaxine had a measurable reduction in their ADHD symptomatology at doses of 75–150 mg daily [119,121,166]. In summary, antidepressants with documented efficacy in ADHD share a catecholaminergic (particularly noradrenergic or dopaminergic) mechanism of action. "
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    ABSTRACT: Adults with attention-deficit/hyperactivity disorder (ADHD) are more frequently presenting for diagnosis and treatment. Medication is considered to be appropriate among available treatments for ADHD; however, the evidence supporting the use of pharmacotherapeutics for adults with ADHD remains less established. In this article, the effectiveness and dosing parameters of the various agents investigated for adult ADHD are reviewed. In adults with ADHD, short-term improvements in symptomatology have been documented through the use of stimulants and antidepressants. Studies suggest that methylphenidate and amphetamine maintained an immediate onset of action, whereas the ADHD response to the nonstimulants appeared to be delayed. At a group level, there appears to be some, albeit not entirely consistent, dose-dependent responses to amphetamine and methylphenidate. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies was considerable, and most studies were of a relatively short duration. The aggregate literature shows that the stimulants and catecholaminergic nonstimulants investigated had a clinically significant beneficial effect on treating ADHD in adults.
    Full-text · Article · Oct 2011 · Expert Review of Neurotherapeutics
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    • "Aufgrund der noradrenergen Modulation gab es Mitte der 90er-Jahre Fallberichte und offene Studien zur Wirksamkeit des Serotonin-und Noradrenalin-Wiederaufnahmehemmers Venlafaxin in der Behandlung von Erwachsenen mit ADHD. Während Findling et al. (1996) "

    Full-text · Article · Jan 2009 · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie
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