Hypertension and orthostatic hypotension with venlafaxine treatment in depressed older adults.
Hypertension and orthostatic hypotension with venlafaxine treatment in depressed older adults.
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DOI：
10.1177/0269881120944154
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Blumberger DM
中科院分区：
文献类型：
--
作者：
Wathra R;Mulsant BH;Thomson L;Goldberger KW;Lenze EJ;Karp JF;Sanches M;Reynolds CF 3rd;Blumberger DM
文拉法辛是一种血清素-去甲肾上腺素再摄取抑制剂，常被用作老年人抑郁症的一线或二线治疗。它可能与不利的血压影响有关。当前重度抑郁发作的60岁及以上的成年人以文拉法辛- xr的协议方式治疗；429名参与者接受了8至16周的治疗，每日剂量高达300毫克，以达到抑郁缓解。心脏测量包括坐着和站立时的血压和心率。6.5%基线血压正常的受试者在研究期间发现血压升高（1.9% < 225mg/天；9.8%≥225mg/天）。总体样本或剂量≥225mg/天的亚组的平均血压没有显著变化。此外，20.1%基线时没有直立性低血压的参与者被发现有直立性低血压（16.8% < 225mg/天，22.4%≥225mg/天）。新发直立性低血压的参与者明显比其他参与者更容易跌倒。很大一部分接受文拉法辛治疗的老年人经历了直立性低血压，使他们有跌倒的危险。血压升高的比例较小。服用文拉法辛的老年患者，特别是大剂量服用文拉法辛时，应被告知这些不良反应。
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 effects. Adults aged 60 and older in a current major depressive episode were treated in a protocolized manner with venlafaxine-XR; 429 participants were treated for 8 to 16 weeks with daily dose up to 300 mg to achieve remission from depression. Cardiac measures included sitting and standing blood pressures and heart rate. 6.5% of participants who were normotensive at baseline were found to have elevated blood pressure during the study (1.9% < 225 mg/day; 9.8% ≥ 225mg/day). There was no significant change in mean blood pressure in the overall sample, or in the subgroup treated with doses ≥225mg/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, and 22.4% ≥ 225mg/day). Participants with new-onset orthostatic hypotension were significantly more likely to fall than the other participants. A large proportion of older adults treated with venlafaxine experience orthostatic hypotension putting them at risk for falls. A smaller proportion experience elevated blood pressure. Older patients prescribed venlafaxine, particularly at high dose, should be advised and counselled about these adverse effects.
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DOI：
10.1016/s0140-6736(15)00308-6
发表时间：
2015-12-12
期刊：
Lancet (London, England)
影响因子：
--
作者：
Lenze EJ;Mulsant BH;Blumberger DM;Karp JF;Newcomer JW;Anderson SJ;Dew MA;Butters MA;Stack JA;Begley AE;Reynolds CF 3rd
通讯作者：
Reynolds CF 3rd
影响因子：
2
作者：
Fu, Wenjing;Ma, Lina;Liu, Huizhen
通讯作者：
Liu, Huizhen
影响因子：
5.3
作者：
Oslin, DW;Ten Have, TR;Katz, IR
通讯作者：
Katz, IR
影响因子：
1.6
作者：
Rojas-Fernandez, Carlos H.;Miller, Lisa J.;Sadowski, Cheryl A.
通讯作者：
Sadowski, Cheryl A.
影响因子：
2.4
作者：
de Vasconcelos Cunha, Ulisses Gabriel;Rocha, Fabio Lopes;Sakurai, Emilia
通讯作者：
Sakurai, Emilia