A pharmacoeconomic evaluation of esCitalopram ( Celexa ), a new selective serotonin reuptake inhibitor Comparison of cost-effectiveness between esCitalopram ( Celexa ), Citalopram ( Celexa ), Fluoxetine ( Prozac ),and Venlafaxine ( Effexor ) for the treatment of depression in Norway.

This study compared the cost-effectiveness of esCitalopram ( Celexa ) to that of Citalopram ( Celexa ),Fluoxetine ( Prozac ), and Venlafaxine ( Effexor ) in the treatment of depression in Norway.A two-path decision analytic model with a 6-month horizon was used.Patients start at the primary path and are referred to specialist care in the secondary care path. Model inputs included drugspecific probabilities from comparative trial data, literature, and a panel of experts.The main outcome measure is success (remission), and costs of treatment (total and drug costs).Treatment with esCitalopram ( Celexa ) yielded lower expected cost and greater effectiveness than Citalopram ( Celexa ),Fluoxetine ( Prozac ), and Venlafaxine ( Effexor ). The expected success rate was 64.2% with esCitalopram ( Celexa ),58.7% with Citalopram ( Celexa ), 58.7% with Fluoxetine ( Prozac ), and 62.1% with Venlafaxine ( Effexor ).Average expected total costs per patient were similar with esCitalopram ( Celexa ) (19,661 Norwegian crowns) and Venlafaxine ( Effexor ) (20,989) and somewhat higher with Citalopram ( Celexa ) (22,379) and Fluoxetine ( Prozac ) (22,558).Budgetary impact estimates a decrease in total health care budget of 72 million crowns.EsCitalopram ( Celexa ) is therefore the most cost-effective alternative and its use would significantly reduce health care costs for the treatment of depression in Norway.

Analysis of Venlafaxine ( Effexor ) by capillary zone electrophoresis.

Capillary electrophoresis has been used for the separation of Venlafaxine ( Effexor ) and two of its impurities deriving from the synthesis process. The electrophoretic experiments were performed using background electrolytes at different pHs in the 2.5-9.2 range in order to study the effective mobilities and resolution of the three examined compounds. The optimum experimental conditions for the baseline resolution of the three analytes was found at pH 6.5. Very good repeatability for both migration time and corrected peak areas was achieved. The calibration curve was studied for Venlafaxine ( Effexor ) (concentration range 26-224 micrograms/mL), and the plot of the peak area ratio (sample/internal standard [IS]) versus Venlafaxine ( Effexor ) concentration was linear with a correlation coefficient of 0.9991. The effect of different cyclodextrins (CDs), namely, gamma-cyclodextrin (gamma-CD), hydroxypropyl-beta-CD (HP-beta-CD), and alpha-cyclodextrin (alpha-CD), on effective mobility and enantiomeric resolution (R) of Venlafaxine ( Effexor ) (Wy45030) and its impurities (imp1 and imp2) was studied at different pHs, and the best results were obtained at pH 9.2. Venlafaxine ( Effexor ) was baseline resolved in its enantiomers using gamma-CD or HP-beta-CD, while imp1 (Wy45494) was baseline resolved using alpha-CD.

PET neuroimaging with [11C]Venlafaxine ( Effexor ): serotonin uptake inhibition, biodistribution and binding in living pig brain.

The brain binding kinetics and distribution of the antidepressant Venlafaxine ( Effexor ), labelled with 11C in the O-methyl position, was studied by PET after intravenous injection in anesthetized pigs. In addition, Venlafaxine ( Effexor )'s action on serotonin (5-HT) uptake was studied in vitro in blood platelets obtain from humans or pigs. Venlafaxine ( Effexor ) resembled imipramine, Paroxetine ( Paxil ) and Citalopram ( Celexa ) in causing a dose-dependent inhibition of 5-HT uptake in blood platelets from pigs and humans. Venlafaxine ( Effexor )-derived radioactivity entered the living brain readily and showed higher binding potentials in diencephalic and telencephalic regions than in cerebellum. Acute administration of an antidepressant drug (i.e. imipramine, Citalopram ( Celexa ) or Paroxetine ( Paxil )) enhanced the distribution and altered the binding of Venlafaxine ( Effexor ) in certain brain regions. The findings show that [11C]Venlafaxine ( Effexor ) is not an ideal PET radiotracer mainly because of its relatively low binding potentials and its lack of specificity for the 5-HT transporter in living brain.

Antidepressant-like effect of tramadol and its enantiomers in reserpinized mice: comparative study with desipramine, fluvoxamine, Venlafaxine ( Effexor ) and opiates.

Tramadol is a centrally acting analgesic that demonstrates opioid and monoaminergic properties. Several studies have suggested that tramadol could play a role in mood improvement. Moreover, it has previously been shown that tramadol is effective in the forced swimming test in mice and the learned helplessness model in rats, two behavioural models predictive of antidepressant activity. The aim of the present study was to test tramadol and its enantiomers in the reserpine test in mice, a classical observational test widely used in the screening of antidepressant drugs. This test is a non-behavioural method where only objective parameters such as rectal temperature and palprebral ptosis are considered. Moreover, we compared the effects of tramadol and its enantiomers with those of antidepressants (desipramine, fluvoxamine and Venlafaxine ( Effexor )) and opiates [morphine (-)-methadone and levorphanol]. Racemic tramadol, (-)-tramadol, desipramine and Venlafaxine ( Effexor ) reversed the reserpine syndrome (rectal temperature and ptosis), whereas(+)-tramadol and fluvoxamine only antagonized the reserpine-induced ptosis, without any effect on temperature. Opiates did not reverse reserpine-induced hypothermia. (-)-Methadone showed slight effects regarding reserpine-induced ptosis, morphine and levorphanol had no effect. These results show that tramadol has an effect comparable to clinically effective antidepressants in a test predictive of antidepressant activity, without behavioural implications. Together with other clinical and experimental data, this suggests that tramadol has an inherent antidepressant-like (mood improving) activity, and that this effect could have clinical repercussions on the affective component of pain.