Venlafaxine Versus Sertraline for Major Depressive Disorder

Letter to the Editor

Sir: The recent report by Mehtonen et al. concludes that venlafaxine is superior in efficacy to sertraline in depressed psychiatric outpatients. A number of factors within the study suggest that their conclusion needs to be tempered. While the overall rates of discontinuation may have been comparable, the proportion of adverse advents in the venlafaxine cohort was twice that of the sertraline cohort (16% vs. 7%), and of all patients who discontinued medication treatment over the course of the study, the proportion of those discontinuing therapy in the first week with venlafaxine was also twice that of the sertraline group (8/16 = 50% vs. 3/12 = 25%, respectively). The proportion of adverse advents for those discontinuing therapy in the first week of venlafaxine treatment was slightly greater than twice that for the sertraline group (6/8 = 75% vs. 1/3 = 33%, respectively).