Efficacy of venlafaxine for symptomatic relief in young adult patients with
functional chest pain: a randomized, double-blind, placebo-controlled, crossover
trial.
Author(s): Lee H, Kim JH, Min BH, Lee JH, Son HJ, Kim JJ, Rhee JC, Suh YJ, Kim S, Rhee PL.
Affiliation(s): Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul, Korea.
Publication date & source: 2010, Am J Gastroenterol. , 105(7):1504-12
OBJECTIVES: Esophageal hypersensitivity is currently believed to have a crucial
role in the pathogenesis of functional chest pain (FCP). The aim of this study
was to evaluate the clinical efficacy of venlafaxine, a serotonin-norepinephrine
reuptake inhibitor (SNRI), for FCP in young adult patients.
METHODS: Patients diagnosed with FCP were randomized to either an
extended-release formulation of venlafaxine (75 mg hora somni) or a placebo for 4
weeks. After a washout period of 2 weeks, patients crossed over to the other arm
of the study. The primary efficacy variable was the number of patients with >50%
improvement in symptom scores. The secondary efficacy variables were (i) the
symptom intensity score during each week, (ii) quality of life (QOL), (iii) the
Beck Depression Inventory (BDI) score, and (iv) side effects.
RESULTS: A total of 43 patients (37 men, mean age 23.5 + or - 1.9 years)
completed the study. A positive response was observed in 52.0% of patients during
venlafaxine treatment; 4.0% had a positive response with placebo treatment as
assessed by the intention-to-treat analysis (venlafaxine vs. placebo: odds ratio
26.0; 95% confidence interval 5.7-118.8; P<0.001). Results of Short-Form 36
(SF-36) indicated that patients who received venlafaxine treatment had a
significantly greater improvement in body pain and emotional role compared with
those who received placebo treatment (P=0.002 and P=0.002, respectively). No
significant change was noted in the depression score after venalafaxine or
placebo treatment. One patient withdrew from the study because of sleep
disturbance and loss of appetite while receiving venlafaxine.
CONCLUSIONS: Venlafaxine, an SNRI antidepressant, significantly improved symptoms
in young adult patients with FCP.
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