Conclusion There is now a substantial amount of clinical information on both duloxetine and venlafaxine taken at therapeutic doses and in overdose. FTI data are confounded by a number of variables, in particular differential protocol antidepressant prescribing in patients with different baseline risks of taking antidepressant overdose. This and other confounders must be considered #Tanespimycin keyword# when interpreting FTI data as without adjustment the data prove unreliable. It must be remembered, however, that many confounders are unknown or unrecorded

and therefore cannot be adjusted for. Case fatality indices suggest a slightly higher toxicity of venlafaxine than that of duloxetine or SSRIs, although venlafaxine users may have taken larger overdoses.

Further studies would be required to investigate this possibility. In addition, a large nested case–control study and clinical data do not currently suggest that venlafaxine is significantly more toxic than first-line SSRIs or that it is associated with Inhibitors,research,lifescience,medical increased rates of attempted suicide, successful or otherwise. Duloxetine data are more limited but demonstrate no significant safety issues relating to suicidality or mortality from overdose compared with SSRIs. Considering as few as one-third of patients treated with SSRIs achieve full remission from their symptoms [Trivedi et al. 2006] there is a Inhibitors,research,lifescience,medical clinical need for alternative antidepressants. Switching to another Inhibitors,research,lifescience,medical antidepressant class after SSRI treatment failure may be a more effective strategy than within class switching [Papakostas et al. 2008]and data specifically support the safety and efficacy of switching SSRI treatment failures to SNRIs, such as duloxetine [Perahia et al. 2008, 2009; Romera et al. 2012]. Based on this review of the safety data from the SNRIs duloxetine and venlafaxine Inhibitors,research,lifescience,medical and the evidence of their efficacy in depression and GAD [Allgulander et al. 2008; Smith et al. 2002; Thase et al. 2007], both drugs appear to have a positive benefit risk profile. This evidence suggests both duloxetine and venlafaxine are appropriate for use in primary care, especially as a second-line option following an SSRI. Footnotes Funding:

This research received no specific grant from any funding agency in the public, commercial or not for profit sectors. Conflict of interest statement: AV-951 ALS and AB are employees of Eli Lilly and Company who manufacture and market duloxetine, an SNRI antidepressant. Contributor Information David Taylor, Pharmacy Department, Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK. Alan Lenox-Smith, Eli Lilly and Company Ltd, Basingstoke, UK. Andrew Bradley, Eli Lilly and Company Ltd, Basingstoke, UK.
Alzheimer’s disease (AD) starts with marked memory and/or orientation impairment, and progresses to generalized cognitive dysfunction. During the course of the disease, behavioral and psychological symptoms of dementia (BPSD) are observed [Finkel et al. 1996].