Therapeutic Drug Monitoring of Venlafaxine: A Systematic Review and Meta-analysis on Concentration–Response Relationship in Depression
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2026
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| _version_ | 1866901183266816000 |
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| author | Saurabh Yadav*, Abhishek Singh, Pradeep kumar Yadav |
| author_facet | Saurabh Yadav*, Abhishek Singh, Pradeep kumar Yadav |
| contents | <p><span>Venlafaxine is a widely prescribed antidepressant belonging to the class of selective serotonin and norepinephrine reuptake inhibitors. Clinical guidelines recommend therapeutic drug monitoring (TDM) to optimize venlafaxine therapy by measuring its active moiety (AM), which includes venlafaxine (VEN) and its active metabolite O-desmethylvenlafaxine (ODV). However, the clinical utility of TDM depends on the presence of a clear relationship between drug concentration and therapeutic response. The present study aimed to evaluate the association between venlafaxine plasma concentrations, therapeutic efficacy, and adverse drug reactions in patients with depression. A systematic review and meta-analysis were conducted using four electronic databases including MEDLINE (PubMed), PsycINFO, Web of Science Core Collection, and the Cochrane Library. Relevant studies published up to March 2022 were screened according to predefined criteria and critically evaluated. A total of 68 studies met the inclusion criteria. Several cohort studies demonstrated a positive association between higher blood concentrations of venlafaxine and improved antidepressant response. Meta-analysis indicated that responders showed higher concentrations of the active moiety and O-desmethylvenlafaxine compared with non-responders. A linear relationship between daily dose and active moiety concentration was observed within the recommended dosage range of 75–225 mg/day. Based on available evidence, a therapeutic reference range of 140–600 ng/ml for the active moiety (VEN + ODV) is suggested to optimize treatment outcomes while minimizing adverse drug reactions.</span></p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_19383964 |
| institution | Zenodo |
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| publishDate | 2026 |
| publisher | Zenodo |
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| spellingShingle | Therapeutic Drug Monitoring of Venlafaxine: A Systematic Review and Meta-analysis on Concentration–Response Relationship in Depression Saurabh Yadav*, Abhishek Singh, Pradeep kumar Yadav Venlafaxine, Therapeutic Drug Monitoring, Antidepressant Therapy, O-desmethylvenlafaxine, Depression, Meta-analysis <p><span>Venlafaxine is a widely prescribed antidepressant belonging to the class of selective serotonin and norepinephrine reuptake inhibitors. Clinical guidelines recommend therapeutic drug monitoring (TDM) to optimize venlafaxine therapy by measuring its active moiety (AM), which includes venlafaxine (VEN) and its active metabolite O-desmethylvenlafaxine (ODV). However, the clinical utility of TDM depends on the presence of a clear relationship between drug concentration and therapeutic response. The present study aimed to evaluate the association between venlafaxine plasma concentrations, therapeutic efficacy, and adverse drug reactions in patients with depression. A systematic review and meta-analysis were conducted using four electronic databases including MEDLINE (PubMed), PsycINFO, Web of Science Core Collection, and the Cochrane Library. Relevant studies published up to March 2022 were screened according to predefined criteria and critically evaluated. A total of 68 studies met the inclusion criteria. Several cohort studies demonstrated a positive association between higher blood concentrations of venlafaxine and improved antidepressant response. Meta-analysis indicated that responders showed higher concentrations of the active moiety and O-desmethylvenlafaxine compared with non-responders. A linear relationship between daily dose and active moiety concentration was observed within the recommended dosage range of 75–225 mg/day. Based on available evidence, a therapeutic reference range of 140–600 ng/ml for the active moiety (VEN + ODV) is suggested to optimize treatment outcomes while minimizing adverse drug reactions.</span></p> |
| title | Therapeutic Drug Monitoring of Venlafaxine: A Systematic Review and Meta-analysis on Concentration–Response Relationship in Depression |
| topic | Venlafaxine, Therapeutic Drug Monitoring, Antidepressant Therapy, O-desmethylvenlafaxine, Depression, Meta-analysis |
| url | https://doi.org/10.5281/zenodo.19383964 |