{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:25:33Z","timestamp":1787120733087,"version":"build-2736575974"},"reference-count":11,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Electroconvulsive therapy (ECT) effectively treats severe late\u2010life depression but is often approached with caution in very elderly patients with cardiac or cerebrovascular disease. Venlafaxine, a serotonin\u2013norepinephrine reuptake inhibitor with dose\u2010dependent transporter engagement, may be useful for anxious depression with psychomotor disturbance, yet data are limited. We describe two elderly inpatients with severe major depressive disorder for whom ECT was planned. Case 1 was a man in his late 70s with complete atrioventricular block and a permanent pacemaker who relapsed despite long\u2010term duloxetine\u2010based outpatient therapy. Case 2 was a woman in her late 80s with prior clipping of an unruptured middle cerebral artery aneurysm whose symptoms worsened despite outpatient mirtazapine and risperidone with the addition of duloxetine. In both cases, duloxetine was cross\u2010tapered to venlafaxine extended\u2010release while mirtazapine was continued, and venlafaxine ER was titrated to 150\u2009mg\/day as a closely monitored, time\u2010limited pharmacological re\u2010optimization step during ECT preparation. Symptoms improved; the 21\u2010item GRID\u2010Hamilton Depression Rating Scale total scores fell into the remission range. Appetite and oral intake improved, and planned ECT was canceled. These cases highlight the potential value of individualized pharmacological re\u2010evaluation, including SNRI switching, even when ECT is being considered.<\/jats:p>","DOI":"10.1002\/ccr3.73120","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T21:58:57Z","timestamp":1785103137000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacological Re\u2010Optimization With Venlafaxine in Two Elderly Patients With Severe Major Depressive Disorder Considered for Electroconvulsive Therapy: A Two\u2010Patient Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2453-6080","authenticated-orcid":false,"given":"Wataru","family":"Omori","sequence":"first","affiliation":[{"name":"Department of Psychiatry NHO Kure Medical Center and Chugoku Cancer Center  Kure Japan"},{"name":"Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Oga","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikazu","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2217\/npy.14.3"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000851"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/08919887211039016"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyab086"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyz003"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.180.5.396"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.178.3.234"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/YIC.0000000000000105"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881115581093"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716659417"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.08.003"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73120","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73120","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:33:57Z","timestamp":1787117637000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":11,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/ccr3.73120"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73120","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-12-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73120"}}