Internal Med

Your Article Summary

See Latest Articles

Review: differences in efficacy and acceptability exist for 12 new-generation antidepressants for major depression
Evidence-Based Medicine, 10/26/09

Usherwood T – In patients with major depression, new–generation antidepressants differ in efficacy and acceptability.

• Included studies were randomised controlled trials (RCTs) that compared any of 12 new–generation antidepressants (bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnaciprin, mirtazapine, paroxetine, reboxetine, sertraline, and venlafaxine) as monotherapy for acute–phase treatment of major depression. Placebo groups and RCTs of postpartum depression were excluded. Outcomes were response and dropout rates at 8 weeks.
• Cochrane Collaboration Depression, Anxiety, and Neurosis Review Group’s controlled trials register (to Nov 2007) and reference lists were searched for RCTs. Pharmaceutical companies, regulatory agencies, and study investigators were contacted. 117 RCTs (n = 25 928; 64% women; 53 RCTs [n = 9321] had patients >65 y of age) were included. Mean study duration was 8 weeks (14 RCTs had >12 wks’ follow–up). 12 RCTs had adequate allocation concealment and blinding.

• When direct comparisons of antidepressants were pooled, differences existed in response rates for various comparisons.
• Direct comparisons for response favour escitalopram over citalopram; citalopram over reboxetine and paroxetine; mirtazapine over fluoxetine and venlafaxine; sertraline over fluoxetine; and venlafaxine over fluoxetine and fluvoxamine./li>
• Network meta–analysis, which included indirect comparisons, showed that escitalopram and sertraline have high efficacy and the best acceptability profile.
• Fluoxetine had fewer dropouts than reboxetine (number needed to treat [NNT] 13, 95% CI 8 to 74), and citalopram had fewer dropouts than sertraline (NNT 15, CI 9 to 255).

Related Articles

See all related articles

Deep brain stimulation as a new therapeutic approach in therapy-resistant mental disorders: ethical aspects of investigational treatment
European Archives of Psychiatry and Clinical Neuroscience, 11/10/09    Relevance Score: 93%

Omega-3 Augmentation of Sertraline in Treatment of Depression in Patients With Coronary Heart Disease: A Randomized Controlled Trial
JAMA, 10/22/09    Relevance Score: 93%

Major depression: the importance of clinical characteristics and treatment response to prognosis
Depression and Anxiety, 10/07/09    Relevance Score: 93%

Pharmacogenetics Studies in STARD: Strengths, Limitations, and Results
Psychiatric Services, 11/02/09    Relevance Score: 92%

Sexual Functions and Depressive Symptoms after Photodynamic Therapy for Vulvar Lichen Sclerosus in Postmenopausal Women from the Upper Silesian Region of Poland
The Journal of Sexual Medicine, 10/08/09    Relevance Score: 92%

Today in Clinical Pharmacology...keeping you current

Receive free subspecialty "5-minute updates" via email

Update on the efficacy, effectiveness and safety of artemether–lumefantrine combination therapy for treatment of uncomplicated malaria
Therapeutics and Clinical Risk Management, 12/20/09

How do providers assess antihypertensive medication adherence in medical encounters?
Journal of General Internal Medicine, 12/19/09

Nilotinib As Front-Line Treatment for Patients With Chronic Myeloid Leukemia in Early Chronic Phase
Journal of Clinical Oncology, 12/19/09

 See all of Clinical Pharmacology

Today in Psychiatry...keeping you current

Receive free subspecialty "5-minute updates" via email

Nitrous oxide (laughing gas) inhalation as an alternative to electroconvulsive therapy
Medical Hypotheses, 12/20/09

Evolving Definitions of Mental Illness and Wellness
Preventing Chronic Disease, 12/19/09

Patterns and Predictors of Adoption Openness and Contact: 14 Years Postadoption
Family Relations, 12/18/09

 See all of Psychiatry