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ACP guideline: New antidepressants are similarly effective
JAAPA, 03/05/09

Citing similar effectiveness and effect on quality of life, this guideline from the American College of Physicians (ACP) recommends choosing a second-generation antidepressant on the basis of factors other than effectiveness. They suggest selecting an antidepressant according to its side effect profile, cost, and patient preference; not by mechanism of action or presumed differences in effectiveness. Mirtazapine has a faster onset of action, producing a significantly better response after 2 weeks of treatment, though the difference disappears by week 4. Anxiety responds well to any antidepressant. The authors did not locate research allowing them to conclude whether any antidepressant is better than any other at controlling melancholia, pain, or insomnia. Venlafaxine (Effexor) is more likely to cause nausea, sertraline (Zoloft) causes more diarrhea, and mirtazapine is associated with weight gain. Bupropion is less likely to cause sexual dysfunction.

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