Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression: An update of the 2007 Comparative Effectiveness Review [Entered Retrospectively]

Project Summary Title and Description

Title
Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression: An update of the 2007 Comparative Effectiveness Review [Entered Retrospectively]
Description
Background: Depressive disorders such as major depressive disorder (MDD), dysthymia, and subsyndromal depression may be serious disabling illnesses. MDD affects more than 16 percent of adults at some point during their lifetimes. Second-generation antidepressants dominate the medical management of depressive disorders. These drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and other drugs with related mechanisms of action that selectively target neurotransmitters. Objectives: The objective of this report was to compare the benefits and harms of bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine for the treatment of depressive disorders, including variations of effects in patients with accompanying symptoms and patient subgroups. Data Sources: We updated a comparative effectiveness review published in 2007 by the Agency for Healthcare Research and Quality searching PubMed, Embase, The Cochrane Library, and International Pharmaceutical Abstracts up to January 2011. Review Methods: Two people independently reviewed the literature, abstracted data, and rated the risk of bias. If data were sufficient, we conducted meta-analyses of head-to-head trials of the relative benefit of response to treatment. In addition, we conducted mixed treatment comparisons to derive indirect estimates of the comparative efficacy among all second-generation antidepressants. Results: From a total of 3,722 citations, we identified 248 studies of good or fair quality. Overall, no substantial differences in efficacy could be detected among second-generation antidepressants for the treatment of acute-phase MDD. Statistically significant differences in response rates between some drugs are small and likely not clinically relevant. No differences in efficacy were apparent in patients with accompanying symptoms or in subgroups based on age, sex, ethnicity, or comorbidities, although evidence within these subpopulations was limited. Differences exist in the incidence of specific adverse events and the onset of action. Venlafaxine leads to higher rates of nausea and vomiting, sertraline to higher rates of diarrhea, and mirtazapine to higher rates of weight gain than comparator drugs. Bupropion causes lower rates of sexual dysfunction than other antidepressants. The evidence is insufficient to draw conclusions about the comparative efficacy and effectiveness for the treatment of dysthymia and subsyndromal depression. Conclusions: Our findings indicate that the existing evidence does not warrant the choice of one second-generation antidepressant over another based on greater efficacy and effectiveness. Differences with respect to onset of action and adverse events may be taken into consideration for the choice of a medication.
Attribution
N/A
Authors of Report
N/A
Methodology description
We have made only a few changes to the methods used for the CER published in 2007. They involve drugs, approaches to the literature searches, articles included or excluded, techniques for quantitative synthesis, and grading strength of evidence for the overall body of evidence. Specific changes are noted here; longer documentation will be found in later parts of this methods chapter. We added one drug—desvenlafaxine—to the literature searches and analyses (we used the same search strategy in electronic databases as for the original report). For manual literature searches, we changed the process to semi-automatic searches using the ScopusTM abstraction and citation database (www.scopus.com/home.url). The method is described below in the section on Literature Searches. We did not make any changes to the eligibility criteria (Table 4 in the Introduction). We used the same approach as in the 2007 report to select literature, assess the quality of individual studies (i.e., appraise their risk for bias), and extract relevant data. Despite using identical methods to select relevant evidence, however, we removed some studies in the 2007 report from the current update. These studies had not met eligibility criteria in the 2007 report to begin with, but because they represented the only available evidence to answer a particular question at the time we had retained them. In the 2007 report we also had briefly summarized findings of such studies to provide a synopsis of the best available evidence (best- evidence approach). When, for this update, we have identified newer evidence that meets our eligibility criteria, we excluded the other "ineligible" studies from the current update. For indirect comparisons we changed our statistical methods. Specifically, we now use a Bayesian mixed-treatment comparisons approach rather than meta-regressions and network meta-analyses. A detailed description of this approach appears in the section below on Data Synthesis. We changed our method for rating the strength of evidence. In 2007 we used the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. For this update, we follow the principles outlined for use by the AHRQ Evidence-based Practice Centers in AHRQ’s Methods Guide for Effectiveness and Comparative Effectiveness Reviews20 (www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and- reports/?pageaction=displayproduct&productid=318). Details are summarized below in Grading Strength of a Body of Evidence.
PROSPERO
N/A
DOI
10.7301/Z0NP22CC
Notes
The following Key Questions addressed in this report: 1a. For adults with major depressive disorder (MDD), dysthymia, or subsyndromal depressive disorders, do commonly used medications for depression differ in efficacy or effectiveness in treating depressive symptoms? 1b. If a patient has responded to one agent in the past, is that agent better than current alternatives at treating depressive symptoms? 1c. Are there any differences in efficacy or effectiveness between immediate-release and extended-release formulations of second-generation antidepressants? 2a. For adults with a depressive syndrome that has responded to antidepressant treatment, do second-generation antidepressants differ in their efficacy or effectiveness for preventing relapse (i.e., continuation phase) or recurrence (i.e., maintenance phase) when a patient o Continues the drug they initially responded to, or o Switches to a different antidepressant? 2b. For adults with a depressive syndrome that has not responded to acute antidepressant treatment or has relapsed (continuation phase) or recurred (maintenance phase), do alternative second-generation antidepressants differ in their efficacy or effectiveness? 3. In depressed patients with accompanying symptoms such as anxiety, insomnia, and neurovegetative symptoms, do medications or combinations of medications (including tricyclics in combination) differ in their efficacy or effectiveness for treating the depressive episode or for treating the accompanying symptoms? 4a. For adults with a depressive syndrome, do commonly used antidepressants differ in safety, adverse events, or adherence? Adverse effects of interest include but are not limited to nausea, diarrhea, headache, tremor, daytime sedation, decreased libido, failure to achieve orgasm, nervousness, insomnia, and more serious events including suicide. 4b. Are there any differences in safety, adverse events, or adherence between immediate- release and extended-release formulations of second-generation antidepressants? 5. How do the efficacy, effectiveness, or harms of treatment with antidepressants for a depressive syndrome differ for the following subpopulations? o Elderly or very elderly patients o Other demographic groups (defined by age, ethnic or racial groups, and sex) o Patients with medical comorbidities (e.g., ischemic heart disease, cancer) o Patients with psychiatric and behavioral comorbidities (e.g., substance abuse disorders) o Patients taking other medications *** The systematic review data of this published project was retrospectively imported into SRDR by the Brown EPC on behalf of the Research Triangle Institute International-University of North Carolina (RTI-UNC ) Evidence-based Practice Center and the Agency for Healthcare Research and Quality (AHRQ). For access to the full report available on the AHRQ website, follow this link: http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=863&pageaction=displayproduct ***
Funding Source
The Agency for Healthcare Research and Quality (AHRQ)

Key Questions

1. Key Question 1 - Randomized controlled trials and observational studies
2. Key Question 2 - Systematic evidence reviews and meta-analyses

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Sertraline versus paroxetine in major depression: clinical outcome after six months of continuous therapy.2000
Efficacy and tolerability of venlafaxine in geriatric outpatients with major depression: a double-blind, randomised 6-month comparative trial with citalopram.
Efficacy and tolerability of venlafaxine compared with selective serotonin reuptake inhibitors and other antidepressants: a meta-analysis.
Effective treatment of poststroke depression with the selective serotonin reuptake inhibitor citalopram.1994
Management of depression relapse: re-initiation of duloxetine treatment or dose increase.2006
A multicenter double-blind comparison of nefazodone and paroxetine in the treatment of outpatients with moderate-to-severe depression.
The efficacy and tolerability of venlafaxine and paroxetine in outpatients with depressive disorder or dysthymia.
Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years.2001
Fluoxetine versus trazodone: efficacy and activating-sedating effects.1991
Mirtazapine orally disintegrating tablet versus sertraline: a prospective onset of action study.2003
Mirtazapine compared with paroxetine in major depression.2000
A double-blind multicenter trial comparing sertraline and fluoxetine in outpatients with major depression.1995
A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder.2004
Clinical and economic comparison of sertraline and fluoxetine in the treatment of depression. A 6-month double-blind study in a primary-care setting in France.1998
Duloxetine 60 mg once-daily in the treatment of painful physical symptoms in patients with major depressive disorder.2005
Fatal toxicity of serotoninergic and other antidepressant drugs: analysis of United Kingdom mortality data.2002
Fixed-dose trial of the single isomer SSRI escitalopram in depressed outpatients.
Paroxetine and fluoxetine effects on mood and cognitive functions in depressed nondemented elderly patients.
A Canadian multicenter, double-blind study of paroxetine and fluoxetine in major depressive disorder.1999
A double-blind comparison of paroxetine with imipramine in the long-term treatment of depression.
Prevalence of sexual dysfunction among newer antidepressants.
Sexual dysfunction associated with the treatment of depression: a placebo-controlled comparison of bupropion sustained release and sertraline treatment.1999
A placebo-controlled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine.2001
A randomized, double-blind, 24-week study of escitalopram (10 mg/day) versus citalopram (20 mg/day) in primary care patients with major depressive disorder.2005
Randomized, double-blind comparison of venlafaxine and fluoxetine in outpatients with major depression.
A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline.1999
A comparison of venlafaxine, trazodone, and placebo in major depression.1994
Fluvoxamine versus fluoxetine in major depressive episode: a double-blind randomised comparison.2003
Venlafaxine compared with fluoxetine in outpatients with depression and concomitant anxiety.2002
A double-blind, comparative, multicentre study comparing paroxetine with fluoxetine in depressed patients.1993
Sexual functioning assessed in 4 double-blind placebo- and paroxetine-controlled trials of duloxetine for major depressive disorder.
Duloxetine, 60 mg once daily, for major depressive disorder: a randomized double-blind placebo-controlled trial.2002
Duloxetine 60 mg once daily dosing versus placebo in the acute treatment of major depression.-- Not Found --
Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo- and paroxetine-controlled trial.2004
Randomized, double-blind, placebo-controlled trial of fluoxetine treatment for elderly patients with dysthymic disorder.2005
Suicide and self-harm following prescription of SSRIs and other antidepressants: confounding by indication.2005
A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients.1996
Sertraline in the prevention of depression.1992
A prospective safety surveillance study for bupropion sustained-release in the treatment of depression.1998
A double-blind multicenter trial comparing sertraline and citalopram in patients with major depression treated in general practice.1997
A double-blind study of paroxetine, fluoxetine, and placebo in outpatients with major depression.1998
Fluoxetine versus sertraline and paroxetine in major depressive disorder: changes in weight with long-term treatment.
Fluoxetine versus sertraline and paroxetine in major depression: tolerability and efficacy in anxious depression.2000
Treatment approaches to major depressive disorder relapse. Part 1: dose increase.-- Not Found --
Nefazodone versus sertraline in outpatients with major depression: focus on efficacy, tolerability, and effects on sexual function and satisfaction.1996
Double-blind, placebo-substitution study of nefazodone in the prevention of relapse during continuation treatment of outpatients with major depression.1999
Double-blind comparison of bupropion and fluoxetine in depressed outpatients.1991
Reemergence of sexual dysfunction in patients with major depressive disorder: double-blind comparison of nefazodone and sertraline.2001
Predictors of an acute antidepressant response to fluoxetine and sertraline.
A double-blind study of long-term treatment with sertraline or fluvoxamine for prevention of highly recurrent unipolar depression.1997
Randomized, placebo-controlled trial of nefazodone maintenance treatment in preventing recurrence in chronic depression.2003
Fluoxetine in the prevention of depressive recurrences: a double-blind study.
Sertraline treatment of major depression in patients with acute MI or unstable angina.2002
Fluoxetine in medically stable, depressed geriatric patients: effects on weight.1997
Duloxetine in the treatment of major depressive disorder: a double-blind clinical trial.
Sertraline for the prevention of relapse in detoxicated alcohol dependent patients with a comorbid depressive disorder: a randomized controlled trial.-- Not Found --
Mirtazapine versus venlafaxine in hospitalized severely depressed patients with melancholic features.2001
Efficacy and tolerability of citalopram in comparison with fluvoxamine in depressed outpatients: a double-blind, multicentre study. The LUCIFER Group.1996
Nefazodone treatment of comorbid alcohol dependence and major depression.2004
Randomised controlled study of sleep after nefazodone or paroxetine treatment in out-patients with depression.
Prophylactic effect of citalopram in unipolar, recurrent depression: placebo-controlled study of maintenance therapy.2001
A double-blind, randomized, group-comparative study of the tolerability and efficacy of 6 weeks' treatment with mirtazapine or fluoxetine in depressed Chinese patients.2003
Comparison of frequencies of suicidal tendencies among patients receiving fluoxetine, lofepramine, mianserin, or trazodone.1992
Antidepressants and suicide.1995
Antidepressants and the risk of suicidal behaviors.2004
A 102-center prospective study of seizure in association with bupropion.1991
Randomized, placebo-controlled trial of fluoxetine for acute treatment of minor depressive disorder.2004
Discontinuation symptoms: comparison of brief interruption in fluoxetine and paroxetine treatment.
A comparative, randomised, double-blind study of trazodone prolonged-release and paroxetine in the treatment of patients with major depressive disorder.2005
Escitalopram in the treatment of depressed elderly patients.
Double-blind comparison of bupropion sustained release and sertraline in depressed outpatients.1997
Maintenance phase efficacy of sertraline for chronic depression: a randomized controlled trial.1998
Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine.2000
The use of venlafaxine in the treatment of major depression and major depression associated with anxiety: a dose-response study. Venlafaxine Investigator Study Group.1998
A double-blind comparison of fluvoxamine and paroxetine in the treatment of depressed outpatients.1997
Efficacy of citalopram in the prevention of recurrent depression in elderly patients: placebo-controlled study of maintenance therapy.
Efficacy and tolerability of mirtazapine versus citalopram: a double-blind, randomized study in patients with major depressive disorder. Nordic Antidepressant Study Group.
A randomized, placebo-controlled trial of sertraline for prophylactic treatment of highly recurrent major depressive disorder.2004
Escitalopram (10-20 mg/day) is effective and well tolerated in a placebo-controlled study in depression in primary care.2003
Treating depression in Alzheimer disease: efficacy and safety of sertraline therapy, and the benefits of depression reduction: the DIADS.2003
A comparison of fluvoxamine, fluoxetine, sertraline and paroxetine examined by observational cohort studies.1997
Antidepressant treatment and the risk of fatal and non-fatal self harm in first episode depression: nested case-control study.
Randomized, double-blind comparison of venlafaxine and sertraline in outpatients with major depressive disorder. Venlafaxine 631 Study Group.2000
Adverse events in users of sertraline: results from an observational study in psychiatric practice in The Netherlands.2002
Changes in weight during a 1-year trial of fluoxetine.1999
Sertraline and cognitive behavioral therapy for depressed alcoholics: results of a placebo-controlled trial.2003
Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction.2001
Citalopram 20 mg, citalopram 40 mg and placebo in the prevention of relapse of major depression.1992
Paroxetine is better than placebo in relapse prevention and the prophylaxis of recurrent depression.1993
A randomised study comparing escitalopram with venlafaxine XR in primary care patients with major depressive disorder.2004
Venlafaxine versus placebo in the preventive treatment of recurrent major depression.2004
Double-blind comparison of sertraline and placebo in stroke patients with minor depression and less severe major depression.2005
Citalopram versus fluoxetine: a double-blind, controlled, multicentre, phase III trial in patients with unipolar major depression treated in general practice.1996
A comparative trial of fluoxetine versus trazodone in outpatients with major depression.1989
Fluoxetine treatment of depressive disorders in methadone-maintained opioid addicts.1998
Comparison of moclobemide with selective serotonin reuptake inhibitors (SSRIs) on sexual function in depressed adults. The Australian and German Study Groups.2000
Venlafaxine and paroxetine in treatment-resistant depression. Double-blind, randomised comparison.
Testosterone versus fluoxetine for depression and fatigue in HIV/AIDS: a placebo-controlled trial.2004
A comparison of fluvoxamine and fluoxetine in the treatment of major depression.1996
Efficacy of controlled-release paroxetine in the treatment of late-life depression.
Escitalopram continuation treatment prevents relapse of depressive episodes.2004
Treatment of dysthymia with sertraline: a double-blind, placebo-controlled trial in dysthymic patients without major depression.2000
Optimal length of continuation therapy in depression: a prospective assessment during long-term fluoxetine treatment.1998
Citalopram in doses of 20-60 mg is effective in depression relapse prevention: a placebo-controlled 6 month study.1995
Sertraline versus fluvoxamine in the treatment of elderly patients with major depression: a double-blind, randomized trial.
A double-blind, randomized, placebo-controlled trial of once-daily venlafaxine extended release (XR) and fluoxetine for the treatment of depression.1999
Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression.
Double-blind, randomized comparison of mirtazapine and paroxetine in elderly depressed patients.
A double-blind comparison of sertraline and fluoxetine in the treatment of major depressive episode in outpatients.1999
Once-daily venlafaxine extended release (XR) compared with fluoxetine in outpatients with depression and anxiety. Venlafaxine XR 360 Study Group.1999
Extended-release venlafaxine in relapse prevention for patients with major depressive disorder.-- Not Found --
Randomized trial of sertraline versus venlafaxine XR in major depression: efficacy and discontinuation symptoms.2005
Efficacy and safety of fluoxetine in the treatment of patients with major depression after first myocardial infarction: findings from a double-blind, placebo-controlled trial.-- Not Found --
Fluvoxamine prevents recurrence of depression: results of a long-term, double-blind, placebo-controlled study.1998
Antidepressants and the risk of falls among nursing home residents.1998
Efficacy of mirtazapine for prevention of depressive relapse: a placebo-controlled double-blind trial of recently remitted high-risk patients.2001
A double-blind, randomized, fluoxetine-controlled, multicenter study of paroxetine in the treatment of depression.
Increased remission rates with venlafaxine compared with fluoxetine in hospitalized patients with major depression and melancholia.2000
Mirtazapine is more effective than trazodone: a double-blind controlled study in hospitalized patients with major depression.1995
Controlled efficacy study of fluoxetine in dysthymia.1997
Comparison of the effects of mirtazapine and fluoxetine in severely depressed patients.2005
Bupropion sustained release versus paroxetine for the treatment of depression in the elderly.2000
Continuation phase treatment with bupropion SR effectively decreases the risk for relapse of depression.2002
Comparison of bupropion and trazodone for the treatment of major depression.1994
Mirtazapine: efficacy and tolerability in comparison with fluoxetine in patients with moderate to severe major depressive disorder. Mirtazapine-Fluoxetine Study Group.1998
Relative toxicity of venlafaxine and selective serotonin reuptake inhibitors in overdose compared to tricyclic antidepressants.2003
Treatment of dysthymia and minor depression in primary care: A randomized controlled trial in older adults.2000
Older community residents with depression: long-term treatment with sertraline. Randomised, double-blind, placebo-controlled study.
Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus.
A double-blind, randomized, parallel-group, flexible-dose study to evaluate the tolerability, efficacy and effects of treatment discontinuation with escitalopram and paroxetine in patients with major depressive disorder.2006
Mirtazapine orally disintegrating tablets versus venlafaxine extended release: a double-blind, randomized multicenter trial comparing the onset of antidepressant response in patients with major depressive disorder.
Mirtazapine and paroxetine in major depression: a comparison of monotherapy versus their combination from treatment initiation.2009
A comparative study of the efficacy of long-term treatment with escitalopram and paroxetine in severely depressed patients.
Efficacy and safety of duloxetine 60 mg once daily in the treatment of pain in patients with major depressive disorder and at least moderate pain of unknown etiology: a randomized controlled trial.
Bupropion extended release compared with escitalopram: effects on sexual functioning and antidepressant efficacy in 2 randomized, double-blind, placebo-controlled studies.2006
Changes in sexual functioning associated with duloxetine, escitalopram, and placebo in the treatment of patients with major depressive disorder.2007
Patient compliance to a new enteric-coated weekly formulation of fluoxetine during continuation treatment of major depressive disorder.2000
A randomized, double-blind comparison of olanzapine/fluoxetine combination, olanzapine, fluoxetine, and venlafaxine in treatment-resistant depression.2006
Once-daily venlafaxine extended release (XR) and venlafaxine immediate release (IR) in outpatients with major depression. Venlafaxine XR 208 Study Group.1997
Effect of pharmacological treatment of depression on A1C and quality of life in low-income Hispanics and African Americans with diabetes: a randomized, double-blind, placebo-controlled trial.
Efficacy of paroxetine in treating major depressive disorder in persons with multiple sclerosis.-- Not Found --
Comparisons of the efficacy and tolerability of extended-release venlafaxine, mirtazapine, and paroxetine in treatment-resistant depression: a double-blind, randomized pilot study in a Chinese population.2010
Eszopiclone co-administered with fluoxetine in patients with insomnia coexisting with major depressive disorder.
Relationship between antidepressants and suicide attempts: an analysis of the Veterans Health Administration data sets.2007
A comparison of nefazodone and fluoxetine on mood and on objective, subjective, and clinician-rated measures of sleep in depressed patients: a double-blind, 8-week clinical trial.1997
Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression.
Escitalopram prevents relapse in older patients with major depressive disorder.
Eight-week, placebo-controlled, double-blind comparison of the antidepressant efficacy and tolerability of bupropion XR and venlafaxine XR.2009
Double-blind, placebo-controlled comparison of the antidepressant efficacy and tolerability of bupropion XR and venlafaxine XR.2010
Treatment of post-myocardial infarction depressive disorder: a randomized, placebo-controlled trial with mirtazapine.-- Not Found --
Extended-release bupropion for patients with major depressive disorder presenting with symptoms of reduced energy, pleasure, and interest: findings from a randomized, double-blind, placebo-controlled study.2006
A placebo-controlled, randomized withdrawal study of sertraline for major depressive disorder in Japan.2006
Sexual function during bupropion or paroxetine treatment of major depressive disorder.2006
Double-blind comparison of escitalopram and duloxetine in the acute treatment of major depressive disorder.2007
Prevention of recurrent episodes of depression with venlafaxine ER in a 1-year maintenance phase from the PREVENT Study.2007
Escitalopram maintenance treatment for prevention of recurrent depression: a randomized, placebo-controlled trial.
Sertraline treatment of co-occurring alcohol dependence and major depression.2006
Once-daily duloxetine 60 mg in the treatment of major depressive disorder: multicenter, double-blind, randomized, paroxetine-controlled, non-inferiority trial in China, Korea, Taiwan and Brazil.2007
Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor.
Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial.2007
The beneficial effects of the herbal medicine Free and Easy Wanderer Plus (FEWP) and fluoxetine on post-stroke depression.2008
Time to rehospitalization in patients with major depressive disorder taking venlafaxine or fluoxetine.2008
Sertraline for prevention of depression recurrence in diabetes mellitus: a randomized, double-blind, placebo-controlled trial.
Escitalopram in major depressive disorder: a multicenter, randomized, double-blind, fixed-dose, parallel trial in a Chinese population.2008
Use of venlafaxine compared with other antidepressants and the risk of sudden cardiac death or near death: a nested case-control study.2010
Treatment of insomnia in depressed insomniacs: effects on health-related quality of life, objective and self-reported sleep, and depression.2010
Predictors of relapse in a prospective study of fluoxetine treatment of major depression.2006
A comparative, randomized, double-blind study of trazodone prolonged-release and sertraline in the treatment of major depressive disorder.
Maintenance treatment of major depression in old age.2006
Sertraline for the treatment of depression in Alzheimer disease.2010
A double-blind, placebo-controlled study of venlafaxine and fluoxetine in geriatric outpatients with major depression.
Variation in the risk of suicide attempts and completed suicides by antidepressant agent in adults: a propensity score-adjusted analysis of 9 years' data.2010
A randomized, double-blind, active-control study of sertraline versus venlafaxine XR in major depressive disorder.
Suicide risk during antidepressant treatment.2006
Desvenlafaxine and escitalopram for the treatment of postmenopausal women with major depressive disorder.2010
Better patient persistence with once-daily bupropion compared with twice-daily bupropion.-- Not Found --
Desvenlafaxine 50 and 100 mg/d in the treatment of major depressive disorder: an 8-week, phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group trial and a post hoc pooled analysis of three studies.2009
Evaluation of double-blind comparison of fluvoxamine and paroxetine in the treatment of depressed outpatients in menopause transition.2004
Escitalopram versus sertraline in the treatment of major depressive disorder: a randomized clinical trial.2007
A comparative study of the efficacy of acute and continuation treatment with escitalopram versus duloxetine in patients with major depressive disorder.2007
Efficacy and tolerability of escitalopram versus citalopram in major depressive disorder: a 6-week, multicenter, prospective, randomized, double-blind, active-controlled study in adult outpatients.
Selective serotonin reuptake inhibitors and other antidepressants and risk of fracture.2008
Stastical Review of NDA 21- 323 (Escitalopram Oxalate)
A double blind comparison of paroxetine and fluoxetine in patients with major depression
Org 3770 (mirtazapine) versus trazodone: A placebo controlled trial in depressed elderly patients.
Reduced suicidality with paroxetine.
A comparison of once-daily venlafaxine XR and paroxetine in depressed outpatients treated in general practice
Double-blind multicenter comparison of fluvoxamine versus sertraline in the treatment of depressed outpatients. Depression.
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A double-blind, randomized, 12-week comparison study of the safety and efficacy of venlafaxine and fluoxetine in moderate to severe major depression in general practice
A controlled comparison of sertraline and fluoxetine in acute and continuation treatment of major depression
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NA
A double-blind, placebo-controlled comparison of venlafaxine and fluoxetine treatment in depressed outpatients.-- Not Found --
Safety and efficacy of sertraline for depression in patients with heart failure: results of the SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial.2010
A case-control study of antidepressants and attempted suicide during early phase treatment of major depressive episodes.
Estimates of serotonin and norepinephrine transporter inhibition in depressed patients treated with paroxetine or venlafaxine.2008
Duloxetine in the treatment of major depressive disorder: a placebo- and paroxetine-controlled trial.2006
Duloxetine in the prevention of relapse of major depressive disorder: double-blind placebo-controlled study.
Duloxetine in the prevention of depressive recurrences: a randomized, double-blind, placebo-controlled trial.
Suicide attempts in clinical trials with paroxetine randomised against placebo.2005
Side-effect profile of fluoxetine in comparison with other SSRIs, tricyclic and newer antidepressants: a meta-analysis of clinical trial data.2005
Post-myocardial infarction depression.2005
Report of the CSM expert working group on the safety of selective serotonin reuptake inhibitor antidepressants
Association between suicide attempts and selective serotonin reuptake inhibitors: systematic review of randomised controlled trials.
Incidence and duration of antidepressant-induced nausea: duloxetine compared with paroxetine and fluoxetine.2004
Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults: meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA's safety review.2005
Suicide rates in clinical trials of SSRIs, other antidepressants, and placebo: analysis of FDA reports.
Bupropion versus selective serotonin-reuptake inhibitors for treatment of depression.2001
Escitalopram and suicidality in adult depression and anxiety.2005
Symptoms following abrupt discontinuation of duloxetine treatment in patients with major depressive disorder.2005
Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies.2009
Sertraline versus other antidepressive agents for depression.2010
Superiority of escitalopram to paroxetine in the treatment of depression.2009
Treating the physical symptoms of depression with second-generation antidepressants: a systematic review and metaanalysis.-- Not Found --
A pooled analysis of suicidality in double-blind, placebo-controlled studies of sertraline in adults.2009
Effects of the antidepressant duloxetine on body weight: analyses of 10 clinical studies.2006

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