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The comparative efficacy of second-generation antidepressants for the accompanying symptoms of depression: a systematic review

Published online by Cambridge University Press:  16 April 2020

K. Thaler ,
G. Gartlehner ,
R.A. Hansen ,
L.C. Morgan ,
L.J. Lux ,
M. Van Noord ,
U. Mager ,
B.N. Gaynes ,
P. Thieda  and
M. Strobelberger
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K. Thaler
Affiliation:
Department for Evidence-Based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
G. Gartlehner
Affiliation:
Department for Evidence-Based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
R.A. Hansen
Affiliation:
Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill
L.C. Morgan
Affiliation:
RTI International, Research Triangle Park, NC, USA
L.J. Lux
Affiliation:
RTI International, Research Triangle Park, NC, USA
M. Van Noord
Affiliation:
Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill
U. Mager
Affiliation:
Department for Evidence-Based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
B.N. Gaynes
Affiliation:
Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill
P. Thieda
Affiliation:
Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill
M. Strobelberger
Affiliation:
Department for Evidence-Based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
S. Lloyd
Affiliation:
RTI International, Research Triangle Park, NC, USA
U. Reichenpfader
Affiliation:
Department for Evidence-Based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
K.N. Lohr
Affiliation:
RTI International, Research Triangle Park, NC, USA

Abstract

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Introduction

Clinicians treating patients with Major Depressive Disorder (MDD) might favor one second-generation antidepressant (SGA) because of perceived benefits for the accompanying symptoms of MDD.

Objectives

To compare the efficacy of bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine for the treatment of the accompanying symptoms of MDD.

Methods

This review is part of a larger review on the comparative effectiveness of SGAs for MDD. We searched MEDLINE, Embase, The Cochrane Library, and the International Pharmaceutical Abstracts up to May 2010. Two persons independently reviewed the literature, abstracted data, and rated the risk of bias.

Results

We located 26 head-to-head and 7 placebo-controlled trials that provided evidence for this review. We did not locate any studies on treating accompanying appetite change, low energy, melancholia, or psychomotor change. There was no evidence for many comparisons and we were unable to conduct quantitative analysis for any comparisons. For the comparisons that were studied, we concluded that the SGAs are similarly efficacious for treating anxiety, insomnia, pain, and somatization. The strength of the evidence for these conclusions is low (meaning further research is very likely to have an important impact on our confidence in the estimate of the effect and is likely to change the estimate).

Conclusions

Our findings indicate that the existing evidence does not warrant the choice of one second-generation antidepressant over another based on greater efficacy for the accompanying symptoms of depression.

Type
P02-101
Information
European Psychiatry , Volume 26 , Issue S2: Abstracts of the 19th European Congress of Psychiatry , March 2011 , pp. 697
Copyright
Copyright © European Psychiatric Association 2011
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