Similar Efficacy Among Second-Generation Antidepressants

But different onset of action and adverse events in adults with major depressive disorder

MONDAY, Dec. 5 (HealthDay News) -- Second-generation antidepressants show no evidence of differences in efficacy for the treatment of major depressive disorder (MDD) in adults, but differ according to onset of action and adverse events, according to a meta-analysis published in the Dec. 6 issue of the Annals of Internal Medicine.

Gerald Gartlehner, M.D., M.P.H., from Danube University in Krems, Austria, and colleagues reviewed available literature from 1980 to August 2011 to compare the benefits and harms of second-generation antidepressants for treating MDD in adult patients. Data were extracted on study design and conduct, participants, and interventions and outcomes. Efficacy was evaluated in 234 randomized trials of at least six weeks, and harm was assessed in observational studies with at least 1,000 participants. Meta-analyses and mixed-treatment comparisons were performed to study the response to treatment, and weighted mean differences in the depression rate.

The investigators found that there were no clinically relevant differences in efficacy or effectiveness for the treatment of acute, continuation, and maintenance phases of MDD. Patients with accompanying symptoms, or patients sub-grouped on the basis of age, gender, ethnicity, or comorbid conditions, also showed no differences in efficacy. Each drug differed on the basis of onset of action, adverse events, and some measures of health-related quality of life.

"Current evidence does not warrant recommending a particular second-generation antidepressant on the basis of differences in efficacy. Differences in onset of action and adverse events may be considered when choosing a medication," the authors write.

One of the study authors disclosed financial ties to Novartis and Takeda Pharmaceutical Company.

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