PsychoTropicalResearch, serotonin and serotonin syndrome research.
Antidepressants - SSRIs compared
Antidepressants - SSRIs compared
Date Created: 21/06/1999 Last Modified: 19/01/2002 Last Checked: 07/01/2003
A recent meta-analysis comparing the various SSRIs to each other concludes:--
"In the light of existing knowledge the only SSRI that appears to have no apparent (sic) disadvantages is (sic) relation to its competitors is sertraline".
The main noteworthy observations are:--14 studies of suitable 'quality' were located for inclusion in the whole analysis, with a total of 2464 patients.
Drop outs from treatment failure = 6.9%, with no significant difference between individual drugs.
Total discontinuation rate, ie side effects and treatment failure (in 19 trails, total 2999 patients) was 25.6%.
Adverse effect discontinuation rate (3098 patients) was 10.8%
Fluoxetine-- slower onset of antidepressant effect and a possibility of lesser overall benefit after 6 weeks treatment duration.
This total discontinuation rate of 25.6% should be borne in mind; it is the bottom line which serves to remind us that SSRIs have significant limitations. Indeed it suggests that the less side effect prone of the TCAs might be better than SSRIs.
If, as recent findings suggest, their medium to long term ability to induce full remission is limited then we still have a lot to learn before we can see these drugs in the correct perspective.
All text ©Dr Ken Gillman MRC Psych - PsychoTropical Research®
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