Second-Generation Antidepressants for Treating Adult Depression—An Update
Comparative Harms of Second-Generation Antidepressants
This portion (slides 19–25) of the presentation addresses whether the medications differ in safety or adverse effects. Of interest, as before, are the following: the selective serotonin reuptake inhibitors (SSRIs) citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline); the selective serotonin and norepinephrine reuptake inhibitors (SSNRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) desvenlafaxine, duloxetine, mirtazapine, and venlafaxine; and all other second-generation agents (bupropion, nefazodone, and trazodone). Data included outcomes from head-to-head trials, placebo-controlled trials, and observational studies assessing the comparative harms of second-generation antidepressants. Observational studies were also included when the sample size was larger than 1,000 and the study duration at least 3 months. Comparisons across different drugs should be made with caution, given differences in assessment and reporting of adverse events across trials.
- Gartlehner G, Hansen RA, Morgan LC, et al. Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression: An Update of the 2007 Comparative Effectiveness Review. Comparative Effectiveness Review No. 46 (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I). Rockville, MD: Agency for Healthcare Research and Quality; December 2011. AHRQ Publication No. 12-EHC012-EF. Available at www.effectivehealthcare.ahrq.gov/secondgenantidep.cfm.
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