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Second-Generation Antidepressants for Treating Adult Depression—An Update

Slide: 23 of 28

Specific Comparative Harms of Second-Generation Antidepressants for Adults With MDD (3 of 3)

When compared with most selective serotonin reuptake inhibitors, there was high-strength evidence that higher discontinuation rates due to adverse effects were seen with duloxetine (67% higher risk) and venlafaxine (40% higher risk). There was also high-strength evidence that venlafaxine had lower discontinuation rates due to lack of efficacy (35% lower risk).

The highest rates of withdrawal symptoms (headache, dizziness, light-headedness, nausea, and anxiety) were reported after discontinuation of paroxetine or venlafaxine, and fluoxetine had the lowest rate of withdrawal symptoms (moderate-strength evidence).