Sertraline versus other antidepressive agents for depression

摘要: BACKGROUND: The National Institute for Health and Clinical Excellence clinical practice guideline on the treatment of depressive disorder recommended that selective serotonin reuptake inhibitors should be first-line option when drug therapy is indicated a episode. Preliminary evidence suggested sertraline might slightly superior in terms effectiveness. OBJECTIVES: To assess efficacy, acceptability tolerability comparison with tricyclics (TCAs), heterocyclics, other SSRIs newer agents acute-phase major depression. SEARCH STRATEGY: MEDLINE (1966 to 2008), EMBASE (1974 Cochrane Collaboration Depression, Anxiety Neurosis Controlled Trials Register Central up July 2008. No language restriction was applied. Reference lists relevant papers previous systematic reviews were hand-searched. Pharmaceutical companies experts this field contacted supplemental data. SELECTION CRITERIA: Randomised controlled trials allocating patients depression versus any antidepressive agent. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted Discrepancies resolved another member team. A double-entry procedure employed by two reviewers. Information included study characteristics, participant intervention details outcome measures efficacy (the number who responded or remitted), failed complete study) (side-effects). MAIN RESULTS: total 59 studies, mostly low quality, review, involving multiple comparisons between antidepressant agents. Evidence favouring over some antidepressants acute phase found, either (fluoxetine) acceptability/tolerability (amitriptyline, imipramine, paroxetine mirtazapine). However, differences (mirtazapine) (bupropion) also found. In individual side effects, generally associated higher rate participants experiencing diarrhoea. AUTHORS' CONCLUSIONS: This meta-analysis highlighted trend favour both acceptability, using 95% confidence intervals conservative approach, random effects analysis. studies did not report all outcomes pre-specified protocol review. Outcomes clear relevance clinicians reported studies.