Direct comparison of tricyclic and serotonin-reuptake inhibitor antidepressants in randomized head-To-head trials in acute major depression: Systematic review and meta-Analysis

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dc.contributor.authorUndurraga, Juan
dc.contributor.authorBaldessarini, Ross
dc.date.accessioned2018-01-17T12:37:09Z
dc.date.available2018-01-17T12:37:09Z
dc.date.issued2017
dc.description.abstractBACKGROUND: A comparison across trials conducted over several decades suggested superior efficacy of tricyclic antidepressants (TCAs) over selective serotonin-reuptake inhibitors (SSRIs). However, this outcome may reflect a selective secular decline of responses after randomization to placebo. Remaining uncertainty encouraged direct comparison of the drug-types in trials involving randomized, head-to-head comparisons. METHODS: We systematically identified reports of randomized trials of TCAs versus SSRIs for major depression in several digital databases, and applied standard meta-analytic and multiple-factor regression methods to analyze and pool the findings. RESULTS: In 89 head-to-head trials, there was no detectable overall difference in responder rates or percent-improvement between TCAs and SSRIs. In addition to non-difference between drug-types, outcomes were unrelated to reporting-year, trial-size or nominal duration, proportion of women participants, initial depression ratings, rating scales, subjects/arm, imipramine-equivalent mg/day drug dose, or dropout rate. Trial size and duration increased significantly over the years 1980-2016. CONCLUSIONS: Previous evidence suggesting superior benefits of TCAs over SSRIs for the treatment of acute major depression is probably an artifact of a selective secular decline in responses to placebo, as no difference was found in a large series of direct comparisons of these antidepressant-types.
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dc.identifier.citationUndurraga J, Baldessarini RJ. Direct comparison of tricyclic and serotonin-reuptake inhibitor antidepressants in randomized head-to-head trials in acute major depression: Systematic review and meta-analysis. J Psychopharmacol. 2017 Sep;31(9):1184-1189.
dc.identifier.urihttp://hdl.handle.net/11447/1908
dc.identifier.urihttp://dx.doi.org/10.1177/0269881117711709
dc.language.isoen_US
dc.publisherSage Publications
dc.subjectAntidepressants
dc.subjecthead-to-head
dc.subjectrandomized trials
dc.subjectserotonin-reuptake inhibitor
dc.subjecttricyclic
dc.titleDirect comparison of tricyclic and serotonin-reuptake inhibitor antidepressants in randomized head-To-head trials in acute major depression: Systematic review and meta-Analysis
dc.typeArtículo

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