Cited by 107Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

A comparison of side effects of selective serotonin reuptake inhibitors and tricyclic antidepressants in older depressed patients: a meta‐analysis

Wilson, Kenneth, Mottram, Pat·2004·International Journal of Geriatric Psychiatry

Abstract

Objective: To examine the relative tolerability and side effect profile of tricyclic antidepressants and selective serotonin reuptake inhibitors in older depressed people. Methods: A systematic literature search generated 37 randomised controlled trials of TCAs and SSRIs of which 11 were entered into a meta analysis comparing withdrawal rates and side effect profiles. Results: 537 TCA recipients and 554 SSRI recipients were compared. TCAs had an increased withdrawal rate (RR: 0.24, CI 1.04, 1.47). A similar result was found when comparing classical TCAs (451 patients) (amitriptyline, clomipramine, doxepin and dothiepin) with SSRIs (466 patients) (RR 1.30 CI: 1.02,1.64). These findings were reflected in the increased TCA prevalence of side effects including dry mouth, drowsiness, dizziness and lethargy. No differences were found when comparing TCA related drugs (mianserin and trazadone) with SSRIs (RR 1.07 CI 0.43, 2.70). Conclusions: Despite the relative low prevalence of side effects associated with SSRIs a significant minority of older people find these drugs intolerable and experience nausea, vomiting, dizziness and drowsiness. We conclude that TCA related drugs are comparable to SSRIs in terms of tolerability and may offer an alternative when SSRIs are either contra‐indicated or clinically unacceptable. Copyright © 2004 John Wiley & Sons, Ltd.

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Crossref · 10.1002/gps.1156

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Authors
Wilson, K., & Mottram, P.
Affiliations
University of Liverpool (GB)
Corresponding author
Wilson, Kenneth
Venue
International Journal of Geriatric Psychiatry
Publisher
Wiley
Published
2004-07-08
Volume
19
Issue
8
Pages
754-762
ISSN
  • 0885-6230 (ISSN-L)
  • 1099-1166
OpenAlex
W2058871965
Cited by
107
References
18
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 6 · 2015: 5 · 2014: 4 · 2013: 7 · 2012: 4
FWCI
3.56
Type
journal article
Language
en
Open access
closed
Locations
  • International Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
selective serotonin reuptake inhibitors, tricyclic antidepressants, older adults, depression, adverse drug reactions, drug tolerability, drug withdrawal, mianserin, amitriptyline, clomipramine, doxepin, dothiepin
MeSH terms
Aged, Antidepressive Agents, Tricyclic, Depression, Humans, Randomized Controlled Trials as Topic, Selective Serotonin Reuptake Inhibitors

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