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Cited by 62Treatment of Major DepressionMental Health Treatment and AccessPsychotherapy Techniques and Applications

Efficacy and safety of levomilnacipran, vilazodone and vortioxetine compared with other second-generation antidepressants for major depressive disorder in adults: A systematic review and network meta-analysis

Wagner, Gernot, Schultes, Marie-Therese, Titscher, Viktoria, Teufer, Birgit, Klerings, Irma, Gartlehner, Gerald·2018·Journal of Affective Disorders
DOI 10.1016/j.jad.2017.11.056
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Abstract

Background Second-generation antidepressants dominate the medical management of major depressive disorder (MDD). Levomilnacipran, vilazodone and vortioxetine are the latest therapeutic options approved for the treatment of MDD. This systematic review aims to compare the benefits and harms of vilazodone, levomilnacipran, and vortioxetine with one another and other second-generation antidepressants.Methods We searched electronic databases up to September 2017 and reviewed reference lists and pharmaceutical dossiers to detect published and unpublished studies. Two reviewers independently screened abstracts and full text articles, and rated the risk of bias of included studies. Randomized controlled trials (RCTs) and controlled observational studies including adult outpatients with MDD were eligible for inclusion. We conducted network meta-analyses on response to treatment using frequentist multivariate meta-analyses models. Placebo- and active-controlled trials were eligible for network meta-analyses.Results Twenty-four studies met our inclusion criteria. Direct comparisons were limited to vilazodone versus citalopram, and vortioxetine versus duloxetine, paroxetine, or venlafaxine XR (extended release). Results of head-to-head trials and network meta-analyses, overall, indicated similar efficacy among levomilnacipran, vilazodone, or vortioxetine and other second-generation antidepressants. Although rates of overall adverse events and discontinuation due to adverse events were similar, RCTs reported several differences in specific adverse events. For most outcomes the strength of evidence was low.Limitations Limitations are the focus of literature searches on studies published in English, possible reporting biases, and general methodological limitations of network meta-analyses.Conclusions Overall, the available evidence does not indicate greater benefits or fewer harms of levomilnacipran, vilazodone, and vortioxetine compared with other second-generation antidepressants.

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Authors
Wagner, G., Schultes, M.-T., Titscher, V., Teufer, B., Klerings, I., & Gartlehner, G.
Affiliations
Universität für Weiterbildung Krems (AT)
Corresponding author
Gartlehner, Gerald
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2018-03
Volume
228
Pages
1-12
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2017.11.056
OpenAlex
W2769781658
Semantic Scholar
e6ed5b00bbba2c3b0e64800b5d47d4b3631b9d94
Cited by
61
References
35
Citations by year
2026: 4 · 2025: 5 · 2024: 11 · 2023: 6 · 2022: 6 · 2021: 13 · 2020: 4 · 2019: 4 · 2018: 7
FWCI
0.52
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Funders
Drug Effectiveness Review Project
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
major depressive disorder, second-generation antidepressants, levomilnacipran, vilazodone, vortioxetine, citalopram, duloxetine, paroxetine, venlafaxine, treatment response, adverse events, drug safety, drug efficacy comparison
MeSH terms
Vilazodone Hydrochloride, Milnacipran, Vortioxetine, Adult, Cyclopropanes, Major Depressive Disorder, Humans, Piperazines, Sulfides, Antidepressive Agents, Second-Generation

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