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Cited by 941Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

The DOI matches its Crossref record; 153 of the 159 references it cites were found in a registry or an index.

Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability

Anderson, Ian M.·2000·Journal of Affective Disorders
DOI 10.1016/s0165-0327(99)00092-0
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Abstract

Background A meta-analysis of the efficacy and tolerability of selective serotonin reuptake inhibitors (SSRIs) against tricyclic antidepressants (TCAs) in depressed patients was carried out. Methods Efficacy data from 102 randomised controlled trials (10706 patients) were pooled to provide a summary variance-weighted effect size. Tolerability data from 95 studies (10553 patients) were combined to give variance-weighted relative risk of drop out for all reasons and for adverse effects from each study. The effect of age, treatment setting, severity and TCA dose were examined as well as the performance of individual SSRIs and TCAs where there were sufficient studies. Results There is no overall difference in efficacy between SSRIs and TCAs (effect size -0.03, 95% confidence interval -0.09 to 0.03). TCAs do appear more effective in in-patients (-0.23, -0.40 to -0.05) and amitriptyline is more effective than SSRI comparators (-0.14, -0.25 to -0.03) but publication bias cannot be excluded. The SSRIs are better tolerated, with significantly lower rates of treatment discontinuations overall (relative risk 0.88, 0.83 to 0.93; number needed to treat 26) and due to side effects (0.73, 0.67 to 0.80; number needed to treat 33). Individual SSRIs show a similar advantage except for fluvoxamine which does not differ from the TCAs. Individual TCAs show a similar disadvantage in tolerability compared to SSRIs except for dothiepin against which SSRI treatment results in more side-effect related…

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Research works printed but not linked: 14

  1. Amin, 1984, Fluvoxamine: antidepressant effects confirmed in a placebo-controlled international study, Clin. Neuropharmacol., 7, S316
  2. Anderson, 1998, A meta-analysis of controlled trials comparing SSRIs in the treatment of depression, J. Psychopharmacol., 12, A20
  3. Dowling, 1990, Fluoxetine: a comparative study with dothiepin, Irish J. Psychiatry, Spring, 3
  4. 1993, The treatment of depression in primary care, Effective Health Care Bull., 5, 1
  5. Fawcett, 1989, Fluoxetine versus amitriptyline in adult out-patients with major depression, Curr. Ther. Res., 45, 821
  6. Ginestet, 1989, Fluoxetine in endogenous depression melancholia versus clomipramine, Int. Clin. Psychopharmacol., 4, 37
  7. Harris, 1991, Fluvoxamine versus amitriptyline in depressed hospital out-patients: A multicentre double-blind comparative trial, Br. J. Clin. Res., 2, 89
  8. Hutchinson, 1991, A double blind study in general practice to compare the efficacy and tolerability of paroxetine and amitriptyline in depressed elderly patients, Br. J. Clin. Res., 2, 43
  9. Masco, 1985, Double-blind comparison of fluoxetine and amitriptyline in the treatment of major depressive illness, Adv. Ther., 2, 275
  10. Pakesch, 1991, Depressive syndrome in a clinical trial with private practitioners. [German] OT – Wirkung und Sicherheit von Fluoxetin versus Clomipramin bei ambulanten Patienten mit einem depressiven Syndrom in einer klinischen Prufung bei niedergelassenen Arzten, Wien. Klin. Wochenschr., 103, 176
  11. Pélicier, 1993, Etude multicentrique en double aveugle comparant l’efficacité et la tolerance de la paroxetine et de la clomipramine dans la dépression réactionnelle du sujet âgé, L’Encéphale, XIX, 257
  12. Peters, 1990, Therapy of depression in the psychiatrist’s office – A double-blind multicenter study, Nervenheilkunde, 9, 28
  13. Remick, 1989, A comparison between fluoxetine and doxepin in depressed patients, Curr. Ther. Res., 46, 842
  14. Taneri, 1989, Fluoxetine versus nomifensine in out-patients with neurotic or reactive depression disorder, Int. Clin. Psychopharmacol., 4, 56

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Metadata

Authors
Anderson, I. M.
Affiliations
University of Manchester (GB)
Corresponding author
Anderson, Ian M.
ORCID
Anderson, Ian M.
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2000-04
Volume
58
Issue
1
Pages
19-36
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/s0165-0327(99)00092-0
OpenAlex
W2101963851
Cited by
940
References
159
Citations by year
2026: 9 · 2025: 11 · 2024: 29 · 2023: 22 · 2022: 19 · 2021: 13 · 2020: 175 · 2019: 18 · 2018: 26 · 2017: 34 · 2016: 23 · 2015: 35 · 2014: 44 · 2013: 36 · 2012: 52
FWCI
4.28
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)
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
selective serotonin reuptake inhibitors, tricyclic antidepressants, depression, antidepressant efficacy, antidepressant tolerability, treatment discontinuation, adverse drug reactions, amitriptyline, fluvoxamine, dothiepin, inpatient care, publication bias
MeSH terms
Antidepressive Agents, Tricyclic, Depressive Disorder, Humans, Randomized Controlled Trials as Topic, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Antidepressive Agents, Second-Generation

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