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
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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“Moreover, studies have found that between 27 and 31% of patients taking antidepressant medication discontinue treatment because of side effects (Anderson, 2000; MacGillivray et al., 2003).”
From A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial (2020) · cites this paper as Anderson, 2000
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PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder
Gelenberg, A. J., Freeman, P. B., Markowitz, J. C., Rosenbaum, J. F., Thase, M. E., Trivedi, M. H., & Rhoads, R. S. (2010) · Cited by 1,372
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Self-citationMalhi, G. S., Bassett, D., Boyce, P., Bryant, R., Fitzgerald, P. B., Fritz, K., Hopwood, M., Lyndon, B., Mulder, R., Murray, G., et al. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415617657 · Cited by 842
“Lithium, a widely supported and used augmentation agent, is found to be more effective than placebo in augmentation of TCAs, SSRIs and other antidepressants (Bauer et al., 2000; Crossley and Bauer, 2007).”
BackgroundInfluentialCleare, A., Pariante, C., Young, A., Anderson, I., Christmas, D., Cowen, P., Dickens, C., Ferrier, I., Geddes, J., Gilbody, S., et al. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115581093 · Cited by 759
Self-citationBymaster, F. P. (2001) · Neuropsychopharmacology · doi:10.1016/s0893-133x(01)00298-6 · Cited by 725
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)
- 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
- 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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