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Cited by 399Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

The DOI matches its Crossref record; 84 of the 85 references it cites were found in a registry or an index.

Selective serotonin reuptake inhibitors: meta-analysis of efficacy and acceptability.

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Song, F, Freemantle, N, Sheldon, T A, House, A, Watson, P, Long, A, Mason, J·1993·BMJ
DOI 10.1136/bmj.306.6879.683
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Abstract

OBJECTIVE--To examine the evidence for using selective serotonin reuptake inhibitors instead of tricyclic antidepressants in the first line treatment of depression. DESIGN--Meta-analysis of 63 randomised controlled trials comparing the efficacy and acceptability of selective serotonin reuptake inhibitors with those of tricyclic and related antidepressants. MAIN OUTCOME MEASURES--Improvement in mean scores on Hamilton depression rating scale for 53 randomised controlled trials. Pooled drop out rates from the 58 trials which reported drop out by treatment group. RESULTS--Among the 20 studies reporting standard deviation for the Hamilton score no difference was found in efficacy between serotonin reuptake inhibitors and tricyclic and related antidepressants (standardised mean difference 0.004, 95% confidence interval -0.096 to 0.105). The difference remained insignificant when the remaining 33 studies that used the 17 item and 21 item Hamilton score were included by ascribing weighted standard deviations. The odds ratio for drop out rate in patients receiving serotonin reuptake inhibitors compared with those receiving tricyclic antidepressants was 0.95 (0.86 to 1.07). Similar proportions in both groups cited lack of efficacy as the reason for dropping out but slightly more patients in the tricyclic group cited side effects (18.8% v 15.4% in serotonin reuptake group). CONCLUSIONS--Routine use of selective serotonin reuptake inhibitors as the first line treatment of depressive illness may greatly increase cost with only questionable benefit.

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Research works printed but not linked: 2

  1. Sertraline for treatment of depression. Medical Letter on Drugs and Therapeutics 1992;34:47-8.
  2. Cohn JB, Crowder JE, Wilcox CS, Ryan PJ. A placeboand imipraminecontrolled study ofparoxetine. Psychopharmacol BuUl 1990;26:185-9.

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Metadata

Authors
Song, F., Freemantle, N., Sheldon, T. A., House, A., Watson, P., Long, A., & Mason, J.
Affiliations
University of Leeds (GB)
ORCID
Venue
BMJ
Publisher
BMJ
Published
1993-03-13
Volume
306
Issue
6879
Pages
683-687
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.306.6879.683
OpenAlex
W2052223361
Cited by
399
References
85
Citations by year
2025: 3 · 2023: 2 · 2021: 3 · 2019: 10 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 4 · 2013: 3 · 2012: 11
FWCI
9.42
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords
selective serotonin reuptake inhibitors, tricyclic antidepressants, depression, treatment efficacy, treatment acceptability, treatment discontinuation, adverse effects, cost-effectiveness
MeSH terms
Antidepressive Agents, Tricyclic, Depressive Disorder, Humans, Patient Dropouts, Psychiatric Status Rating Scales, Randomized Controlled Trials as Topic, Treatment Outcome, Patient Satisfaction, Selective Serotonin Reuptake Inhibitors

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