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.
Open accessAbstract
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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“while psychotropic medication has a role to play in treating mood disorders, it is not always effective, nor is it acceptable to many patients [12].”
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Citations
Cites
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
Development of a Rating Scale for Primary Depressive Illness
Hamilton, M. (1967) · British Journal of Social and Clinical Psychology · doi:10.1111/j.2044-8260.1967.tb00530.x · Cited by 8,410
The combination of estimates from different experiments
Cochran, W. G. (1954) · Biometrics · doi:10.2307/3001666 · Cited by 5,380
Ostwald, P. F. (1960) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1960.14.4.817 · Cited by 1,422
Recognition and management of depression in general practice: consensus statement
Paykel, E. S., & Priest, R. G. (1992) · BMJ · doi:10.1136/bmj.305.6863.1198 · Cited by 540
A comparison of statistical methods for combining event rates from clinical trials
Berlin, J. A., Laird, N. M., Sacks, H. S., & Chalmers, T. C. (1989) · Statistics in Medicine · doi:10.1002/sim.4780080202 · Cited by 418
Peto, R. (1987) · Statistics in Medicine · doi:10.1002/sim.4780060306 · Cited by 409
Danish University Antidepressant Group (1990) · Journal of Affective Disorders · doi:10.1016/0165-0327(90)90081-i · Cited by 398
Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients.
Cohn, C. K., Shrivastava, R., Mendels, J., Cohn, J. B., Fabre, L. F., Claghorn, J. L., Dessain, E. C., Itil, T. M., & Lautin, A. (1990) · PubMed · Cited by 348
Reimherr, F. W., Chouinard, G., Cohn, C. K., Cole, J. O., Itil, T. M., LaPierre, Y. D., Masco, H. L., & MENDELS, J. (1990) · PubMed · Cited by 263
Stark, P., & Hardison, C. D. (1985) · PubMed · Cited by 239
A Comparison of Paroxetine, Imipramine and Placebo in Depressed Out-patients
Dunbar, G. C., Cohn, J. B., Fabre, L. F., Feighner, J. P., Fieve, R. R., MENDELS, J., & Shrivastava, R. K. (1991) · The British Journal of Psychiatry · doi:10.1192/bjp.159.3.394 · Cited by 172
Feighner, J. P., & Cohn, J. B. (1985) · PubMed · Cited by 170
Chouinard, G. (1985) · PubMed · Cited by 157
A comparison of fluoxetine, imipramine, and placebo in patients with major depressive disorder.
Jb, C., & Wilcox, C. M. (1985) · PubMed · Cited by 133
A comparative clinical trial of fluoxetine, mianserin and placebo in depressed outpatients
Muijen, M., Roy, D. H., Silverstone, T., Mehmet, A., & Christie, M. (1988) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1988.tb06353.x · Cited by 110
Double-blind comparison of bupropion and fluoxetine in depressed outpatients.
Feighner, J. P., Gardner, E. A., Johnston, J. A., Batey, S. R., Khayrallah, M. A., Ascher, J. A., & Lineberry, C. G. (1991) · PubMed · Cited by 107
Dl, D., Jb, C., Walshe, T., Ck, C., Feighner, J. P., Rr, F., Jp, H., Jt, H., Ed, H., & Settle, E. C. (1992) · PubMed · Cited by 89
Panic disorder: impact on quality of life.
Weissman, M. M. (1991) · PubMed · Cited by 87
Paroxetine in the treatment of depression ‐ a randomized comparison with amitriptyline
Laursen, A. L., Mikkelsen, P. L., Rasmussen, S., & Honoré, P. (1985) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1985.tb01281.x · Cited by 83
Itil, T. M., Rk, S., Mukherjee, S., Coleman, B., & Michael, S. (1983) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1983.tb02134.x · Cited by 80
A Placebo-controlled Inpatient Comparison of Fluvoxamine Maleate and Imipramine in Major Depression
Feighner, J. P., Boyer, W. F., Meredith, C. H., & HENDRICKSON, G. G. (1989) · International Clinical Psychopharmacology · doi:10.1097/00004850-198907000-00006 · Cited by 79
A double‐blind, multicentre study of paroxetine versus clomipramine in depressed elderly patients
Guillibert, E., Pélicier, Y., Archambault, J. C., Chabannes, J.-P., Cierc, G., Desvilles, M., Guibert, M., Pagot, R., Poisat, J. L., & Thobie, Y. (1989) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1989.tb07192.x · Cited by 75
A comparative trial of fluoxetine and amitriptyline in patients with major depressive disorder.
Feighner, J. P. (1985) · PubMed · Cited by 70
Fluoxetine Versus Trazodone in Depressed Geriatric Patients
Falk, W. E., Rosenbaum, J. F., Otto, M. W., Zusky, P. M., Weilburg, J. B., & Nixon, R. A. (1989) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/089198878900200407 · Cited by 70
Fluoxetine in depressed patients: a comparison with imipramine.
Bremner, J. D. (1984) · PubMed · Cited by 70
A double‐blind controlled clinical trial comparing fluvoxamine with imipramine.
Guelfi, J., Dreyfus, J. F., & Pichot, P. (1983) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1983.tb02131.x · Cited by 67
Fluoxetine, a Highly Selective Serotonin Reuptake Inhibitor: A Review of Preclinical Studies
Schmidt, M. J., Fuller, R. W., & Wong, D. T. (1988) · The British Journal of Psychiatry · doi:10.1192/s0007125000297274 · Cited by 67
A double-blind placebo-controlled study of fluvoxamine and imipramine in depression.
Dominguez, R. A., Goldstein, B. J., Jacobson, A. F., & Steinbook, R. M. (1985) · PubMed · Cited by 65
Paroxetine in the Treatment of Elderly Depressed Patients in General Practice
HUTCHINSON, D. R., TONG, S., Moon, C. A. L., Vince, M., & Clarke, A. H. (1992) · International Clinical Psychopharmacology · doi:10.1097/00004850-199206004-00009 · Cited by 64
Treatment of major affective disorder with fluvoxamine.
Lapierre, Y. D., Browne, M., Horn, E., Lk, O., Sarantidis, D., Roberts, N., Badoe, K., & Tessier, P. (1987) · PubMed · Cited by 60
Clinical trials of fluvoxamine vs chlorimipramine with single and three times daily dosing.
de Wilde, J., Mertens, C., & Wakelin, J. S. (1983) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1983.tb02133.x · Cited by 59
McIntyre, I. M., Judd, F. K., Burrows, G. D., & Norman, T. R. (1989) · International Clinical Psychopharmacology · doi:10.1097/00004850-198901000-00001 · Cited by 56
A double‐blind comparison of fluvoxamine and dothiepin in the treatment of major affective disorder
Mullin, J. M., Vr, P.-G., & Whitehead, A. M. (1988) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.1988.tb08510.x · Cited by 54
Fluoxetine compared with amitriptyline in elderly depression: a controlled clinical trial.
Altamura, A. C., Novellis, F. D., Guercetti, G., INVERNIZZI, G., Percudani, M., & Montgomery, S. (1989) · PubMed · Cited by 52
Selective serotonin reuptake inhibitors.
Edwards, J. G. (1992) · BMJ · doi:10.1136/bmj.304.6843.1644 · Cited by 50
A double-blind comparison of fluvoxamine, imipramine and placebo in depressed patients
Norton, K., Sireling, L., Bhat, A., Rao, B., & Paykel, E. S. (1984) · Journal of Affective Disorders · doi:10.1016/0165-0327(84)90051-x · Cited by 49
Phanjoo, A. L., Wonnacott, S., & Hodgson, A. (1991) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1991.tb05579.x · Cited by 48
Mk, R., Mj, A., Savla, N., Rr, S., Jm, K., & Ashford, J. J. (1991) · PubMed · Cited by 47
Fluoxetine vs Amitriptyline in the Treatment of Depressed Out-patients
Laakmann, G., Blaschke, D., Engel, R. R., & Schwarz, A. (1988) · The British Journal of Psychiatry · doi:10.1192/s0007125000297316 · Cited by 44
March, J. S., Kobak, K. A., Jefferson, J. W., Mazza, J., & Greist, J. H. (1990) · PubMed · Cited by 44
A double-blind comparison of fluvoxamine, desipramine and placebo in outpatients with depression
Roth, D. A., Mattes, J. A., Sheehan, K. H., & Sheehan, D. V. (1990) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/0278-5846(90)90078-u · Cited by 43
A Controlled Comparison of Fluoxetine and Amitriptyline in Depressed Out-patients
Young, J. P. R., Coleman, A., & Lader, M. H. (1987) · The British Journal of Psychiatry · doi:10.1192/bjp.151.3.337 · Cited by 42
A Double-Blind Multicentre Study of Paroxetine and Amitriptyline in Depressed Outpatients
Bignamini, A., & Rapisarda, V. (1992) · International Clinical Psychopharmacology · doi:10.1097/00004850-199206004-00008 · Cited by 42
A double‐blind comparative study of the clinical efficacy of fluvoxamine and chlorimipramine.
DICK, P. H., & Ferrero, E. (1983) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1983.tb02132.x · Cited by 42
Fluoxetine versus trazodone in the treatment of outpatients with major depression.
Debus, J. R., Rush, A. J., Himmel, C., Tyler, D., Polatin, P. B., & Weissenburger, J. E. (1988) · PubMed · Cited by 41
Sleep and Paroxetine: A Comparison with Mianserin in Elderly Depressed Patients
DORMAN, T. (1992) · International Clinical Psychopharmacology · doi:10.1097/00004850-199206004-00010 · Cited by 41
A Comparative Trial of a New Antidepressant, Fluoxetine
Levine, S., Deo, R., & Mahadevan, K. (1987) · The British Journal of Psychiatry · doi:10.1192/bjp.150.5.653 · Cited by 41
A comparative trial of fluoxetine versus trazodone in outpatients with major depression.
Perry, P. J., Garvey, M. J., Kelly, M. W., Cook, B. L., Dunner, F. J., & Winokur, G. (1989) · PubMed · Cited by 40
Peselow, E. D., Filippi, A.-M., Goodnick, P. J., Barouche, F., & Rr, F. (1989) · PubMed · Cited by 39
Paroxetine in the treatment of depression
MERTENS, C., & Pintens, H. (1988) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1988.tb05188.x · Cited by 39
CORNE, S. J., & HALL, J. R. (1989) · International Clinical Psychopharmacology · doi:10.1097/00004850-198907000-00007 · Cited by 39
A placebo- and imipramine-controlled study of paroxetine.
Cohn, J. B., Crowder, J. E., Wilcox, C. S., & Ryan, P. J. (1990) · PubMed · Cited by 39
Fluvoxamine and imipramine in the treatment of depressive patients: A double-blind controlled study
Gonella, G., Baignoli, G., & Ecari, U. (1990) · Current Medical Research and Opinion · doi:10.1185/03007999009111499 · Cited by 38
Lf, F., Mb, S., & Tm, I. (1991) · PubMed · Cited by 38
Fluoxetine Efficacy vs Comparative Drugs: An Overview
LADER, M. H. (1988) · The British Journal of Psychiatry · doi:10.1192/s0007125000297298 · Cited by 37
A Randomized, Double-Blind Study of Fluoxetine and Maprotiline in the Treatment of Major Depression
de Jonghe, F., Ravelli, D. P., & Tuynman-Qua, H. G. (1991) · Pharmacopsychiatry · doi:10.1055/s-2007-1014440 · Cited by 36
A double-blind, randomized comparison of fluvoxamine with mianserin in depressive illness
Perez, A., Ashford, J. J., & Biol, M. I. (1990) · Current Medical Research and Opinion · doi:10.1185/03007999009111652 · Cited by 34
A double‐blind study of the comparative antidepressant effect of paroxetine and amitriptyline
Kuhs, H., & Rudolf, G. A. E. (1989) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1989.tb07198.x · Cited by 32
Randomized Double-Blind Study of Fluvoxamine and Maprotiline in Treatment of Depression
de Jonghe, F., Swinkels, J. A., & Tuynman-Qua, H. G. (1991) · Pharmacopsychiatry · doi:10.1055/s-2007-1014428 · Cited by 31
Bascara, L. (1989) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1989.tb07196.x · Cited by 28
A double‐blind clinical trial of fluvoxamine and imipramine in patients with primary depression
Guy, W., Wilson, W. H., Ban, T. A., King, D. L., Manov, G., & Fjetland, O. K. (1984) · Drug Development Research · doi:10.1002/ddr.430040203 · Cited by 28
Meta-analysis and multiple publication of clinical trial reports
Leizorovicz, A., Haugh, M. C., & Boissel, J. (1992) · The Lancet · doi:10.1016/0140-6736(92)93126-8 · Cited by 27
Nielsen, O. A., Morsing, I., Petersen, J. S., Larsen, T., Møller, S. E., Manniche, P. M., Skausig, O. B., Bille, N., Fredslund‐Andersen, F., Jensen, E., et al. (1991) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1991.tb03136.x · Cited by 24
Fluoxetine versus clomipramine in major depressive disorders.
Ropert, R. (1989) · PubMed · Cited by 24
Enhancing effective and acceptable purchaser and provider decisions: overview and methods.
Long, A., & Sheldon, T. (1992) · BMJ Quality & Safety · doi:10.1136/qshc.1.1.74 · Cited by 22
Self-citationFluoxetine 40 mg vs maprotiline 75 mg in the treatment of out-patients with depressive disorders.
Poelinger, W., & Haber, H. L. (1989) · PubMed · Cited by 22
Double-blind comparison of fluvoxamine and imipramine in depressed patients
Amore, M., Bellini, M., Berardi, D., Berlinzani, L., Cerviño, G., Cremonini, A., Ferrari, G. R. A., & Innamorati, A. (1989) · CINECA IRIS Institutial Research Information System (University of Genoa) · Cited by 22
A double-blind clinical trial of fluvoxamine and imipramine in patients with primary depression.
Guy, W., Wh, W., Ban, T. A., King, D. L., Manov, G., & Ok, F. (1984) · PubMed · Cited by 21
Fluoxetine in endogenous depression and melancholia versus clomipramine.
Ginestet, D. (1989) · PubMed · Cited by 19
Mayo, C. W., Fishbein, M., Covet, S. S., Armstrong, H. G., & Warren, S. (1953) · Postgraduate Medicine · doi:10.1080/00325481.1953.11711400 · Cited by 19
A double-blind study of fluoxetine and imipramine in major depression.
Bressa, G. M., Brugnoli, R., & Pancheri, P. (1989) · PubMed · Cited by 18
A Double-blind Multi-centre Trial of Fluoxetine and Dothiepin in Major Depressive Illness
SOUTH WALES ANTIDEPRESSANT DRUG TRIAL GROUP (1988) · International Clinical Psychopharmacology · doi:10.1097/00004850-198801000-00006 · Cited by 18
An Italian multicenter experience with fluvoxamine, a new antidepressant drug, versus imipramine
Bramanti, P., Ricci, R. M., Roncari, R., Bilone, F., Inga, F., Teti, V., Cristofaro, A. M. D., Ceccarelli, G., Perri, R. D., & Candela, L. (1988) · Current Therapeutic Research · Cited by 17
Tamminen, T., & Vv, L. (1989) · PubMed · Cited by 16
Loeb, C., Albano, C., & Gandolfo, C. (1989) · PubMed · Cited by 16
Manna, V., Martucci, N., & AGNOLI, A. (1989) · PubMed · Cited by 14
Fluoxetine versus amineptine in the treatment of outpatients with major depressive disorders.
Ferreri, M. (1989) · PubMed · Cited by 13
Selective serotonin reuptake inhibitors
Fradd, S. (1992) · BMJ · doi:10.1136/bmj.305.6849.366-c · Cited by 13
Fluoxetine versus nomifensine in outpatients with neurotic or reactive depressive disorder.
Taneri, Z., & Köhler, R. (1989) · PubMed · Cited by 12
Dangers of aspirin before cardiac surgery: Author's reply
Cobbe, S. M. (1992) · BMJ · doi:10.1136/bmj.305.6849.366 · Cited by 11
A multicentre open trial of fluoxetine in depressed out-patients in Belgium.
Brasseur, R. (1989) · PubMed · Cited by 5
Pegg, D. E., & Meade, T. W. (1992) · The Lancet · doi:10.1016/0140-6736(92)93125-7 · Cited by 2
Research works printed but not linked: 2
- Sertraline for treatment of depression. Medical Letter on Drugs and Therapeutics 1992;34:47-8.
- 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)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1993-03-13
- Volume
- 306
- Issue
- 6879
- Pages
- 683-687
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- 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
- bronze
- doi.org
- 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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