Cited by 355Treatment of Major DepressionMental Health Treatment and AccessPsychotherapy Techniques and Applications

The DOI matches its Crossref record; 132 of the 132 references it cites were found in a registry or an index.

Comparative Benefits and Harms of Second-Generation Antidepressants for Treating Major Depressive Disorder: An Updated Meta-analysis

Abstract

BACKGROUND: Second-generation antidepressants dominate the management of major depressive disorder (MDD), but evidence on the comparative benefits and harms of these agents is contradictory. PURPOSE: To compare the benefits and harms of second-generation antidepressants for treating MDD in adults. DATA SOURCES: English-language studies from PubMed, Embase, the Cochrane Library, PsycINFO, and International Pharmaceutical Abstracts from 1980 to August 2011 and reference lists of pertinent review articles and gray literature. STUDY SELECTION: 2 independent reviewers identified randomized trials of at least 6 weeks' duration to evaluate efficacy and observational studies with at least 1000 participants to assess harm. DATA EXTRACTION: Reviewers abstracted data about study design and conduct, participants, and interventions and outcomes and rated study quality. A senior reviewer checked and confirmed extracted data and quality ratings. DATA SYNTHESIS: Meta-analyses and mixed-treatment comparisons of response to treatment and weighted mean differences were conducted on specific scales to rate depression. On the basis of 234 studies, no clinically relevant differences in efficacy or effectiveness were detected for the treatment of acute, continuation, and maintenance phases of MDD. No differences in efficacy were seen in patients with accompanying symptoms or in subgroups based on age, sex, ethnicity, or comorbid conditions. Individual drugs differed in onset of action, adverse events, and some measures of health-related quality of life. LIMITATIONS: Most trials were conducted in highly selected populations. Publication bias might affect the estimates of some comparisons. Mixed-treatment comparisons cannot conclusively exclude differences in efficacy. Evidence within subgroups was limited. CONCLUSION: Current evidence does not warrant recommending a particular second-generation antidepressant on the basis of differences in efficacy. Differences in onset of action and adverse events may be considered when choosing a medication. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.

Overview

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Crossref · 10.7326/0003-4819-155-11-201112060-00009

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Citations

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Show all 131 references

Research works printed but not linked: 10

  1. Bennie EH, 1995, J Clin Psychiatry, 56, 229
  2. Alves C, 1999, Primary Care Psychiatry, 5, 57
  3. Beasley CM, 1991, J Clin Psychiatry, 52, 294
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  5. Gagiano CA, 1993, Br J Clin Res, 4, 145
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  9. Khazaie H, 2011, Neurosciences (Riyadh), 16, 42
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Metadata

Authors
Gartlehner, G., Hansen, R. A., Morgan, L. C., Thaler, K., Lux, L., Van Noord, M., Mager, U., Thieda, P., Gaynes, B. N., Wilkins, T., Strobelberger, M., Lloyd, S., Reichenpfader, U., & Lohr, K. N.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • From Danube University, Krems, Austria; Auburn University, Auburn, Alabama; RTI International, Research Triangle Park, North Carolina; the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and the Ludwig Boltzmann Institute for Health Promotion Research, Vienna, Austria.
Venue
Annals of Internal Medicine
Published
2011-12-06
Volume
155
Issue
11
Pages
772-785
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
OpenAlex
W2082270426
Cited by
355
References
131
Citations by year
2026: 13 · 2025: 17 · 2024: 15 · 2023: 22 · 2022: 23 · 2021: 13 · 2020: 23 · 2019: 20 · 2018: 34 · 2017: 20 · 2016: 35 · 2015: 32 · 2014: 36 · 2013: 29 · 2012: 23
FWCI
3.51
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Annals of Internal Medicine
Funders
U.S. Public Health Service (290200710056I#2)
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
second-generation antidepressants, major depressive disorder, antidepressant efficacy, antidepressant side effects, onset of action, health-related quality of life, maintenance therapy, continuation treatment, acute treatment
MeSH terms
Delayed-Action Preparations, Major Depressive Disorder, Humans, Recurrence, Remission Induction, Sexual Dysfunction, Physiological, Treatment Outcome, Antidepressive Agents, Second-Generation, Comparative Effectiveness Research, Suicidal Ideation

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