Objective: To summarize remission rates and dropouts due to adverse drug reactions (ADRs) or lack of efficacy (LoE) of serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin-reuptake inhibitors (SSRIs), and tricyclic antidepressants (TCAs) in treating major depressive disorder.
Methods: We searched MEDLINE, EMBASE, IPA, and the Cochrane International Library from 1980-2005. Meta-analysis summarized outcomes from head-to-head randomized clinical trials comparing >or= 2 drugs from three antidepressants classes (SNRIs, and/or SSRIs, and/or TCAs) followed by >or= 6 weeks of treatment. Remission was a final Hamilton Depression Rating Scale (HAMD) score
Results: We obtained data from 30 arms of 15 head-to-head trials with 2458 patients. SNRIs had the highest ITT remission rate (49.0%), then TCAs (44.1%), and SSRIs (37.7%) (p > 0.05 for SNRIs versus TCAs; p < 0.001 for TCAs versus SSRIs and SNRIs versus SSRIs). When categorized as inpatients (n = 582) and outpatients (n = 1613), SNRIs had the highest remission rates (52.0% for 144 inpatients and 49.3% for 559 outpatients). SNRIs had lowest overall dropouts (26.1%), followed by SSRIs (28.4%), and TCAs (35.7%). Dropouts due to ADRs and LoE were 10.3% and 6.2% for SNRIs, 8.3% and 7.2% for SSRIs, and 19.8% and 9.9% for TCAs, respectively (p > 0.05 for ADR dropouts only). One limitation was the inclusion of only venlafaxine-XR; results may not be the same for immediate release forms. In addition, few studies reported remission rates.
Conclusions: SNRIs had the highest efficacy remission rates (statistically significant for inpatients and outpatients), and the lowest overall dropout rates, suggesting clinical superiority in treating major depression.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1185/030079906X132415 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effects of Intensive Impairment-Oriented Arm Rehabilitation for Chronic Stroke Survivors: An Observational Cohort Study.
J Clin Med
December 2024
Hand and Occupational Therapy Outpatient Service Laborn, 80802 München, Germany.
: To assess the effects of a two-week course of intensive impairment-oriented arm rehabilitation for chronic stroke survivors on motor function. : An observational cohort study that enrolled chronic stroke survivors (≥6 months after stroke) with mild to severe arm paresis, who received a two-week course of impairment-oriented and technology-supported arm rehabilitation (1:1 participant-therapist setting), which was carried out daily (five days a week) for four hours. The outcome measures were as follows: the primary outcome was the arm motor function of the affected arm (mild paresis: BBT, NHPT; severe paresis: Fugl-Meyer arm motor score).
View Article and Find Full Text PDFUncertainty-aware diabetic retinopathy detection using deep learning enhanced by Bayesian approaches.
Sci Rep
January 2025
Department of Computer Science and Information Technology, Benazir Bhutto Shaheed University Lyari, Karachi, 75660, Pakistan.
Deep learning-based medical image analysis has shown strong potential in disease categorization, segmentation, detection, and even prediction. However, in high-stakes and complex domains like healthcare, the opaque nature of these models makes it challenging to trust predictions, particularly in uncertain cases. This sort of uncertainty can be crucial in medical image analysis; diabetic retinopathy is an example where even slight errors without an indication of confidence can have adverse impacts.
View Article and Find Full Text PDFDocumentary Analysis of (St. John's Wort) and Its Effect on Depressive Disorders.
Pharmaceuticals (Basel)
December 2024
Laboratory of Applied Microbiology, Center for Biotechnology of Natural Resources, Faculty of Agrarian and Forestry Sciences, Catholic University of Maule, Avda. San Miguel 3605, Talca 3460000, Chile.
, also known as St. John's Wort, pericon, or yellow grass, is known for its antidepressant potential. It could represent a natural alternative to current pharmacological antidepressant treatments, which have a high incidence of side effects in patients and therefore lead to early dropouts.
View Article and Find Full Text PDFPharmacological Strategies to Decrease Long-Term Prescription Opioid Use: A Systematic Review.
J Clin Med
December 2024
Department of Pharmacy, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
: As long-term prescription opioid use is associated with increased morbidity and mortality, timely dose reduction of prescription opioids should be considered. However, most research has been conducted on patients using heroin. Given the differences between prescription and illicit opioid use, the aim of this review was to provide an overview of pharmacological strategies to reduce prescription opioid use or improve clinical outcomes for people who experience long-term prescription opioid use, including those with opioid use disorder.
View Article and Find Full Text PDFA safety and feasibility randomized placebo controlled trial exploring electroencephalographic effective connectivity neurofeedback treatment for fibromyalgia.
Sci Rep
January 2025
Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand.
Fibromyalgia is a chronic pain condition contributing to significant disability worldwide. Neuroimaging studies identify abnormal effective connectivity between cortical areas responsible for descending pain modulation (pregenual anterior cingulate cortex, pgACC) and sensory components of pain experience (primary somatosensory cortex, S1). Neurofeedback, a brain-computer interface technique, can normalise dysfunctional brain activity, thereby improving pain and function.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!