How should primary care doctors select which antidepressants to administer?

Current Psychiatry Reports

Volumn 14, Issue 4, 2012, Pages 360-369

  Gartlehner, Gerald ^a,b   Thaler, Kylie ^a   Hill, Seth ^c   Hansen, Richard A ^c  

^a DANUBE UNIVERSITY KREMS   (Austria)

^b RTI INTERNATIONAL   (United States)

^c AUBURN UNIVERSITY   (United States)

Author keywords

Dysthymia; Major depressive disorder; Primary care; Second generationantidepressants; Subsyndromaldepression; Treating depressive disorders

Indexed keywords

AMFEBUTAMONE; ANTIDEPRESSANT AGENT; BUSPIRONE; CITALOPRAM; DESVENLAFAXINE; DULOXETINE; ESCITALOPRAM; FLUOXETINE; FLUVOXAMINE; FLUVOXAMINE MALEATE; MIRTAZAPINE; MONOAMINE OXIDASE INHIBITOR; NEFAZODONE; NORADRENALIN UPTAKE INHIBITOR; PAROXETINE; PLACEBO; REMER ON; SEROTONIN; SEROTONIN UPTAKE INHIBITOR; SERTRALINE; TRAZODONE; TRICYCLIC ANTIDEPRESSANT AGENT; UNCLASSIFIED DRUG; VENLAFAXINE;

ANXIETY DISORDER; ARTICLE; BEHAVIOR THERAPY; BLEEDING; CARDIOVASCULAR DISEASE; COMPARATIVE EFFECTIVENESS; COST BENEFIT ANALYSIS; DEPRESSION; DIARRHEA; DISEASE ASSOCIATION; DISEASE SEVERITY; DIZZINESS; DRUG CHOICE; DRUG EFFICACY; DRUG INDUCED HEADACHE; DRUG MECHANISM; DRUG MEGADOSE; DRUG PREFERENCE; DRUG SAFETY; DRUG WITHDRAWAL; DYSTHYMIA; EVIDENCE BASED MEDICINE; FRACTURE; GENERAL PRACTITIONER; HUMAN; HYPONATREMIA; INSOMNIA; LIVER TOXICITY; MAJOR DEPRESSION; META ANALYSIS (TOPIC); MOOD DISORDER; NAUSEA; QUALITY OF LIFE; RECURRENT DISEASE; RELAPSE; REMISSION; SEIZURE; SEROTONIN SYNDROME; SEXUAL DYSFUNCTION; SIDE EFFECT; SOMNOLENCE; SUBSYNDROMAL DEPRESSION; SUICIDE ATTEMPT; SYSTEMATIC REVIEW (TOPIC); VOMITING; WEIGHT GAIN;

ANTIDEPRESSIVE AGENTS, SECOND-GENERATION; DEPRESSIVE DISORDER; EVIDENCE-BASED MEDICINE; FAMILY PRACTICE; HUMANS; PRACTICE GUIDELINES AS TOPIC; RECURRENCE;

EID: 84865646363     PISSN: 15233812     EISSN: 15351645     Source Type: Journal    
DOI: 10.1007/s11920-012-0283-x     Document Type: Article

References (102)

1. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision. Washington, DC. 2000.
2. Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62 (6):593-602. (Pubitemid 40973434)
3. Olfson M, Marcus SC. National patterns in antidepressant medication treatment. Arch Gen Psychiatry. 2009;66(8):848-56.
4. Greenberg PE, Kessler RC, Birnbaum HG, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry. 2003;64(12):1465-75. (Pubitemid 41270106)
5. Birnbaum HG, Ben-Hamadi R, Greenberg PE, et al. Determinants of direct cost differences among US employees with major depressive disorders using antidepressants. Pharmacoeconomics. 2009;27 (6):507-17.
6. Kupfer DJ. Long-term treatment of depression. J Clin Psychiatry. 1991;52(Suppl):28-34.
7. Berkrot B. US prescription drug sales hit $300 bln in 2009, e. Gary Hill, Editor 2010, Reuters.
8. Williams JW, Mulrow CD, Chiquette E, et al. A systematic review of newer pharmacotherapies for depression in adults: evidence report summary. Ann Intern Med. 2000;132(9):743-56. (Pubitemid 30244176)
9. Geddes JR, Freemantle N, Mason J et al. Selective serotonin reuptake inhibitors (SSRIs) versus other antidepressants for depression. The Cochrane Library (Cochrane Review), 2006 (1).
10. Hansen RA, Gartlehner G, Lohr KN, et al. Efficacy and safety of second-generation antidepressants in the treatment of major depressive disorder. Ann Intern Med. 2005;143(6):415-26. (Pubitemid 41341413)
11. Cipriani A, Furukawa TA, Geddes JR et al. Does randomized evidence support sertraline as first-line antidepressant for adults with acute major depression? A systematic review and metaanalysis, in J Clin Psychiatry 2008; 1732-42.
12. Omori IM, Watanabe N, Nakagawa A et al. Efficacy, tolerability and side-effect profile of fluvoxamine for major depression: Meta-analysis. Journal of Psychopharmacology 2009; 539-550.
13. Watanabe N, Omori IM, Nakagawa A et al. Mirtazapine versus other antidepressants in the acute-phase treatment of adults with major depression: Systematic review and meta-analysis, in Journal of Clinical Psychiatry 2008; 1404-1415.
14. Weinmann S, Becker T, Koesters M. Re-evaluation of the efficacy and tolerability of venlafaxine vs SSRI: meta-analysis. Psychopharmacology (Berl). 2008;196(4):511-20. discussion 521-2. (Pubitemid 351623005)
15. Girardi P, Pompili M, Innamorati M, et al. Duloxetine in acute major depression: review of comparisons to placebo and standard antidepressants using dissimilar methods. Hum Psychopharmacol. 2009;24(3):177-90.
16. Eckert L, Falissard B. Using meta-regression in performing indirect-comparisons: comparing escitalopram with venlafaxine XR. Curr Med Res Opin 2006;2313-21. (Pubitemid 44789994)
17. Eckert L and Lançon C. Duloxetine compared with fluoxetine and venlafaxine: Use of meta-regression analysis for indirect comparisons. BMC Psychiatry 2006.
18. Gartlehner G, Hansen RA, Morgan LC, et al. Comparative Benefits and Harms of Second-Generation Antidepressants for Treating Major Depressive Disorder: An Updated Meta-analysis. Ann Intern Med. 2011;155(11):772-85. This is the most recent and most comprehensive assessment of the comparative efficacy and safety of second-generation antidepressants for the treatment of depressive disorders.
19. Cipriani A, Furukawa TA, Salanti G et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 2009;746-58.
20. Turner E, Moreno SG, Sutton AJ. Ranking antidepressants. Lancet. 2009;373(9677):1760. author reply 1761-2.
21. Seyringer ME, Kasper S. Ranking antidepressants. Lancet. 2009;373(9677):1760-1. author reply 1761-2.
22. Schwan S, Hallberg P. Ranking antidepressants. Lancet. 2009;373(9677):1761. author reply 1761-2.
23. Ioannidis JP. Ranking antidepressants. Lancet. 2009;373 (9677):1759-60. author reply 1761-2.
24. Gartlehner G, Gaynes BN, Hansen RA, Lohr KN. Ranking antidepressants. Lancet. 2009;373(9677):1761. author reply 1761-2.
25. Gartlehner G, Hansen RA, Morgan LC, et al. Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression: An Update of the 2007 Comparative Effectiveness Review. AHRQ. 2011;46:171.
26. Benkert O, Szegedi A, Kohnen R. Mirtazapine compared with paroxetine in major depression. J Clin Psychiatry. 2000;61(9):656-63.
27. Schatzberg AF, Kremer C, Rodrigues HE, Murphy Jr. GM. Double-blind, randomized comparison of mirtazapine and paroxetine in elderly depressed patients. Am J Geriatr Psychiatry. 2002;10(5):541-50. (Pubitemid 34984390)
28. Behnke K, Sogaard J, Martin S, et al. Mirtazapine orally disintegrating tablet versus sertraline: a prospective onset of action study. J Clin Psychopharmacol. 2003;23(4):358-64. (Pubitemid 36951177)
29. Hong CJ, Hu WH, Chen CC, et al. A double-blind, randomized, group-comparative study of the tolerability and efficacy of 6 weeks' treatment with mirtazapine or fluoxetine in depressed Chinese patients. J Clin Psychiatry. 2003;64(8):921-6.
30. Versiani M, Moreno R, Ramakers-van Moorsel CJ, Schutte AJ. Comparison of the effects of mirtazapine and fluoxetine in severely depressed patients. CNS Drugs. 2005;19(2):137-46. (Pubitemid 40321765)
31. Wheatley DP, van Moffaert M, Timmerman L, Kremer CM. Mirtazapine: efficacy and tolerability in comparison with fluoxetine in patients with moderate to severe major depressive disorder. Mirtazapine-Fluoxetine Study Group. J Clin Psychiatry. 1998;59 (6):306-12. (Pubitemid 28353979)
32. Leinonen E, Skarstein J, BehnkeK, et al. Efficacy and tolerability of mirtazapine versus citalopram: a double-blind, randomized study in patients with major depressive disorder. Nordic Antidepressant Study Group. Int Clin Psychopharmacol. 1999;14(6):329-37. (Pubitemid 29531381)
33. Coleman CC, Cunningham LA, Foster VJ, et al. Sexual dysfunction associated with the treatment of depression: a placebo-controlled comparison of bupropion sustained release and sertraline treatment. Ann Clin Psychiatry. 1999;11(4):205-15.
34. Croft H, Settle Jr. E, Houser T, et al. A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline. Clin Ther. 1999;21 (4):643-58. (Pubitemid 29252088)
35. Kavoussi RJ, Segraves RT, Hughes AR, et al. Double-blind comparison of bupropion sustained release and sertraline in depressed outpatients. J Clin Psychiatry. 1997;58(12):532-7. (Pubitemid 28100273)
36. Feighner JP, Gardner EA, Johnston JA, et al. Double-blind comparison of bupropion and fluoxetine in depressed outpatients. J Clin Psychiatry. 1991;52(8):329-35.
37. Coleman CC, King BR, Bolden-Watson C, et al. A placebocontrolled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine. Clin Ther. 2001;23 (7):1040-58. (Pubitemid 32709626)
38. Ventura D, Armstrong EP, Skrepnek GH, Haim Erder M. Escitalopram versus sertraline in the treatment of major depressive disorder: a randomized clinical trial. Curr Med Res Opin 2007; 245-50. (Pubitemid 46333371)
39. Clayton AH, Croft HA, Horrigan JP et al. Bupropion extended release compared with escitalopram: effects on sexual functioning and antidepressant efficacy in 2 randomized, double-blind, placebo-controlled studies. J Clin Psychiatry 2006;736-46. (Pubitemid 43946180)
40. Kennedy SH, Fulton KA, Bagby RM et al. Sexual function during bupropion or paroxetine treatment of major depressive disorder. Can J Psychiatry 2006;234-42.
41. Qaseem A, Snow V, Denberg TD, et al. Using second-generation antidepressants to treat depressive disorders: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;149(10):725-33.
42. Zimmerman M, Posternak M, Friedman M, et al. Which factors influence psychiatrists' selection of antidepressants? Am J Psychiatry. 2004;161(7):1285-9. (Pubitemid 38859180)
43. Kim HM, Zivin K, Ganoczy D, et al. Predictors of alternative antidepressant agent initiation among U. S. veterans diagnosed with depression. Pharmacoepidemiol Drug Saf. 2010;19 (10):1049-56.
44. Garrison GD, Levin GM. Factors affecting prescribing of the newer antidepressants. Ann Pharmacother. 2000;34(1):10-4. (Pubitemid 30058917)
45. Eli Lilly aC. Cymbalta -"Depression Hurts" campaign. 2011 26th January 2012]; Available from: http://www.youtube.com/watch?v- 7d6Ra0n2pUA&feature0related
46. Silverstone PH, Ravindran A. Once-daily venlafaxine extended release (XR) compared with fluoxetine in outpatients with depression and anxiety. Venlafaxine XR 360 Study Group. J Clin Psychiatry. 1999;60(1):22-8. (Pubitemid 29069881)
47. De Nayer A, Geerts S, Ruelens L, et al. Venlafaxine compared with fluoxetine in outpatients with depression and concomitant anxiety. Int J Neuropsychopharmacol. 2002;5(2):115-20. (Pubitemid 34662973)
48. Sir A, D'Souza RF, Uguz S, et al. Randomized trial of sertraline versus venlafaxine XR in major depression: efficacy and discontinuation symptoms. J Clin Psychiatry. 2005;66(10):1312-20. (Pubitemid 41546512)
49. Rush AJ, Trivedi MH, Carmody TJ, et al. Response in relation to baseline anxiety levels in major depressive disorder treated with bupropion sustained release or sertraline. Neuropsychopharmacology. 2001;25(1):131-8. (Pubitemid 32493829)
50. Baldwin DS, Hawley CJ, Abed RT, et al. A multicenter doubleblind comparison of nefazodone and paroxetine in the treatment of outpatients with moderate-to-severe depression. J Clin Psychiatry. 1996;57 Suppl 2:46-52. (Pubitemid 26146709)
51. Gillin JC, Rapaport M, Erman MK, et al. A comparison of nefazodone and fluoxetine on mood and on objective, subjective, and clinician-rated measures of sleep in depressed patients: a double-blind, 8-week clinical trial. J Clin Psychiatry. 1997;58 (5):185-92. (Pubitemid 27242004)
52. Cunningham LA, Borison RL, Carman JS, et al. A comparison of venlafaxine, trazodone, and placebo in major depression. J Clin Psychopharmacol. 1994;14(2):99-106. (Pubitemid 24120707)
53. Beasley Jr. CM, Dornseif BE, Pultz JA, et al. Fluoxetine versus trazodone: efficacy and activating-sedating effects. J Clin Psychiatry. 1991;52(7):294-9.
54. Detke MJ, Wiltse CG, Mallinckrodt CH, et al. Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo-and paroxetine-controlled trial. Eur Neuropsychopharmacol. 2004;14(6):457-70. (Pubitemid 39626894)
55. Goldstein DJ, Lu Y, Detke MJ, et al. Duloxetine in the treatment of depression: a double-blind placebo-controlled comparison with paroxetine. J Clin Psychopharmacol. 2004;24(4):389-99. (Pubitemid 38944137)
56. Perahia DG, Wang F, Mallinckrodt CH et al. Duloxetine in the treatment of major depressive disorder: a placebo-and paroxetine-controlled trial. Eur Psychiatry 2006; 367-78.
57. Eli Lilly aC. DuloxetineVersus Placebo and Paroxetine in the Acute Treatment of Major Depression, Study Group A. Clinical Study Summary: Study F1J-MC-HMAT. At: http://www.clinicalstudyresults. org/documents/company-study- 170-0.pdf (Accessed 08/24/2006). 2004.
58. Practice guideline for the treatment of patients with major depressive disorder (revision). American Psychiatric Association. Am J Psychiatry, 2000; 157(4 Suppl):1-45.
59. Hansen R, Gaynes B, Thieda P et al. Meta-analysis of major depressive disorder relapse and recurrence with second-generation antidepressants. Psychiatr Serv 2008;1121-30.
60. Bauer M, Tharmanathan P, Volz HP et al. The effect of venlafaxine compared with other antidepressants and placebo in the treatment of major depression: ameta-analysis. Eur Arch Psychiatry Clin Neurosci 2009;172-85.
61. Soares CN, Thase ME, Clayton A et al. Desvenlafaxine and escitalopram for the treatment of postmenopausal women with major depressive disorder. Menopause 2010;700-11.
62. Baldwin DS, Cooper JA, Huusom AK, Hindmarch I. A doubleblind, randomized, parallel-group, flexible-dose study to evaluate the tolerability, efficacy and effects of treatment discontinuation with escitalopram and paroxetine in patients with major depressive disorder. Int Clin Psychopharmacol 2006;159-69. (Pubitemid 43740307)
63. Van Moffaert M, Bartholome F, Cosyns P, De Nayer AR. A controlled comparison of sertraline and fluoxetine in acute and continuation treatment of major depression. Hum Psychopharmacol. 1995;10:393-405.
64. Keller MB, Trivedi MH, Thase ME et al. The Prevention of Recurrent Episodes of Depression with Venlafaxine for Two Years (PREVENT) Study: Outcomes from the 2-year and combined maintenance phases. J Clin Psychiatry 2007; 1246-56. (Pubitemid 47395628)
65. Franchini L, Gasperini M, Zanardi R, Smeraldi E. Four-year follow-up study of sertraline and fluvoxamine in long-term treatment of unipolar subjects with high recurrence rate. J Affect Disord. 2000;58(3):233-6. (Pubitemid 30232779)
66. Franchini L, Gasperini M, Perez J, et al. A double-blind study of long-term treatment with sertraline or fluvoxamine for prevention of highly recurrent unipolar depression. J Clin Psychiatry. 1997;58(3):104-7. (Pubitemid 27149250)
67. Lin CC. Duloxetine treatment of social anxiety disorder with comorbid major depression. J Clin Psychopharmacol. 2008;28 (5):591-2. author reply 592-3.
68. Rush AJ, Trivedi MH, Wisniewski SR et al. Acute and Longer-Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D Report. Am J Psychiatry 2006;1905-17. (Pubitemid 44807782)
69. Trivedi MH, Fava M, Wisniewski SR. et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med 2006;1243-52.
70. Gaynes BN, Dusetzina SB, Ellis AR, et al. Treating depression after initial treatment failure: directly comparing switch and augmenting strategies in STAR*D. J Clin Psychopharmacol. 2012;32 (1):114-9.
71. Fang Y, Yuan C, Xu Y et al. Comparisons of the efficacy and tolerability of extended-release venlafaxine, mirtazapine, and paroxetine in treatment-resistant depression: a double-blind, randomized pilot study in a Chinese population. J Clin Psychopharmacol 2010;357-64.
72. Poirier MF, Boyer P. Venlafaxine and paroxetine in treatmentresistant depression. Double-blind, randomised comparison. Br J Psychiatry. 1999;175:12-6. (Pubitemid 29307849)
73. Lenox-Smith AJ, Jiang Q. Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor. Int Clin Psychopharmacol. 2008;23 (3):113-9. (Pubitemid 351535902)
74. Corya SA,Williamson D, Sanger TM et al. A randomized, doubleblind comparison of olanzapine/fluoxetine combination, olanzapine, fluoxetine, and venlafaxine in treatment-resistant depression. Depress Anxiety 2006;364-72. (Pubitemid 44619788)
75. Baldomero EB, Ubago JG, Cercos CL, et al. Venlafaxine extended release versus conventional antidepressants in the remission of depressive disorders after previous antidepressant failure: ARGOS study. Depress Anxiety. 2005;22(2):68-76.
76. Blier P, Ward HE, Tremblay P, et al. Combination of antidepressant medications from treatment initiation for major depressive disorder: a double-blind randomized study. Am J Psychiatry. 2010;167(3):281-8.
77. Carpenter LL, Yasmin S, Price LH. A double-blind, placebocontrolled study of antidepressant augmentation with mirtazapine. Biol Psychiatry. 2002;51(2):183-8. (Pubitemid 34127908)
78. Lam RW, Hossie H, Solomons K, Yatham LN. Citalopram and bupropion-SR: combining versus switching in patients with treatment-resistant depression. J Clin Psychiatry. 2004;65(3): 337-40.
79. Blier P, Gobbi G, Turcotte JE et al. Mirtazapine and paroxetine in major depression: a comparison of monotherapy versus their combination from treatment initiation. Eur Neuropsychopharmacol 2009;457-65.
80. Rush AJ, Trivedi MH, Stewart JW, et al. Combining Medications to Enhance Depression Outcomes (CO-MED): Acute and longterm outcomes of a single-blind randomized study. Am J Psychiatry. 2011;168(7):689-701.
81. Vanelle JM, Attar-Levy D, Poirier MF, et al. Controlled efficacy study of fluoxetine in dysthymia. Br J Psychiatry. 1997;170:345-50. (Pubitemid 27208232)
82. Kocsis JH, Zisook S, Davidson J, et al. Double-blind comparison of sertraline, imipramine, and placebo in the treatment of dysthymia: psychosocial outcomes. Am J Psychiatry. 1997;154(3):390-5. (Pubitemid 27098290)
83. Thase ME, Fava M, Halbreich U, et al. A placebo-controlled, randomized clinical trial comparing sertraline and imipramine for the treatment of dysthymia. Arch Gen Psychiatry. 1996;53 (9):777-84. (Pubitemid 26303618)
84. Devanand DP, Nobler MS, Cheng J, et al. Randomized, doubleblind, placebo-controlled trial of fluoxetine treatment for elderly patients with dysthymic disorder. Am J Geriatr Psychiatry. 2005;13(1):59-68. (Pubitemid 41031116)
85. Barrett JE, Williams Jr. JW, Oxman TE, et al. Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. J Fam Pract. 2001;50 (5):405-12. (Pubitemid 32440814)
86. Ravindran AV, Guelfi JD, Lane RM, Cassano GB. Treatment of dysthymia with sertraline: a double-blind, placebo-controlled trial in dysthymic patients without major depression. J Clin Psychiatry. 2000;61(11):821-7.
87. Williams Jr. JW, Barrett J, Oxman T, et al. Treatment of dysthymia and minor depression in primary care: A randomized controlled trial in older adults. JAMA. 2000;284(12):1519-26.
88. Kroenke K. Minor depression: midway between major depression and euthymia. Ann Intern Med. 2006;144(7):528-30. (Pubitemid 46780677)
89. Cuijpers P, Smit F. Subthreshold depression as a risk indicator for major depressive disorder: a systematic review of prospective studies. Acta Psychiatr Scand. 2004;109(5):325-31. (Pubitemid 38491278)
90. Judd LL, Rapaport MH, Yonkers KA, et al. Randomized, placebo-controlled trial of fluoxetine for acute treatment of minor depressive disorder. Am J Psychiatry. 2004;161(10):1864-71. (Pubitemid 39314681)
91. Rocca P, Calvarese P, Faggiano F, et al. Citalopram versus sertraline in late-life nonmajor clinically significant depression: a 1-year follow-up clinical trial. J Clin Psychiatry. 2005;66 (3):360-9. (Pubitemid 40476760)
92. Stewart DE. Hepatic adverse reactions associated with nefazodone. Can J Psychiatry. 2002;47(4):375-7. (Pubitemid 34728759)
93. Strombom I, Wernicke JF, Seeger J, et al. Hepatic effects of duloxetine-III: analysis of hepatic events using external data sources. Curr Drug Saf. 2008;3(2):154-62.
94. Fergusson D, Doucette S, Glass KC, et al. Association between suicide attempts and selective serotonin reuptake inhibitors: systematic review of randomised controlled trials. BMJ. 2005;330 (7488):396.
95. Didham RC, McConnell DW, Blair HJ, Reith DM. Suicide and self-harm following prescription of SSRIs and other antidepressants: confounding by indication. Br J Clin Pharmacol. 2005;60 (5):519-25. (Pubitemid 41532452)
96. Rahme E, Dasgupta K, Turecki G et al. Risks of suicide and poisoning among elderly patients prescribed selective serotonin reuptake inhibitors: a retrospective cohort study. J Clin Psychiatry 2008;349-57. (Pubitemid 351549386)
97. Friedman RA, Leon AC. Expanding the black box -depression, antidepressants, and the risk of suicide. N Engl J Med. 2007;356 (23):2343-6. (Pubitemid 46883767)
98. Barbui C, Esposito E, Cipriani A. Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies. CMAJ. 2009;180(3):291-7. Suicidal attempts or suicides are rare but severe adverse effects of second-generation antidepressants. Randomized controlled trials are usually too small to assess the excess risk of suicidality. This study provides a meta-analyses of large observational studies.
99. Gunnell D, Saperia J, Ashby D. Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults: meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA's safety review. BMJ. 2005;330 (7488):385.
100. Jick H, Kaye JA, Jick SS. Antidepressants and the risk of suicidal behaviors. JAMA. 2004;292(3):338-43. (Pubitemid 38944257)
101. Khan A, Khan S, Kolts R, Brown WA. Suicide rates in clinical trials of SSRIs, other antidepressants, and placebo: analysis of FDA reports. Am J Psychiatry. 2003;160(4):790-2. (Pubitemid 41079617)
102. Martinez C, Rietbrock S, Wise L, et al. Antidepressant treatment and the risk of fatal and non-fatal self harm in first episode depression: nested case-control study. BMJ. 2005;330 (7488):389.