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Review: second-generation antidepressants have similar effectiveness, but specific adverse effects differed

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What are the benefits and harms of different second-generation antidepressants?


Included studies were randomised controlled trials (RCTs) of ⩾6 weeks’ duration that compared 1 second-generation drug with another: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine. Outcomes were response rates and adverse effects.


Medline, CINAHL, EMBASE/Excerpta Medica, PsycINFO, Cochrane Central Register of Controlled Trials, International Pharmaceutical Abstracts (1980 to Apr 2007); and reference lists were searched for RCTs. Pharmaceutical manufacturers were contacted, and the Center for Drug Evaluation and Research was searched for unpublished trials. Poor-quality studies were not included unless no other direct comparison was available.


In 80 RCTs …

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