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Review: newer and older antidepressants have similar efficacy and total discontinuation rates but different side effects

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 QUESTION: In patients with depressive disorders, do newer and older pharmacotherapies have similar efficacy and adverse effects?

Data sources

Studies were identified by searching the Cochrane Collaboration Depression, Anxiety, and Neurosis Controlled Trials Registry; scanning trial article references and 46 meta-analyses; and contacting experts.

Study selection

Studies were selected if they were randomised controlled trials (RCTs) with an active intervention of ≥6 weeks; compared a “newer” antidepressant with another antidepressant, placebo, or psychosocial intervention in patients with depressive disorders; and assessed depression symptoms, functional status, or quality of life.

Data extraction

2 reviewers independently extracted data on participant and diagnostic descriptors, setting, intervention, study methods, adverse effects, and outcomes (response rate, dropouts, and dropouts because of adverse events).

Main results

315 studies met the selection criteria. Similar response and total discontinuation rates existed for newer and older antidepressants. Newer antidepressants led to greater response rates in patients with major depression (51% …

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