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