Fluoxetine versus other types of pharmacotherapy for depression

Abstract

Background-Depression is common in primary care and it is associated with marked personal, social and economic morbidity, and creates significant demands on service providers in terms of workload. Treatment is predominantly pharmaceutical or psychological. Fluoxetine, the first of a group of antidepressant (AD) agents known as selective serotonin reuptake inhibitors (SSRIs), has been studied in many randomised controlled trials (RCTs) in comparison with tricyclic (TCA), heterocyclic and related ADs, and other SSRIs. These comparative studies provided contrasting findings. In addition, systematic reviews of RCTs have always considered the SSRIs as a group, and evidence applicable to this group of drugs might not be applicable to fluoxetine alone. The present systematic review assessed the efficacy and tolerability profile of fluoxetine in comparison with TCAs, SSRIs and newer agents.

Escitalopram versus other antidepressive agents for depression

“…In terms of side effect profile, different tolerability profiles for different antidepressants were found. This is an important issue from a clinical point of view and results from this review are consistent with previous findings (Cipriani 2005; Hansen 2005). However, a full description of tolerability profile of drugs cannot rely solely on randomised evidence (Etminan 2005).…”

“…In this review the mean sample size was bigger than mean sample size of antidepressant studies included in a similar systematic review comparing fluoxetine versus other antidepressants (Cipriani 2005). Escitalopram is a relatively new compound and the quality of trials in psychiatry may have improved in the last years.…”

Escitalopram versus other antidepressive agents for depression

“…In terms of side effect profile, different tolerability profiles for different antidepressants were found. This is an important issue from a clinical point of view and results from this review are consistent with previous findings (Cipriani 2005; Hansen 2005). However, a full description of tolerability profile of drugs cannot rely solely on randomised evidence (Etminan 2005).…”

“…In this review the mean sample size was bigger than mean sample size of antidepressant studies included in a similar systematic review comparing fluoxetine versus other antidepressants (Cipriani 2005). Escitalopram is a relatively new compound and the quality of trials in psychiatry may have improved in the last years.…”

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

“…This, for example, could lead to participants who are more likely to respond positively to the treatment being allocated to the intervention group. Poor allocation concealment can lead to biased trial results (Cipriani 2005). So adequate allocation concealment is one of the most important aspects of the way a RCT is designed and conducted.…”

Imputing missing standard deviations in meta-analyses can provide accurate results

“…In the comprehensive meta-analysis of three-armed studies involving antidepressants [6], the situation was analogous, as only 14 out of 37 trials employing HRSD had reported SDs. In our fluoxetine review [4], barely half of the identified trials (39 out of 75 trials employing HRSD) had reported SDs or other information to allow exact calculation. The recent consorted efforts by journal editors and clinical epidemiologists to call for better reporting of trial findings represent a step forward to remedy this situation [15].…”

Escitalopram versus other antidepressive agents for depression

“…In terms of side effect profile, different tolerability profiles for different antidepressants were found. This is an important issue from a clinical point of view and results from this review are consistent with previous findings (Cipriani 2005; Hansen 2005). However, a full description of tolerability profile of drugs cannot rely solely on randomised evidence (Etminan 2005).…”

“…In this review the mean sample size was bigger than mean sample size of antidepressant studies included in a similar systematic review comparing fluoxetine versus other antidepressants (Cipriani 2005). Escitalopram is a relatively new compound and the quality of trials in psychiatry may have improved in the last years.…”

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

“…This, for example, could lead to participants who are more likely to respond positively to the treatment being allocated to the intervention group. Poor allocation concealment can lead to biased trial results (Cipriani 2005). So adequate allocation concealment is one of the most important aspects of the way a RCT is designed and conducted.…”

Imputing missing standard deviations in meta-analyses can provide accurate results

“…In the comprehensive meta-analysis of three-armed studies involving antidepressants [6], the situation was analogous, as only 14 out of 37 trials employing HRSD had reported SDs. In our fluoxetine review [4], barely half of the identified trials (39 out of 75 trials employing HRSD) had reported SDs or other information to allow exact calculation. The recent consorted efforts by journal editors and clinical epidemiologists to call for better reporting of trial findings represent a step forward to remedy this situation [15].…”

Escitalopram versus other antidepressive agents for depression

“…In terms of side effect profile, different tolerability profiles for different antidepressants were found. This is an important issue from a clinical point of view and results from this review are consistent with previous findings (Cipriani 2005; Hansen 2005). However, a full description of tolerability profile of drugs cannot rely solely on randomised evidence (Etminan 2005).…”

“…In this review the mean sample size was bigger than mean sample size of antidepressant studies included in a similar systematic review comparing fluoxetine versus other antidepressants (Cipriani 2005). Escitalopram is a relatively new compound and the quality of trials in psychiatry may have improved in the last years.…”

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

“…This, for example, could lead to participants who are more likely to respond positively to the treatment being allocated to the intervention group. Poor allocation concealment can lead to biased trial results (Cipriani 2005). So adequate allocation concealment is one of the most important aspects of the way a RCT is designed and conducted.…”

Imputing missing standard deviations in meta-analyses can provide accurate results

“…In the comprehensive meta-analysis of three-armed studies involving antidepressants [6], the situation was analogous, as only 14 out of 37 trials employing HRSD had reported SDs. In our fluoxetine review [4], barely half of the identified trials (39 out of 75 trials employing HRSD) had reported SDs or other information to allow exact calculation. The recent consorted efforts by journal editors and clinical epidemiologists to call for better reporting of trial findings represent a step forward to remedy this situation [15].…”