scholarly journals Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors

2001 ◽  
Vol 178 (3) ◽  
pp. 234-241 ◽  
Author(s):  
Michael E. Thase ◽  
A. Richard Entsuah ◽  
Richard L. Rudolph
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Depression Score ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Double Blind ◽  
Remission Rates ◽  
The Difference ◽  
Definition Of

BackgroundIt had been suggested that the antidepressant venlafaxine, which inhibits reuptake of both serotonin and (at higher doses) noradrenaline, may result in better outcomes than treatment with selective serotonin reuptake inhibitors (SSRIs).AimsTo compare remission rates during treatment with SSRIs or venlafaxine.MethodData from eight comparable randomised, double-blind studies of major depressive disorder were pooled to compare remission rates (Hamilton Rating Scale for Depression score ≤ 7) during treatment with venlafaxine (n=851), SSRIs (fluoxetine, paroxetine, fluvoxamine; n=748) or placebo (four studies; n=446).ResultsRemission rates were: venlafaxine, 45% (382/851); SSRIs, 35% (260/748); placebo, 25% (110/446) (P < 0.001; odds ratio for remission is 1.50 (1.3–1.9), favouring venlafaxine v. SSRIs). The difference between venlafaxine and the SSRIs was significant at week 2, whereas the difference between SSRIs and placebo reached significance at week 4. Results were not dependent on any one study or the definition of remission.ConclusionsRemission rates were significantly higher with venlafaxine than with an SSRI.

scholarly journals Efficacy and tolerability of venlafaxine compared with selective serotonin reuptake inhibitors and other antidepressants: A meta-analysis

2002 ◽  
Vol 180 (5) ◽  
pp. 396-404 ◽  
Author(s):  
David Smith ◽  
Carrie Dempster ◽  
Julie Glanville ◽  
Nick Freemantle ◽  
Ian Anderson
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Remission Rate ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Randomised Trials ◽  
Double Blind

BackgroundIn individual studies and limited meta-analyses venlafaxine has been reported to be more effective than comparator antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs).AimsTo perform a systematic review of all such studies.MethodWe conducted a systematic review of double-blind, randomised trials comparing venlafaxine with alternative antidepressants in the treatment of depression. The primary outcome was the difference in final depression rating scale value, expressed as a standardised effect size. Secondary outcomes were response rate, remission rate and tolerability.ResultsA total of 32 randomised trials were included. Venlafaxine was more effective than other antidepressants (standardised effect size was −0.14, 95% Cl −0.07 to −0.22). A similar significant advantage was found against SSRIs (20 studies) but nottricyclic antidepressants (7 studies).ConclusionsVenlafaxine has greater efficacy than SSRIs although there is uncertainty in comparison with other antidepressants. Further studies are required to determine the clinical importance of this finding.

Remission Rates Following Antidepressant Therapy With Bupropion or Selective Serotonin Reuptake Inhibitors

2005 ◽  
Vol 66 (08) ◽  
pp. 974-981 ◽  
Author(s):  
Michael E. Thase ◽  
Barbara R. Haight ◽  
Nathalie Richard ◽  
Carol B. Rockett ◽  
Melinda Mitton ◽  
...  
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Antidepressant Therapy ◽  
Selective Serotonin ◽  
Remission Rates

scholarly journals Great boast, small roast on effects of selective serotonin reuptake inhibitors: response to a critique of our systematic review

2018 ◽  
Vol 30 (5) ◽  
pp. 251-265 ◽  
Author(s):  
Kiran Kumar Katakam ◽  
Naqash Javaid Sethi ◽  
Janus Christian Jakobsen ◽  
Christian Gluud
Keyword(s):  
Systematic Review ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Serious Adverse Events ◽  
Hamilton Depression Rating Scale ◽  
Beneficial Effects ◽  
Post Hoc

Our systematic review inBMC Psychiatryconcluded that selective serotonin reuptake inhibitors (SSRIs) compared with placebo significantly increase the risk of serious adverse events (SAEs) in patients with major depression and the potential beneficial effects of SSRIs seem to be outweighed by the harms. Hieronymus et al. accused us of methodological inaccuracies and blatant errors. In theirpost-hocanalysis of our data, they reported that SSRIs only increase the risk of SAEs in elderly and seems safe for non-elderly patients. They also found our review misleading because our efficacy analyses were based on the 17-item Hamilton Depression Rating Scale; we included suboptimal SSRI doses; and we missed some ‘pivotal trials’. We do not agree with Hieronymus et al. regarding several of the ‘errors’ they claim that we have made. However, we acknowledge that they have identified minor errors and that we missed some trials. After rectifying the errors and inclusion of the missed trials by us and Hieronymus et al., we re-analysed the data. The updated analyses are even more robust and confirm our earlier conclusions. SSRIs significantly increase the risk of an SAE both in non-elderly (p=0.045) and elderly (p=0.01) patients [overall odds ratio 1.39; 95% confidence interval (CI) 1.13 to 1.73;p=0.002; I2=0%]. Moreover, SSRIs did not change noticeably the 17-item Hamilton Depression Rating Scale, the internationally accepted scale (mean difference −2.02 points; 95% CI −2.38 to −1.66;p<0.00001). We found no differential effect of dose (p=0.20).

Selective Serotonin Reuptake Inhibitors for the Treatment of Hypersensitive Esophagus: A Randomized, Double-Blind, Placebo-Controlled Study

2012 ◽  
Vol 107 (11) ◽  
pp. 1662-1667 ◽  
Author(s):  
Nikos Viazis ◽  
Anastasia Keyoglou ◽  
Alexandros K Kanellopoulos ◽  
George Karamanolis ◽  
John Vlachogiannakos ◽  
...  
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals Multiple possible inaccuracies cast doubt on a recent report suggesting selective serotonin reuptake inhibitors to be toxic and ineffective

2017 ◽  
Vol 30 (5) ◽  
pp. 244-250 ◽  
Author(s):  
Fredrik Hieronymus ◽  
Alexander Lisinski ◽  
Jakob Näslund ◽  
Elias Eriksson
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Serious Adverse Events ◽  
Efficacy Parameter ◽  
Cast Doubt ◽  
Antidepressant Efficacy ◽  
The Many ◽  
Definition Of

According to a systematic review on the use of selective serotonin reuptake inhibitors (SSRIs) in adult depression that was recently published in BMC Psychiatry, the results of which have been widely disseminated in lay media, these drugs increase the risk for serious adverse events (SAEs) while exerting poor antidepressant efficacy. A cursory analysis, however, suggests the analysis of SAEs conducted by the authors to be marred by both methodological inaccuracies and blatant errors. After having corrected for these apparent mistakes, we conducted a sensitivity analysis in which we also accounted for a possible moderating effect of age; while this suggests SSRIs to be safe drugs in the non-elderly, they do confirm what is already known, that is, that they may enhance the risk for SAEs in the old. Given the loose definition of SAE, including also innocuous phenomena, the possible clinical significance of the latter observation, however, remains unclear until the nature and actual impact of the SAEs in question have been clarified. Moreover, with respect to efficacy, we find the paper in BMC Psychiatry misleading: first, the authors seem unaware of the well-established shortcomings associated with the conventional efficacy parameter on which their analysis is based, second, they have included suboptimal SSRI doses and third, they have missed some pivotal trials. Unless there are explanations for the many peculiarities in this paper that have escaped us, and which may be satisfactorily clarified by the authors, it seems important that the conclusions presented in this paper be publicly rectified.

scholarly journals Efficacy of selective serotonin reuptake inhibitors and adverse events: Meta-regression and mediation analysis of placebo-controlled trials

2016 ◽  
Vol 208 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Michael Barth ◽  
Levente Kriston ◽  
Swaantje Klostermann ◽  
Corrado Barbui ◽  
Andrea Cipriani ◽  
...  
Keyword(s):  
Adverse Events ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Response To Treatment ◽  
Selective Serotonin ◽  
Controlled Trials ◽  
Regression Analyses ◽  
Double Blind ◽  
Meta Regression

BackgroundIt has been suggested that the efficacy of antidepressants has been overestimated in clinical trials owing to unblinding of drug treatments by adverse events.AimsTo investigate the association between adverse events and the efficacy of selective serotonin reuptake inhibitors (SSRIs).MethodThe literature was searched to identify randomised, double-blind, placebo-controlled trials of SSRIs in the treatment of major depression. Efficacy outcomes were response to treatment and change in depressive symptoms. Reporting of adverse events was used as an indicator of tolerability. Random effects meta-analyses were used to calculate pooled estimates. Meta-regression analyses were performed to investigate the association between adverse events and efficacy. Potential mediation was investigated with the Baron & Kenny approach.ResultsA total of 68 trials (n = 17 646) were included in the analyses. In meta-analysis SSRIs were superior to placebo in terms of efficacy (odds ratio, OR = 1.62, 95% CI 1.51–1.72). More patients allocated to SSRIs reported adverse events than did patients receiving placebo (OR = 1.73, 95% CI 1.58–1.89). Meta-regression analyses did not find an association between adverse events and efficacy (P = 0.439). There was no indication of adverse events mediating the effect of SSRI treatment.ConclusionsOur results do not support, but also do not unequivocally disprove, the hypothesis that adverse events lead to an overestimation of the effect of SSRIs over placebo.

Therapeutic efficacy of duloxetine versus selective serotonin reuptake inhibitors in irritable bowel syndrome

2011 ◽  
Vol 26 (S2) ◽  
pp. 1291-1291
Author(s):  
D. Vasile ◽  
O. Vasiliu ◽  
C. Tudor ◽  
V. Bogdan ◽  
A.G. Mangalagiu ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Affective Symptoms ◽  
Significant Difference ◽  
Irritable Bowel

IntroductionSelective serotonin reuptake inhibitors (SSRIs) are frequently used for irritable bowel syndrome, while duloxetine was evaluated in other similar psycho-somatic syndromes.ObjectiveThis prospective, single-blind trial intends to compare the efficacy of SSRIs and duloxetine in the treatment of irritable bowel syndrome.MethodsA group of 22 patients, 15 female and 7 male, mean age 50.2, diagnosed with irritable bowel syndrome according to the Rome II Diagnostic Criteria (1992) were treated with either an SSRI (escitalopram 20 mg/day, n = 6 or fluoxetine 40 mg/day, n = 6) or duloxetine (90 mg/day, n = 10). Patients were evaluated initially and every 4 weeks, for 6 months, using Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale 17 items version (HAMD), Clinical Global Impressions -Severity/Improvement (CGI-I/S) and a 7-points Likert scale (LS) for self-evaluated severity.ResultsDuloxetine improved anxiety and depressive symptoms, as reflected by the significant decrease of HAMA (−17.6 points, p < 0.05) and HAMD scores (−18.2 points, p < 0.05) at week 12. SSRIs also reduced the affective symptoms, significantly to baseline (p < 0.05), but less than duloxetine (−14.3, −15.2) at week 12, with no significant difference at week 24 (p = 0.120). The CGI-I results paralleled the decrease of HAMD and HAMA, while the LS evaluation of gastrointestinal symptoms improved similarly in both groups, with no significant difference (p = 0.09).ConclusionDuloxetine is an efficient agent in the treatment of irritable bowel syndrome, because it decreases the mood symptoms more rapidly than SSRIs. The overall efficacy of SSRIs and duloxetine at 6 months is nevertheless similar.

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