Posted by phidippus on September 17, 2012, at 18:09:50
In reply to Re: Pristiq dosages of 200 - 400 mg/day. » phidippus, posted by SLS on September 17, 2012, at 16:51:53
Here's the original study from The Lancet:
Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis
Dr Andrea Cipriani PhD a d Corresponding AuthorEmail Address, Toshiaki A Furukawa MD b, Georgia Salanti PhD c, John R Geddes MD d, Julian PT Higgins PhD e, Rachel Churchill PhD g, Norio Watanabe PhD b, Atsuo Nakagawa MD h, Ichiro M Omori PhD b, Hugh McGuire MA f, Michele Tansella MD a, Corrado Barbui MD a
Summary
Background
Conventional meta-analyses have shown inconsistent results for efficacy of second-generation antidepressants. We therefore did a multiple-treatments meta-analysis, which accounts for both direct and indirect comparisons, to assess the effects of 12 new-generation antidepressants on major depression.
Methods
We systematically reviewed 117 randomised controlled trials (25 928 participants) from 1991 up to Nov 30, 2007, which compared any of the following antidepressants at therapeutic dose range for the acute treatment of unipolar major depression in adults: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, and venlafaxine. The main outcomes were the proportion of patients who responded to or dropped out of the allocated treatment. Analysis was done on an intention-to-treat basis.
Findings
Mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine (odds ratios [OR] 1·39, 1·33, 1·30 and 1·27, respectively), fluoxetine (1·37, 1·32, 1·28, and 1·25, respectively), fluvoxamine (1·41, 1·35, 1·30, and 1·27, respectively), paroxetine (1·35, 1·30, 1·27, and 1·22, respectively), and reboxetine (2·03, 1·95, 1·89, and 1·85, respectively). Reboxetine was significantly less efficacious than all the other antidepressants tested. Escitalopram and sertraline showed the best profile of acceptability, leading to significantly fewer discontinuations than did duloxetine, fluvoxamine, paroxetine, reboxetine, and venlafaxine.
Interpretation
Clinically important differences exist between commonly prescribed antidepressants for both efficacy and acceptability in favour of escitalopram and sertraline. Sertraline might be the best choice when starting treatment for moderate to severe major depression in adults because it has the most favourable balance between benefits, acceptability, and acquisition cost.
The Venlafaxine study is compelling. The above study seems barebones and lacks details.
Eric
poster:phidippus
thread:1024121
URL: http://www.dr-bob.org/babble/20120912/msgs/1025932.html