Original ArticleAre Antidepressant Drugs That Combine Serotonergic and Noradrenergic Mechanisms of Action More Effective Than the Selective Serotonin Reuptake Inhibitors in Treating Major Depressive Disorder? A Meta-analysis of Studies of Newer Agents
Section snippets
Data Sources and Search Strategy
Seven search strategies were employed to help identify studies for inclusion in the meta-analysis.
Studies were first identified with the use of Pubmed/Medline. Searches were conducted by cross-referencing each of the following six terms: “venlafaxine,” “milnacipran,” “duloxetine,” “mirtazapine, “moclobemide,” and “mianserin,” with each of the six SSRIs: “fluoxetine,” “sertraline,” “paroxetine,” “fluvoxamine,” “citalopram,” and “escitalopram.”
These searches were then repeated with EMBase.
We then
Venlafaxine
Initially, 1188 abstracts were identified in Pubmed/Medline. Of these, 1156 were excluded for a number of reasons (i.e., other topics, reviews). The remaining 32 abstracts described clinical trials comparing venlafaxine with an SSRI for depression. Six of these were excluded from the analysis because they were open-label studies (21, 22, 23, 24, 25, 26), whereas 6 were excluded either because they focused on the treatment of patients with bipolar depression (27, 28), psychotic depression (29),
Discussion
The present work involves the largest meta-analytical comparison between types of newer antidepressant drugs completed to date. Consistent with our prediction, in an all-inclusive set of randomized, double blind trials in MDD, we found evidence suggesting a difference in response rates when comparing newer serotonergic-noradrenergic antidepressant drugs—specifically venlafaxine, milnacipran, duloxetine, moclobemide, mirtazapine, and mianserin—with an SSRI for the treatment of MDD. Specifically,
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