Navigation Links
Newer Class of Antidepressants Similar in Effectiveness, Side Effects Differ

Today’s most commonly prescribed antidepressants are similar in effectiveness to each other but differ when it comes to possible side effects, according to an analysis// released today by HHS’ Agency for Healthcare Research and Quality.

The findings, based on a review of nearly 300 published studies of second-generation antidepressants, show that about six in 10 adult patients get some relief from the drugs. About six in 10 also experience at least one side effect, ranging from nausea to sexual dysfunction.

Patients who don’t respond to one of the drugs often try another medication within the same class. About one in four of those patients recover, according to the review. Overall, current evidence on the drugs is insufficient for clinicians to predict which medications will work best for individual patients.

Second-generation antidepressants, which include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), are often prescribed because first-generation antidepressants (such as tricyclic antidepressants, or TCAs) can cause intolerable side effects and carry high risks.

“Second-generation antidepressants provide hope for many of the millions of Americans who struggle with depression,” said AHRQ Director Carolyn M. Clancy, MD. “But often trying to find the right drug is trial and error, and in many cases relief is temporary or comes with serious side effects. It’s clear we need more evidence to help patients and their doctors make the best choices.”

Authors of the new Comparative Effectiveness Review analyzed the benefits and risks of a dozen second-generation antidepressants: bupropion (sold as Wellbutrin), citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (formerly sold as Luvox), mirtazapine (Remeron), nefazodone (formerly Serzone), paroxetine (Paxil), sertraline (Zoloft), trazodone (formerly Desyre l), and venlafaxine (Effexor). Many of these drugs are also sold in generic form.

The analysis, which examined only adult use of second-generation antidepressants, drew on 293 published studies. Of those, 187 were judged to be of good or fair quality. The analysis compared the drugs’ benefits and risks in the treatment of major depressive disorder, dysthymia (a chronic, less-severe form of depression), and subsyndromal depression (an acute mood disorder that is less severe than major depression).

Each of the disorders can be disabling. Major depressive disorder affects more than 16 percent of U.S. adults at least once during a lifetime, the review noted. In 2000, the economic burden of depressive disorders was estimated to be $83.1 billion. More than 30 percent of these costs are for direct medical expenses, such as doctors’ fees, hospital bills and medications.

The new analysis, produced by AHRQ’s Effective Health Care program, was completed by the Agency’s RTI International-University of North Carolina Evidence-based Practice Center. Evidence reviewed by the authors suggests:

In general, the various second-generation antidepressants have similar rates of effectiveness. In controlled studies, about 38 percent of patients saw no improvement and 54 percent had only partial improvement.

According to the National Institute of Mental Health’s Sequenced Treatment Alternative to Relieve Depression (STAR-D) trial, a substantial number (between about 25 percent and 33 percent) of patients will improve with the addition or substitution of a different drug.

On average, 61 percent of patients taking second-generation antidepressants experience at least one side effect. The most common are nausea and vomiting, constipation, diarrhea, dizziness, headache, and sleeplessness.

Venlafaxine, an SNRI, is associated with a higher incidence of nausea and vomiting than SSRIs. That drug is also more likely than SSRIs to be discontinued due to adverse events.

Sertraline is more likely to cause diarrhea than bupropion, citalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, or venlafaxine. Mirtazapine leads to higher weight gains than fluoxetine, paroxetine, venlafaxine, or trazodone. Trazodone is associated with higher rates of sleeplessness than bupropion, fluoxetine, mirtazapine, paroxetine, or venlafaxine.

Paroxetine and venlafaxine have the highest rates of discontinuation. Fluoxetine has the lowest.

Second-generation antidepressants work at different rates. Seven studies funded by the maker of mirtazapine showed that the drug works faster than citalopram, fluoxetine, paroxetine, or sertraline.

Bupropion is less likely to cause sexual dysfunction than fluoxetine, paroxetine, or sertaline. Paroxetine has higher rates of sexual dysfunction than fluoxetine, fluvoxamine, nefazodone, or sertraline.

“As with all medications, second-generation antidepressants should be used after careful consideration of benefits and risks,’’ Dr. Clancy said. “It’s up to clinicians and patients to work closely together so the best possible results are achieved.”

Soure-Newswise
SRM
'"/>




Related medicine news :

1. The Efficacy Of Newer Stents Questioned
2. Newer Generation Sleeping Pills Lack Superior Performance
3. Autoimmune Diseases – Newer Preventive Measure
4. Need for Newer AIDS Drugs In China
5. Newer Blood Pressure Drugs Decrease Risk Of Diabetes
6. Newer Antidepressants May Trigger Violent Behavior
7. Study Sheds Light on Value of Newer Antipsychotic Drugs for Schizophrenia
8. Cellulose Nanocrystal Research Paves the Way for Newer Vaccines, Computer Inks
9. “ Economy Class Syndrome
10. Latest Tumor Classification More Informative
11. Self-Applied Acupressure May Reduce Sleepiness And Increase Alertness During Class Hours
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:10/13/2017)... ... October 13, 2017 , ... ... process to promote standards of excellence for the field of eating disorders, announces ... 22 – 25, 2018 in Orlando, Florida at the Omni Resort at ChampionsGate. ...
(Date:10/13/2017)... ... 2017 , ... Many families have long-term insurance that covers care for a ... waiver for care if the client has a cognitive impairment diagnosis. , “What ... is often waived, so the benefits from their insurance start immediately,” said Mechell Vieira, ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented ... the lowdown on sciatica in a new episode of "Success Files," which is ... events and innovation and investigates each subject in-depth with passion and integrity. , ...
(Date:10/12/2017)... San Francisco, CA (PRWEB) , ... October 12, ... ... and Dr. Cheng, are now treating sleep apnea using cutting-edge Oventus ... sleep apnea, a serious sleep disorder characterized by frequent cessation in breathing. Oral ...
(Date:10/12/2017)... ... October 12, 2017 , ... Asante, a nationally recognized health ... expanded their existing home health joint venture through an agreement, effective October 1, ... joint venture home health company with Asante, delivering clinically integrated care, for the ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... , Oct. 11, 2017  True Health, ... has amplified its effort during National Breast Cancer ... hereditary cancer risks. ... Clinical Oncology calculated that more than 10 million ... inherited mutations in BRCA1 or BRCA2 and have not ...
(Date:10/10/2017)... 10, 2017   West Pharmaceutical Services, Inc. ... injectable drug administration, today shared the results of a ... improving the intradermal administration of polio vaccines. The study ... in May 2017 by Dr. Ondrej Mach , ... Health Organization (WHO), and recently published in the journal ...
(Date:10/4/2017)... 4, 2017  South Korean-based healthcare product Development Company ... "cprCUBE" on Kickstarter. The device will educate the user ... with better efficiency compared to the dated and pricey ... on efficacy of the compression for a more informed ... goal to raise $5,000. ...
Breaking Medicine Technology: