Healthy Skepticism Library item: 226

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Publication type: Journal Article

Freemantle N, Anderson IM, Young P.
Predictive value of pharmacological activity for the relative efficacy of antidepressant drugs. Meta-regression analysis.
Br J Psychiatry 2000 Oct; 177:292-302
http://bjp.rcpsych.org/cgi/content/full/177/4/292

Abstract:

BACKGROUND: There is uncertainty about the contribution of specific pharmacological properties to the efficacy of antidepressants.

AIMS: To assess whether specific pharmacological characteristics of alternative antidepressants resulted in altered efficacy compared to that of selective serotonin reuptake inhibitors in the treatment of major depression.

METHOD: Meta-regression analysis of randomised trials that compare treatment with a selective serotonin reuptake inhibitor and an alternative antidepressant.

RESULTS: One-hundred-and-five randomised trials were included. None of the factors identified a priori predicted a statistically significant improvement in outcome across the trials.

CONCLUSIONS: This analysis does not provide evidence that antidepressants acting at more than one pharmacological site differ in efficacy from drugs selective for serotonin reuptake in the treatment of major depression.