Are all antidepressants equal?

Are all antidepressants equal? Evidence-Based Mental Health 2009;12:98-100

G Gartlehner^1,2, B N Gaynes³

Abstract:

Primary care physicians and psychiatrists manage the majority of patients suffering from acute phase major depressive disorder (MDD). For most patients, antidepressant treatment is the primary choice of care. Second generation antidepressants (SGAs)—developed following the first generation of tricyclic and monoamine oxidase agents—have become the preferred drug choice because of their greater tolerability, lower risk of lethality and similar efficacy compared with first generation agents.

Clinicians prescribing SGAs face a multitude of drug choices and are the target of extensive marketing campaigns by the pharmaceutical industry. In 2007, three of the 20 top selling drugs in the USA were antidepressants with annual sales ranging from $2.3 billion (venlafaxine XR (Effexor XR)) to $1.4 billion (duloxetine (Cymbalta)).¹ At the time of writing, 13 different SGAs have been approved for the treatment of major depression in the USA and Canada and two additional drugs (reboxetine, milnacipran) are available in some . .

 

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk