111 (HealthDay News)
— Newer antidepressants
seem to be about as successful as one another, a fresh investigation signals.
This suggests that the selection of which drug is not inappropriate for
which patient needs to be made on the basis of such factors as side
Price and patient taste, effects.
“They’re all equally powerful,” said Dr. David Schlager,
A clinical assistant professor of psychiatry and behavioral science at Texas
A&M Health Science Center Faculty of Medicine.
“They are interchangeable except for side
effects,” he added, so psychiatrists do tend to “use
the side-effect profile” to find suitable medications for individual
patients, he included.
According to the background information in the brand new study, appearing
in the Dec. 6 issue of Annals of Internal Medicine,
Of as antidepressants had been taken by some 27 million men and women in the USA
Most of these drugs are “second-generation” medications
such as selective serotonin
reuptake inhibitors (SSRIs), norepinephrine reuptake inhibitors (SNRIs) and
Drugs that are associated.
SSRIs include the best-selling Prozac (fluoxetine) and Zoloft
(sertraline). An example of an SNRI is Effexor (venlafaxine).
Headed by Dr. Gerald Gartlehner, the analysis was funded mainly by
the U.S. Bureau for Healthcare Research and Quality.
Authors reviewed data from 234 formerly published studies, all of
Them randomized trials that had comprised at least 1,000 players each.!
While there was no difference in drug effectiveness, there were
distinctions in how fast a drug took effect, side effects along with quality of
For instance, the authors said, Remeron (mirtazapine) takes effect
Quicker than Prozac, Zoloft, Paxil (paroxetine) or Celexa (citalopram).
Bupropion, which goes by other brand names as well as Wellbutrin, has
Fewer undesirable sexual effects than Prozac, Zoloft, Paxil or Lexapro
“If a patient has insomnia,
you would pick something more promptly sedating,” said Schlager, who is
Also a shrink with Lone Star Circle of Care. “If the
Patient has reduced appetite and weight loss, you’d decide something more
Prone to cause weight gain like mirtazapine.”
Cost, of course, is another thought.
“If one drug costs $200 a month and another costs $20, I do not
see any reason why to not go with all the latter,” said Dr. Radu Saveanu, a
professor of psychiatry at the University of Miami Miller School of Medicine.
Dosing can be important, he said, “because studies have revealed
That if patients need to take the drug less often, compliance is higher,
which will make a big difference when it comes to efficacy.”
But given the likeness prescribing, in effectiveness
Antidepressants is largely a trial and error process.
It is hoped that another series of studies will provide guidance on
which drugs to strive first.
“The actual core of the matter is, should they do not respond to one
type of antidepressant, will there be any guidelines by what you should try
next?” Schlager said.