Predictive value of pharmacological activity for the relative efficacy of antidepressant drugs. Meta-regression analysis.
BACKGROUND
There is uncertainty about the contribution of specific pharmacological properties to the efficacy of antidepressants.


OBJECTIVE
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.


METHODS
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.
Freemantle
N
N
Medicines Evaluation Group, Centre for Health Economics, University of York, Heslington, York YO10 5DD, UK. meg@york.ac.uk
Anderson
I M
IM
Young
P
P
D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D011985:Receptors, Serotonin / Q000187:drug effects; D012044:Regression Analysis; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D011985:Receptors, Serotonin; D017367:Selective Serotonin Reuptake Inhibitors