How well do antidepressants work in older people? A systematic review of Number Needed to Treat.
OBJECTIVE
To make direct comparisons between studies of antidepressant treatment of older people using Number Needed to Treat (NNT) analysis.


METHODS
Medline and Embase Search 1966-1999 and contact with manufacturers of antidepressant drugs asking for any relevant data on file; NNT analyses of outcome in terms of efficacy and adverse effects.


RESULTS
Most antidepressant trials show efficacy; this is less clear for moclobemide and fluoxetine. Head-to-head comparisons between antidepressants showed significant superiority for paroxetine over fluoxetine and a trend in favour of SSRIs and venlafaxine over tricyclics.


CONCLUSIONS
NNT analysis is one way of providing intelligible information on antidepressant efficacy and adverse effects which can inform clinical decisions.


CONCLUSIONS
Many studies do not present data in a form amenable to NNT analysis. Most head-to-head comparisons between antidepressants are underpowered.
Katona
Cornelius
C
Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Wolfson Building, 48 Riding House Street, London W1N 8AA, UK. c.katona@ucl.ac.uk
Livingston
Gill
G
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans
D000928:Antidepressive Agents