Effectiveness of antidepressants: comparative remission rates.
Historically, clinical researchers have gauged the short-term effectiveness of antidepressants by response rates, which have been defined as a "significant" reduction of symptoms or a global impression of at least moderate benefit. However, increased focus over the past decade has led many researchers to suggest that remission, i.e., a virtual elimination of depressive symptoms and restoration of psychosocial functioning, should be the primary goal of the initial phase of therapy. This article examines the relative efficacy of various antidepressant therapies. There is some evidence that medications affecting multiple neurochemical systems, such as the tricyclics amitriptyline and clomipramine (in studies of hospitalized patients) and the more selective "dual reuptake inhibitor" venlafaxine, may result in higher rates of remission relative to other agents. Given the better tolerability of newer antidepressants relative to tricyclics, both logic and an increasing amount of data support a greater role for multiaction antidepressants.
Thase
Michael E
ME
University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA. thaseme@msx.upmc.edu
D000928:Antidepressive Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D004565:Electroconvulsive Therapy; D006801:Humans; D008134:Long-Term Care; D015201:Meta-Analysis as Topic; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D011613:Psychotherapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D009626:Terminology as Topic; D016896:Treatment Outcome
D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors