Selective versus multi-transmitter antidepressants: are two mechanisms better than one?
The issue of selectivity versus efficacy has now reappeared as newer agents have emerged that are less selective than the selective serotonin reuptake inhibitors (SSRIs) but more selective than the tricyclic antidepressants (TCAs). This article provides a critical examination of the clinical literature concerning what evidence there is for differential efficacy. Two broad areas will be discussed: (1) comparisons of SSRIs to TCAs and (2) comparisons of the SSRIs to a somewhat more selective compound (by comparison to the TCAs), venlafaxine. This review should caution one in accepting claims of superiority of any agent based on purported mechanism of action.
Burke
William J
WJ
Department of Psychiatry, University of Nebraska, Nebraska Medical Center, Omaha 68198-5580, USA. wjburke@unmc.edu
D000929:Antidepressive Agents, Tricyclic / Q000494:pharmacology* / Q000627:therapeutic use; D003511:Cyclohexanols / Q000494:pharmacology* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D010347:Patient Care Planning; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D000929:Antidepressive Agents, Tricyclic; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride