J Med Assoc Thai 1998; 81 (6):387

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Response and Discontinuation Rates of Newer Antidepressants: A Meta-Analysis of Randomized Controlled Trials in TreatiiV( ~pression
Srisurapanont M Mail

Several attempts to improve antidepressants have recently led to the availability of some
newer antidepressants (NAs) including nefazodone, mirtazapine, and venlafaxine. The author
proposed to compare both efficacy and discontinuation rates between these NAs and older antidepressants
(OAs) which include tricyclic antidepressants (TCAs), nontricyclic antidepressants
(NTCAs), and selective serotonin reuptake inhibitors (SSRis). In each comparison, the author analyzed
the heterogeneity of outcomes and computed the pooled odd ratio (OR) with 95 per cent confidential
interval (95% CI) by using Peto method. The results show that NAs have slightly higher
efficacy than OAs. The overall discontinuation rate of the NA group was also lower than that of the
TCA group but not that of NTCA-SSRI group. In conclusion, NAs have slightly but significantly
superior efficacy to OAs which probably include SSRis. They are also more tolerable than TCAs
but not NTCAs-SSRis. However, the efficacy difference between NAs and SSRis should be
viewed as a preliminary result since very few studies have compared their efficacy.

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