Efficacy and Tolerability of Tricyclic Antidepressants and SSRIs Compared With Placebo for Treatment of Depression in Primary Care: A Meta-Analysis
Ann Fam Med Arroll et al.
3: 449
The Article in Brief
Efficacy and tolerability of tricyclic antidepressants and SSRIs compared with placebo in primary care treated depression. A Meta-analysis
By Bruce Arroll, MBChB, PhD, and colleagues
Background:
Most patients with clinical depression are seen in a primary care setting. Yet most studies examining the effectiveness of antidepressant medications are done with patients who see a psychiatric specialist and whose depression may have a different cause and disease course. This study examined existing evidence about the effectiveness of antidepressants for treating depression, as compared to placebos, among primary care patients.
What this study found:
Two types of antidepressants--tricyclic antidepressants, which work by increasing levels of the mood chemicals serotonin and norepinephrine in the brain, and selective serotonin reuptake inhibitors, which work by increasing the amount of serotonin—are significantly more effective than placebo in primary care settings. In addition, the relatively low doses of tricyclic antidepressants sometimes used in primary care may be effective.
Implications
• Prescribing antidepressants in primary care is more effective than prescribing a placebo.
