Efficacy of SSRIs and newer antidepressants in severe depression: Comparison with TCAs

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Abstract

This review evaluated antidepressant treatments for patients with severe depression. Comparative clinical trials conducted on patients with sever depression were found. Evidence for efficacy of selective serotonin reuptake inhibitors (SSRIs) in severe or melancholic depression comes from a small but growing number of controlled studies with adequate samples, as well as meta-analyses and retrospective subgroup analysis of premarketing trials. In studies that defined response as a 50% or greater reduction in Hamilton Rating Scale for Depression scores, response rates ranges from 53% to 64% for SSRIs and 43% to 70% for tricyclic antidepressants. In separate trials on severe depression, venlafaxine and mirtazapine were both more effective than placebo and an active comparator. nefazodone and bupropion were each found to be more effective than placebo in studies of severe depression. Venlafaxine and mirtazapine have been found to be more effective than fluoxetine. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

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