In medicine sometimes not all treatments are as tangible as Mexico dental implants, some require more studies to know if they are working, such as antidepressants. A major study comparing several commonly used antidepressants concludes that all are more effective than placebo for the short-term treatment of acute depression in adults, with an effectiveness ranging from small to moderate for different medications.
The study includes the largest amount of unpublished data to date, and all data has been made available for free online.
It is estimated that 350 million people have depression worldwide (2.4 million in Spain). The economic burden only in the US has been estimated at more than 210,000 million dollars. Pharmacological and non-pharmacological treatments are available, but due to inadequate resources, antidepressants are used more frequently than psychological interventions. However, there is considerable debate about its effectiveness.
As part of the study, the authors identified all double-blind randomized controlled trials comparing antidepressants with placebo, or with other antidepressants for the acute treatment for 8 weeks of major depression in adults 18 years of age or older.
The authors then contacted pharmaceutical companies, original study authors and regulatory agencies to supplement incomplete reports of the original documents or provide data for unpublished studies. The primary outcomes were efficacy number of patients who responded to treatment, that is, they had a reduction in depressive symptoms of 50% or more on a rating scale validated for 8 weeks and acceptability which is the proportion of patients who withdrew of the study for some reason a week.
The majority of patients had moderate to severe depression. All 21 antidepressants were more effective than placebo, and only one drug (clomipramine) was less acceptable than placebo.
Some antidepressants were more effective than others. In the first group, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine and vortioxetine and, in the second group, fluoxetine, fluvoxamine, reboxetine and trazodone, the least effective.
Most of the most effective antidepressants are now out of patent and available in generic form. Antidepressants also differ in terms of acceptability, with agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine being the most tolerable, and amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and Venlafaxine are the least tolerable.