Sertraline effective for acute major depression

January 01, 0001

Sertraline effective for acute major depression

Clinical Question:How effective is sertraline (escitalopram) in the acute phase treatment of major depression?

Bottom line: There was evidence favouring sertraline over some other antidepressants for the acute phase treatment of major depression, in terms of efficacy, compared with fluoxetine, (NNT* 10; range, 6 to 14) or acceptability/tolerability, compared with amitriptyline, imipramine, paroxetine and mirtazapine. Follow-up was limited to 24 weeks. However, there were also some differences favouring newer antidepressants in terms of early response (mirtazapine) and acceptability (bupropion). In terms of individual side effects, sertraline was generally associated with a higher rate of participants experiencing diarrhoea. * NNT = number needed to treat to benefit 1 individual

Caveat: The overall quality of included studies was low and the reporting of trials was often inadequate. The included studies did not report on all the outcomes that were pre-specified in the protocol of this review. Outcomes of clear relevance to patients and clinicians, in particular, patients and their relatives attitudes to treatment, and their ability to return to work and resume normal social functioning, were not reported in any of the included studies.

Context: Depression is the fourth leading cause of disease burden worldwide and is expected to show a rising trend over the next 20 years. Although both pharmacological and psychological interventions are effective for major depression, antidepressant drugs remain the mainstay of treatment. During the last 20 years, selective serotonin reuptake inhibitors have progressively become the most commonly prescribed antidepressants.

Cochrane Systematic Review: Cipriani A et al. Sertraline versus other antidepressive agents for depression. Cochrane Reviews 2009, Issue 2. Article No. CD006117. DOI: 10.1002/14651858CD006117.pub2. This review contains 59 trials involving about 10,000 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 258, April 2010. .
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: P. Psychological. Keywords: depression, antidepressants, pharmocological therapy, sertraline
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 21 September 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.