Table 31Studies of efficacy, effectiveness, and harms for patient subgroups

StudyInterventionsNResultsQuality Rating
Age
Roose et al., 2004219 Citalopram vs. placebo174No significant difference in response/remission except in high severity groupFair
Rocca et al., 2005114 Citalopram vs. sertraline138No significant differenceNA
Allard et al., 200455 Citalopram vs. venlafaxine XR151No significant differenceFair
Burt et al., 2005218 Duloxetine vs. placebo114Duloxetine was more efficacious (response/remission); no difference in effect in women 40–55 vs. older or younger womenFair
Kasper et al., 200531 Escitalopram vs. fluoxetine vs. placebo517No significant difference in response rates; remission rates lower for fluoxetine than escitalopramFair
Cassano et al., 200234 Fluoxetine vs. paroxetine242No significant differenceFair
Schone and Ludwig, 199339 Fluoxetine vs. paroxetine106Greater response rate for paroxetineFair
Geretsegger et al., 1994214
Kroenke et al., 200149 Fluoxetine vs. paroxetine vs. sertraline573No significant differenceFair
Devanand et al., 2005100 Fluoxetine vs. placebo90No difference in response rates and quality of lifeGood
Goldstein et al., 1997167 Fluoxetine vs. placebo671Higher weight loss with fluoxetine in older patientsFair
Tollefson et al., 1993222 Fluoxetine vs. placebo671Significantly greater response with fluoxetine; current physical illness not associated with responseFair
Tollefson, et al., 1995223
Small et al., 1996224
Newhouse et al., 200044 Fluoxetine vs. sertraline236Overall similar efficacy, although sertraline patients experienced greater cognitive improvement and greater response among people over 70 years of ageFair
Finkel et al., 199945
Rossini et al., 200552 Fluvoxamine vs. sertraline93No significant difference in response ratesFair
Halikas et al., 199594 Mirtazapine vs. trazodone vs. placebo150No significant differenceFair
Weihs et al., 200084 Paroxetine vs. bupropion SR100No differencesGood
Schatzberg et al., 200273 Paroxetine vs. mirtazapine255Greater early efficacy for mirtazapine; similar number of CGI responders at end of continuation phaseFair
Rapaport et al., 2003213 Paroxetine (CR and IR) vs. placebo319Significantly more responders and remitters for paroxetine (CR and IR formulations) than for placeboFair
Barrett et al., 2001113 Paroxetine vs. placebo vs. behavioral therapy656In patients older than 60 years, significantly greater improvement in symptom scores for paroxetine than for placebo; in patients younger than 60 years, no differenceFair
Williams et al., 2000112
Schneider et al., 2003220 Sertraline vs. placebo752Significantly more responders in sertraline group both with and without comorbid medical illnessFair
Sheikh et al., 2004221
Wilson et al., 2003137 Sertraline vs. placebo113No difference in prevention of depression; sertraline associated with longer time to recurrenceFair
Oslin et al., 2003215 Sertraline vs. venlafaxine52No significant difference in efficacy; tolerability was lower for venlafaxinePoor
Kirby et al., 2002200 SSRIs use vs. venlafaxine199Higher rate of hyponatremia in patients on SSRIs and venlafaxineFair
Entsuah et al., 2001217 Venlafaxine (IR and XR) vs. SSRIs vs. placebo2,045Venlafaxine response not affected by age or sex; SSRI response poorer in older women; similar efficacy of venlafaxine and SSRIs except in older women, but HRT appears to eliminate the differenceFair
Thase et al., 2005216
Sex
Kennedy et al., 2000188 Paroxetine vs. sertraline vs. venlafaxine vs. moclobemide107Sex difference in impairment in drive/desire; rates of dysfunction in men similar in all treatments; in women, greater levels of dysfunction with sertraline and paroxetine; favorable drug response associated with less dysfunctionFair
Thase et al., 2005216 and Enstuah et al., 2001217 SSRIs vs. venlafaxine XR vs. placebo2,045Venlafaxine response not affected by age or sex; SSRI response poorer in older women; similar efficacy of venlafaxine and SSRIs, except in older women, but HRT appears to eliminate the differenceFair
Ethnicity
Wagner et al., 1998225 Fluoxetine vs. placebo118Ethnicity not associated with side effects; whites had a higher response rate, Latinos a higher drop-out ratePoor
Comorbidities
HIV/AIDS
Rabkin et al., 1999228 Fluoxetine vs. placebo120No difference in depressed HIV/AIDS patientsFair
Wagner et al., 1998225 Fluoxetine vs. placebo118Ethnicity not associated with side effects; whites had a higher response rate, Latinos a higher drop-out ratePoor
Rabkin et al., 2004227 Fluoxetine vs. testosterone vs. placebo123No difference in depressed HIV/AIDS patientsFair
Ferrando et al., 1997226 Sertraline vs. paroxetine vs. fluoxetine33Completers (all treatment groups) experienced improvements in affective and somatic symptoms (many of which were attributed to HIV rather than depression)Poor
Alcohol
Hernandez-Avila et al., 2004208 Nefazadone vs. placebo41No significant differencesFair
Gual et al., 2003229 Sertraline vs. placebo83No significant differencesFair
Moak et al., 2003210 Sertraline vs. placebo82Greater depression improvement in females treated with sertraline; less drinking associated with greater depression improvementFair
Alzheimer's disease/dementia
Nyth et al., 1992211 Citalopram vs. placebo149Significantly greater improvement with citalopramPoor
Lyketsos et al., 2003230 Sertraline vs. placebo44Sertraline associated with greater responseFair
Magai et al., 2000231 Sertraline vs. placebo31No significant differenceFair
Breast cancer
Roscoe et al., 2005232 Paroxetine vs. placebo94Paroxetine associated with greater depression responsePoor
Cardiovascular disease
Strik et al., 2000235 Fluoxetine vs. placebo54Significantly greater response with fluoxetineGood
Krishnan et al., 2001209 Sertraline220Vascular comorbidity not associated with more adverse events or premature discontinuationFair
Glassman et al., 2002234 Sertraline vs. placebo369Significantly greater response with sertralineFair
Bush et al., 2005233 SSRIsNRSSRIs improve depression in post-MI patientsFair
Dialysis
Blumenfield et al., 1997236 Fluoxetine vs. placebo14No significant differenceFair
Stroke
Andersen et al., 1994237 Citalopram vs. placebo285Significantly more improvement with citalopramFair
Murray et al., 2005238 Sertraline vs. placebo123No difference in response; greater improvements in quality of life with sertralineFair
Substance abuse
Petrakis et al., 1998212 Fluoxetine vs. placebo44No difference in depressed opioid addictsFair
Schmitz et al., 2001239 Fluoxetine vs. placebo68No difference in depressed cocaine abusersPoor

CGI, Clinical Global Impressions; CR, controlled release; HRT, hormone replacement therapy; IR, immediate release; MI, myocardial infarction; NA, not applicable; SR, slow release; XR, extended release.

From: 3, Results

Cover of Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression
Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression [Internet].
Comparative Effectiveness Reviews, No. 7.
Gartlehner G, Hansen RA, Thieda P, et al.

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