Meta-analysis of randomised controlled trials of fluoxetine v. placebo and tricyclic antidepressants in the short-term treatment of major depression

The results showed that significantly fewer patients on fluoxetine discontinued treatment because of adverse events.ConclusionFluoxetine is superior to placebo, irrespective of the analytical approach use, whereas the results obtained v

P. Bech

2002

Scholarcy highlights

  • Previous meta-analyses of fluoxetine as an antidepressant have many methodological problems, including diagnosis of major depression, validity of outcome measures and lack of intentionto-treat analyses
  • One trial was excluded after the initial analyses which showed that the trial was responsible for a statistically significant heterogeneity, and inspection of the results suggested that they were unlike the others
  • For the non-United States trials, data were analysed from 13 single- and multi-centre, randomised, double-blind trials in which fluoxetine was compared with a tricyclic antidepressants in 643 patients
  • TCAs, with a pooled effect size for the HDRS±17 outcome of 0.17
  • When the USA and nonUSA trials were combined the results showed that significantly fewer patients on fluoxetine discontinued treatment due to adverse events or for any reason
  • Effect size for the HDRS±6 outcome showed a non-significant trend in favour of fluoxetine,
  • In our analyses, we have confirmed the superiority of fluoxetine over placebo for the shortterm treatment of major depression, and we were unable to show a difference in efficacy with TCAs, fewer patients on fluoxetine withdrew due to adverse effects
  • Fluoxetine is superior to placebo, irrespective of the analytical approach use, whereas the results obtained v.tricyclic antidepressants depend on the approach used.the results should be interpreted in this light

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