The Experts below are selected from a list of 99 Experts worldwide ranked by ideXlab platform
James Mason - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
The Cochrane database of systematic reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
Cochrane Database of Systematic Reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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treatment discontinuation with selective serotonin reuptake inhibitors ssris versus tricyclic Antidepressants tcas
Cochrane Database of Systematic Reviews, 2006Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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Selective serotonin reuptake inhibitors versus tricyclic and Heterocyclic Antidepressants: comparison of drug adherence.
The Cochrane database of systematic reviews, 2000Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, M Eccles, John R. Geddes, Rebecca Hardy, Glyn Lewis, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic antdepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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selective serotonin reuptake inhibitors versus tricyclic and Heterocyclic Antidepressants comparison of drug adherence
Cochrane Database of Systematic Reviews, 2000Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, M Eccles, John R. Geddes, Rebecca Hardy, Glyn Lewis, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. REVIEWER'S CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic antdepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
Corrado Barbui - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
The Cochrane database of systematic reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
Cochrane Database of Systematic Reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Amitriptyline for depression
The Cochrane database of systematic reviews, 2007Co-Authors: Giuseppe Guaiana, Corrado Barbui, Matthew HotopfAbstract:BACKGROUND For many years amitriptyline has been considered one of the reference compounds for the pharmacological treatment of depression. However, new tricyclic drugs, Heterocyclic compounds and selective serotonin reuptake inhibitors have been introduced on the market with the claim of a more favourable tolerability/efficacy profile. OBJECTIVES The aim of the present systematic review was to investigate the tolerability and efficacy of amitriptyline in comparison with the other tricyclic/Heterocyclic Antidepressants and with the selective serotonin reuptake inhibitors. SEARCH STRATEGY The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR-Studies) was searched on 28-11-2005. Reference lists of all included studies were checked. SELECTION CRITERIA Only randomised controlled trials were included. Study participants were of either sex and any age with a primary diagnosis of depression. Included trials compared amitriptyline with another tricyclic/Heterocyclic Antidepressant or with one of the selective serotonin reuptake inhibitors. DATA COLLECTION AND ANALYSIS Data were extracted using a standardised form. The number of patients undergoing the randomisation procedure, the number of patients who completed the study and the number of improved patients were extracted. In addition, group mean scores at the end of the trial on Hamilton Depression Scale or any other depression scale were extracted. In the tolerability analysis, the number of patients failing to complete the study and the number of patients complaining of side-effects were extracted. MAIN RESULTS A total number of 194 studies were included in the review. The estimate of the overall odds ratio (OR) for responders showed that more subjects responded to amitriptyline in comparison with the control Antidepressant group (OR 1.12 to 95% confidence interval (CI) 1.02 to 1.23, number needed to treat to benefit (NNTB) = 50). The estimate of the efficacy of amitriptyline and control agents on a continuous outcome revealed an effect size which also significantly favoured amitriptyline (Standardised Mean Difference (SMD) 0.13, 95% CI 0.04 to 0.23). Whilst these differences are statistically significant, their clinical significance is less clear. When the efficacy analysis was stratified by drug class, no difference in outcome emerged between amitriptyline and either tricyclic or selective serotonin reuptake inhibitor comparators. The dropout rate in patients taking amitriptyline and control agents was similar; however, the estimate of the proportion of patients who experienced side-effects significantly favoured control agents in comparison with amitriptyline (OR 0.66, 95% CI 0.59 to 0.74). When the tolerability analysis was stratified by drug class, the dropout rate in patients taking amitriptyline and the selective serotonin reuptake inhibitors significantly favoured the latter (OR 0.84, 95% CI 0.75 to 0.95, number needed to treat to harm (NNTH) = 40). When the responder analysis was stratified by study setting amitriptyline was more effective than control Antidepressants in inpatients (OR 1.22, 95% CI 1.04 to 1.42, NNTB = 24), but not in outpatients (OR 1.01, 95%CI 0.88 to 1.17, NNTB = 200). AUTHORS' CONCLUSIONS This present systematic review indicates that amitriptyline is at least as efficacious as other tricyclics or newer compounds. However, the burden of side-effects in patients receiving it was greater. In comparison with selective serotonin reuptake inhibitors amitriptyline was less well tolerated, and although counterbalanced by a higher proportion of responders, the difference was not statistically significant.
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treatment discontinuation with selective serotonin reuptake inhibitors ssris versus tricyclic Antidepressants tcas
Cochrane Database of Systematic Reviews, 2006Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Amitriptyline versus other types of pharmacotherapy for depression.
The Cochrane database of systematic reviews, 2003Co-Authors: Giuseppe Guaiana, Corrado Barbui, Matthew HotopfAbstract:BACKGROUND For many years amitriptyline has been considered one of the reference compounds for the pharmacological treatment of depression. However, new tricyclic drugs, Heterocyclic compounds and the selective serotonin reuptake inhibitors have been introduced on the market with the claim of a more favourable tolerability/efficacy profile. OBJECTIVES The aim of the present systematic review was to investigate the tolerability and efficacy of amitriptyline in comparison with the other tricyclic/Heterocyclic Antidepressants and with the selective serotonin reuptake inhibitors. SEARCH STRATEGY The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (2002-3) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Key journals and conference abstracts were handsearched. Pharmaceutical companies were contacted for information on unpublished materials. SELECTION CRITERIA Only randomised controlled trials were included. Study participants were of either sex and any age with a primary diagnosis of depression. Included trials compared amitriptyline with another tricyclic/Heterocyclic Antidepressant or with one of the selective serotonin reuptake inhibitors. DATA COLLECTION AND ANALYSIS Data were extracted using a standardised form. The number of patients undergoing the randomisation procedure, the number of patients who completed the study and the number of improved patients were extracted. In addition, group mean scores at the end of the trial on Hamilton Depression Scale or any other depression scale were extracted. In the tolerability analysis, the number of patients failing to complete the study and the number of patients complaining of side-effects was extracted. MAIN RESULTS The estimate of the overall odds ratio for responders showed that more subjects responded to amitriptyline in comparison with the control Antidepressant group (odds ratio 1.12, 95% confidence interval 1.01, 1.23, number needed to treat 50). The estimate of the efficacy of amitriptyline and control agents on a continuous outcome revealed an effect size which also significantly favoured amitriptyline (Standardised Mean Difference 0.13, 95% confidence interval 0.04, 0.23). Whilst these differences are statistically significant, their clinical significance is less clear. When the efficacy analysis was stratified by drug class, no difference in outcome emerged between amitriptyline and either tricyclic or selective serotonin reuptake inhibitor comparators. The dropout rate in patients taking amitriptyline and control agents was similar; however, the estimate of the proportion of patients who experienced side-effects significantly favoured control agents in comparison with amitriptyline (odds ratio 0.63, 95% confidence interval 0.56, 0.71). When the tolerability analysis was stratified by drug class, the dropout rate in patients taking amitriptyline and the selective serotonin reuptake inhibitors significantly favoured the latter (odds ratio 0.84, 95% confidence interval 0.75,0.95, number needed to harm 40). When the responder analysis was stratified by study setting amitriptyline was more effective than control ADs in inpatients (odds ratio 1.22, 95% confidence interval 1.04, 1.42, number needed to treat 24), but not in outpatients (odds ratio 1.01, 95% confidence interval 0.88, 1.17, number needed to treat = 200). REVIEWER'S CONCLUSIONS This present systematic review indicates that amitriptyline is at least as efficacious as other tricyclics or newer compounds. However, the burden of side-effects in patients receiving it was greater. In comparison with the selective serotonin reuptake inhibitors amitriptyline was less well tolerated, and although counterbalanced by a higher proportion of responders, the difference was not statistically significant.
Matthew Hotopf - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
The Cochrane database of systematic reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
Cochrane Database of Systematic Reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Amitriptyline for depression
The Cochrane database of systematic reviews, 2007Co-Authors: Giuseppe Guaiana, Corrado Barbui, Matthew HotopfAbstract:BACKGROUND For many years amitriptyline has been considered one of the reference compounds for the pharmacological treatment of depression. However, new tricyclic drugs, Heterocyclic compounds and selective serotonin reuptake inhibitors have been introduced on the market with the claim of a more favourable tolerability/efficacy profile. OBJECTIVES The aim of the present systematic review was to investigate the tolerability and efficacy of amitriptyline in comparison with the other tricyclic/Heterocyclic Antidepressants and with the selective serotonin reuptake inhibitors. SEARCH STRATEGY The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR-Studies) was searched on 28-11-2005. Reference lists of all included studies were checked. SELECTION CRITERIA Only randomised controlled trials were included. Study participants were of either sex and any age with a primary diagnosis of depression. Included trials compared amitriptyline with another tricyclic/Heterocyclic Antidepressant or with one of the selective serotonin reuptake inhibitors. DATA COLLECTION AND ANALYSIS Data were extracted using a standardised form. The number of patients undergoing the randomisation procedure, the number of patients who completed the study and the number of improved patients were extracted. In addition, group mean scores at the end of the trial on Hamilton Depression Scale or any other depression scale were extracted. In the tolerability analysis, the number of patients failing to complete the study and the number of patients complaining of side-effects were extracted. MAIN RESULTS A total number of 194 studies were included in the review. The estimate of the overall odds ratio (OR) for responders showed that more subjects responded to amitriptyline in comparison with the control Antidepressant group (OR 1.12 to 95% confidence interval (CI) 1.02 to 1.23, number needed to treat to benefit (NNTB) = 50). The estimate of the efficacy of amitriptyline and control agents on a continuous outcome revealed an effect size which also significantly favoured amitriptyline (Standardised Mean Difference (SMD) 0.13, 95% CI 0.04 to 0.23). Whilst these differences are statistically significant, their clinical significance is less clear. When the efficacy analysis was stratified by drug class, no difference in outcome emerged between amitriptyline and either tricyclic or selective serotonin reuptake inhibitor comparators. The dropout rate in patients taking amitriptyline and control agents was similar; however, the estimate of the proportion of patients who experienced side-effects significantly favoured control agents in comparison with amitriptyline (OR 0.66, 95% CI 0.59 to 0.74). When the tolerability analysis was stratified by drug class, the dropout rate in patients taking amitriptyline and the selective serotonin reuptake inhibitors significantly favoured the latter (OR 0.84, 95% CI 0.75 to 0.95, number needed to treat to harm (NNTH) = 40). When the responder analysis was stratified by study setting amitriptyline was more effective than control Antidepressants in inpatients (OR 1.22, 95% CI 1.04 to 1.42, NNTB = 24), but not in outpatients (OR 1.01, 95%CI 0.88 to 1.17, NNTB = 200). AUTHORS' CONCLUSIONS This present systematic review indicates that amitriptyline is at least as efficacious as other tricyclics or newer compounds. However, the burden of side-effects in patients receiving it was greater. In comparison with selective serotonin reuptake inhibitors amitriptyline was less well tolerated, and although counterbalanced by a higher proportion of responders, the difference was not statistically significant.
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treatment discontinuation with selective serotonin reuptake inhibitors ssris versus tricyclic Antidepressants tcas
Cochrane Database of Systematic Reviews, 2006Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Amitriptyline versus other types of pharmacotherapy for depression.
The Cochrane database of systematic reviews, 2003Co-Authors: Giuseppe Guaiana, Corrado Barbui, Matthew HotopfAbstract:BACKGROUND For many years amitriptyline has been considered one of the reference compounds for the pharmacological treatment of depression. However, new tricyclic drugs, Heterocyclic compounds and the selective serotonin reuptake inhibitors have been introduced on the market with the claim of a more favourable tolerability/efficacy profile. OBJECTIVES The aim of the present systematic review was to investigate the tolerability and efficacy of amitriptyline in comparison with the other tricyclic/Heterocyclic Antidepressants and with the selective serotonin reuptake inhibitors. SEARCH STRATEGY The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (2002-3) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Key journals and conference abstracts were handsearched. Pharmaceutical companies were contacted for information on unpublished materials. SELECTION CRITERIA Only randomised controlled trials were included. Study participants were of either sex and any age with a primary diagnosis of depression. Included trials compared amitriptyline with another tricyclic/Heterocyclic Antidepressant or with one of the selective serotonin reuptake inhibitors. DATA COLLECTION AND ANALYSIS Data were extracted using a standardised form. The number of patients undergoing the randomisation procedure, the number of patients who completed the study and the number of improved patients were extracted. In addition, group mean scores at the end of the trial on Hamilton Depression Scale or any other depression scale were extracted. In the tolerability analysis, the number of patients failing to complete the study and the number of patients complaining of side-effects was extracted. MAIN RESULTS The estimate of the overall odds ratio for responders showed that more subjects responded to amitriptyline in comparison with the control Antidepressant group (odds ratio 1.12, 95% confidence interval 1.01, 1.23, number needed to treat 50). The estimate of the efficacy of amitriptyline and control agents on a continuous outcome revealed an effect size which also significantly favoured amitriptyline (Standardised Mean Difference 0.13, 95% confidence interval 0.04, 0.23). Whilst these differences are statistically significant, their clinical significance is less clear. When the efficacy analysis was stratified by drug class, no difference in outcome emerged between amitriptyline and either tricyclic or selective serotonin reuptake inhibitor comparators. The dropout rate in patients taking amitriptyline and control agents was similar; however, the estimate of the proportion of patients who experienced side-effects significantly favoured control agents in comparison with amitriptyline (odds ratio 0.63, 95% confidence interval 0.56, 0.71). When the tolerability analysis was stratified by drug class, the dropout rate in patients taking amitriptyline and the selective serotonin reuptake inhibitors significantly favoured the latter (odds ratio 0.84, 95% confidence interval 0.75,0.95, number needed to harm 40). When the responder analysis was stratified by study setting amitriptyline was more effective than control ADs in inpatients (odds ratio 1.22, 95% confidence interval 1.04, 1.42, number needed to treat 24), but not in outpatients (odds ratio 1.01, 95% confidence interval 0.88, 1.17, number needed to treat = 200). REVIEWER'S CONCLUSIONS This present systematic review indicates that amitriptyline is at least as efficacious as other tricyclics or newer compounds. However, the burden of side-effects in patients receiving it was greater. In comparison with the selective serotonin reuptake inhibitors amitriptyline was less well tolerated, and although counterbalanced by a higher proportion of responders, the difference was not statistically significant.
Nick Freemantle - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
The Cochrane database of systematic reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
Cochrane Database of Systematic Reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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treatment discontinuation with selective serotonin reuptake inhibitors ssris versus tricyclic Antidepressants tcas
Cochrane Database of Systematic Reviews, 2006Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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Selective serotonin reuptake inhibitors versus tricyclic and Heterocyclic Antidepressants: comparison of drug adherence.
The Cochrane database of systematic reviews, 2000Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, M Eccles, John R. Geddes, Rebecca Hardy, Glyn Lewis, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic antdepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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selective serotonin reuptake inhibitors versus tricyclic and Heterocyclic Antidepressants comparison of drug adherence
Cochrane Database of Systematic Reviews, 2000Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, M Eccles, John R. Geddes, Rebecca Hardy, Glyn Lewis, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. REVIEWER'S CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic antdepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
J Boynton - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
The Cochrane database of systematic reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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The Cochrane Library - Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic Antidepressants (TCAs)
Cochrane Database of Systematic Reviews, 2007Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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treatment discontinuation with selective serotonin reuptake inhibitors ssris versus tricyclic Antidepressants tcas
Cochrane Database of Systematic Reviews, 2006Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, John R. Geddes, Rebecca Hardy, Glyn Lewis, Martin P Eccles, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. AUTHORS' CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic Antidepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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Selective serotonin reuptake inhibitors versus tricyclic and Heterocyclic Antidepressants: comparison of drug adherence.
The Cochrane database of systematic reviews, 2000Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, M Eccles, John R. Geddes, Rebecca Hardy, Glyn Lewis, James MasonAbstract:Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic antdepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.
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selective serotonin reuptake inhibitors versus tricyclic and Heterocyclic Antidepressants comparison of drug adherence
Cochrane Database of Systematic Reviews, 2000Co-Authors: Corrado Barbui, Nick Freemantle, Matthew Hotopf, J Boynton, Rachel Churchill, M Eccles, John R. Geddes, Rebecca Hardy, Glyn Lewis, James MasonAbstract:BACKGROUND: Selective serotonin reuptake inhibitors are thought to have better discontinuation rates (i.e. less people dropping out) than tricyclic and Heterocyclic Antidepressant drugs. It is important to quantify the drop-out rates of different Antidepressant drugs in order to have a better understanding of the relative tolerability of these drugs. OBJECTIVES: To assess the comparative tolerability of selective serotonin reuptake inhibitors and tricyclic/Heterocyclic Antidepressant drugs. SEARCH STRATEGY: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (1997 to 1999), MEDLINE (1966 to 1999), EMBASE (1974 to 1999) We also searched specialist journals, the reference lists of relevant papers and previous systematic reviews, conference abstracts and government documents. Representatives of the pharmaceutical industry were contacted. SELECTION CRITERIA: Parallel group randomised controlled trials comparing selective serotonin reuptake inhibitors with tricyclic or Heterocyclic Antidepressants in people with depression. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and a third reviewer checked any cases of disagreement. MAIN RESULTS: We included 136 trials. The selective serotonin reuptake inhibitors showed less participants dropping out compared to the tricyclic/Heterocyclic group (odds ratio 1.21, 95% confidence interval 1.12 to 1.30). A statistically significant difference was found in total drop-outs between the selective serotonin reuptake inhibitors and the old tricyclics as well as the newer tricyclics. When the selective serotonin reuptake inhibitors were compared to the Heterocyclic Antidepressants, there was a non significant difference favouring the selective serotonin reuptake inhibitors. The poor tolerability profile of the old tricyclics was explained by differences in drop-outs for side-effects, but not for inefficacy. REVIEWER'S CONCLUSIONS: Whilst selective serotonin reuptake inhibitors do appear to show an advantage over tricyclic drugs in terms of total drop-outs, this advantage is relatively modest. This has implications for pharmaco-economic models, some of which may have overestimated the difference of drop-out rates between selective serotonin reuptake inhibitors and tricyclic antdepressants. These results are based on short-term randomised controlled trials, and may not generalise into clinical practice.