Second generation antidepressants are all equally effective, according to a new clinical practice guideline released by the American College of Physicians.
The guideline authors reviewed more than 200 published studies about the benefits and risks of the following second generation drugs: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazadone and venlafaxine.
"The studies we analyzed show that second generation drugs have different adverse effects but are equally effective for treating depression," lead author Dr. Amir Qaseem, senior medical associate in ACP's Clinical Programs and Quality of Care Department, said in a group news release.
"ACP recommends that physicians make treatment decisions based on side effects, cost, and patient preferences, and make necessary changes in therapy if the response is not sufficient after six to eight weeks. Doctors should also assess patient status and adverse effects on a regular basis starting within one to two weeks of starting the treatment."
The guideline also recommends that doctors continue treatment for four to nine months after a satisfactory response to an antidepressant in patients with a first episode of major depression. A longer course of treatment may help prevent relapse or recurrence in patients who've had two or more episodes of depression.
The guideline was published Nov. 18 in the journal Annals of Internal Medicine.
Depression, which will affect about 16 percent of American adults at some point in their lives, can be triggered by stressful situations such as the loss of a job or death of a loved one. Depression treatment options include drugs, psychotherapy, and cognitive behavioral therapy.
In drug therapy, second generation antidepressants are often used, because they're effective and have fewer side effects than older antidepressants.
More information
The U.S. National Institute of Mental Health has more about depression.
SOURCE: American College of Physicians, news release, Nov. 18, 2008
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