Does adding noradrenaline reuptake inhibition to selective serotonin reuptake inhibition improve efficacy in patients with depression? A systematic review of meta-analyses and large randomised pragmatic trials

@article{Bradley2013DoesAN,
  title={Does adding noradrenaline reuptake inhibition to selective serotonin reuptake inhibition improve efficacy in patients with depression? A systematic review of meta-analyses and large randomised pragmatic trials},
  author={Andrew J. Bradley and Alan J. Lenox-Smith},
  journal={Journal of Psychopharmacology},
  year={2013},
  volume={27},
  pages={740 - 758}
}
Selective serotonin reuptake inhibitors (SSRIs) are recommended as first-line pharmacological treatment for depression and are the most commonly prescribed class of antidepressants. However, there is substantial evidence that noradrenaline has a role in the pathogenesis and treatment of depression. This review aims to examine the evidence of including noradrenaline reuptake inhibition with serotonin reuptake inhibition with respect to increasing efficacy in the treatment of depression. Evidence… 

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References

SHOWING 1-10 OF 86 REFERENCES

Efficacy and tolerability of venlafaxine compared with selective serotonin reuptake inhibitors and other antidepressants: a meta-analysis.

Venlafaxine has greater efficacy than SSRIs although there is uncertainty in comparison with other antidepressants, and further studies are required to determine the clinical importance of this finding.

Efficacy of Duloxetine and Selective Serotonin Reuptake Inhibitors: Comparisons as Assessed by Remission Rates in Patients With Major Depressive Disorder

Whereas duloxetine and the 2 SSRIs were comparably efficacious overall, therapy with the serotonin and norepinephrine reuptake inhibitor resulted in a significantly higher remission rate among patients with moderate-to-severe depression.

Milnacipran, a new serotonin and noradrenaline reuptake inhibitor: an overview of its antidepressant activity and clinical tolerability

Meta-analyses of the original data of controlled trials involving 1032 patients, comparing milnacipran with imipramine or selective serotonin reuplake inhibitors (SSRIs), show that milnACipran provides antidepressant efficacy similar to that of imipramsine and significantly superior to thatof the SSRIs.

Efficacy of escitalopram in the treatment of major depressive disorder compared with conventional selective serotonin reuptake inhibitors and venlafaxine XR: a meta-analysis.

In this meta-analysis, escitalopram showed significant superiority in efficacy compared with the active controls and comparable to venlafaxine, although the overall results do not necessarily reflect a significant difference between escITALopram and individual SSRIs.

Venlafaxine extended release versus citalopram in patients with depression unresponsive to a selective serotonin reuptake inhibitor

This study was designed to test the hypothesis that, after treatment failure with an SSRI, switching to venlafaxine extended release (ER) would offer advantages over switching to another SS RI, citalopram, and to investigate the effects of severity of depression by categorizing treatment groups according to baseline severity.

Efficacy and tolerability of venlafaxine versus specific serotonin reuptake inhibitors in treatment of major depressive disorder: a meta-analysis of published studies

This meta-analysis includes all published, randomized, double-blind, head-to-head trials, which compared venlafaxine and an SSRI in the treatment of MDD in adults, and shows that venl Lafaxine was superior to SSRIs in achieving remission and response.

Escitalopram versus serotonin noradrenaline reuptake inhibitors as second step treatment for patients with major depressive disorder: a pooled analysis

Escitalopram is associated with a better efficacy and tolerability profile than SNRIs (duloxetine and venlafaxine) when used as a second step treatment in patients with MDD.
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