BMJ 1995;311:1303-1304 (11 November)

Letters

Subject to many potential biases

EDITOR,--I M Anderson and B M Tomenson's paper1 updates our meta-analysis comparing drop out rates in patients taking selective serotonin reuptake inhibitors and tricyclic antidepressants2 but excludes newer tricyclic drugs. Despite this difference, which would tend to favour the selective serotonin reuptake inhibitors, the results are nearly identical. The table compares drop out rates in the three published meta-analyses.1 2 3 Clearly, despite the different inclusion criteria, the results broadly agree: the difference is small and of dubious clinical and economic importance. 


Drop out rates among patients taking selective serotonin
reuptake inhibitors and tricyclic antidepressants in three
meta-analyses
-----------------------------------------------------------------
                           Drop out rate (%)
-----------------------------------------------------------------
                         Selective
                         serotonin     Tricyclic     Absolute
                         reuptake        anti-      difference
                         inhibitors   depressants      (%)
-----------------------------------------------------------------
Song et al2           32.3           33.2         0.9
Montgomery et al3*    33.8           35.6         1.8
Anderson and
 Tomenson1            30.8           33.4         2.6
-----------------------------------------------------------------
*Calculated from figures in paper, with correction for errors.

The small absolute difference found in these meta-analyses . . . [Full text of this article]


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Relevant Article

Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis
I M Anderson and B M Tomenson
BMJ 1995 310: 1433-1438. [Abstract] [Full Text]

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