BMJ  2003;327:289 (2 August), doi:10.1136/bmj.327.7409.289-a

Letter

Pharmacological heterogeneity limits antidepressant study

The first 150 words of the full text of this article appear below.

EDITOR—MacGillivray et al potentially make a huge contribution to the understanding of the relative utility of selective serotonin reuptake inhibitors and older antidepressants in the treatment of depression in primary care.¹ However, the usefulness of their meta-analysis is limited by the original data, as is so often the case.

These results are very difficult to interpret, not least because the comparitors used in the key studies are pharmacologically heterogeneous. Two studies, including one of the key three crucial studies providing data in an unambiguous format, used mianserin as a comparitor. Mianserin is a tetracyclic, not a tricyclic as the paper's title might imply. It is not a potent reuptake inhibitor but a potent and thus sedative anti-histamine. A third study used lofepramine as a comparitor, a more modern tricyclic with a much more benign anticholinergic side effect profile than its older cousins, which have an adverse event rate . . . [Full text of this article]

University of Kent, Canterbury CT2 7NZ A.S.Hale@ukc.ac.uk

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Article

Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and meta-analysis

Steve MacGillivray, Bruce Arroll, Simon Hatcher, Simon Ogston, Ian Reid, Frank Sullivan, Brian Williams, and Iain Crombie
BMJ 2003 326: 1014. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Grazzini, G., Ciatto, S., Cislaghi, C., Castiglione, G., Falcone, M., Mantellini, P., Zappa, M., The Working Group of Regional Reference Centre for, (2008). Cost evaluation in a colorectal cancer screening programme by faecal occult blood test in the District of Florence. J Med Screen 15: 175-181 [Abstract] [Full text]  
• Arbyn, M, Raifu, A., Autier, P, Ferlay, J (2007). Burden of cervical cancer in Europe: estimates for 2004. Ann Oncol 0: mdm079v2- [Abstract] [Full text]  

Online poll

Find out more >>