SSRIs significantly increase the risk of both serious and non-serious adverse events .
The potential small beneficial effects seem to be outweighed by harmful effects .
Background The evidence on selective serotonin reuptake inhibitors ( SSRIs ) for major depressive disorder is unclear .
Methods Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo , ‘ active ’ placebo , or no intervention in adult participants with major depressive disorder .
Analysis of the Hamilton Depression Rating Scale factors from a double‐blind, placebo‐controlled trial of fluoxetine in geriatric major depression
Major depression during later life represents a clinical challenge . Conventional antidepressant pharmacotherapy is relatively less well tolerated in geriatric patients compared with younger patients . Despite the striking impairments associated with this disorder , clinical investigations into the relative risk-benefit ratio of various depression treatment strategies have been limited . In this multicentre , placebo-controlled , double-blind trial with fluoxetine , 671 major depressed ( DSM-III-R-compatible ) out patients aged 60 years or older were evaluated . The 21-item Hamilton Depression Rating le ( HAMD21 ) response ( p = 0.014 ) and remission ( p = 0.008 ) criteria favoured fluoxetine over placebo . Analysis of the treatment effect on change in the HAMD21 factors ( anxiety/somatization , cognitive disturbance , psychomotor retardation , and sleep disturbance ) revealed advantages for fluoxetine within the cognitive disturbance and psychomotor retardation factors . Overall , the rate of discontinuation for an adverse event between fluoxetine ( 11.6 % ) and placebo ( 8.6 % ) was not statistically significant . Baseline HAMD21 factor scores were not predictive of adverse events leading to premature treatment discontinuation . Fluoxetine , 20 mg/day , is a well-tolerated and effective treatment option in the management of geriatric major depression
SSRIs significantly increase the risk of both serious and non-serious adverse events .
The potential small beneficial effects seem to be outweighed by harmful effects .
Background The evidence on selective serotonin reuptake inhibitors ( SSRIs ) for major depressive disorder is unclear .
Methods Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo , ‘ active ’ placebo , or no intervention in adult participants with major depressive disorder .