Conclusion Fluoxetine was not statistically different in either tolerability or efficacy when compared with duloxetine .
Venlafaxine was significantly superior to duloxetine in all analyses except dropout rate .
In the absence of relevant data from head-to-head comparison trials , results suggest that venlafaxine is superior compared with duloxetine and that duloxetine does not differentiate from fluoxetine
Background Data comparing duloxetine with existing antidepressant treatments is limited .
A comparison of duloxetine with fluoxetine has been performed but no comparison with venlafaxine , the other antidepressant in the same therapeutic class with a significant market share , has been undertaken .
In the absence of relevant data to assess the place that duloxetine should occupy in the therapeutic arsenal , indirect comparisons are the most rigorous way to go .
We conducted a systematic review of the efficacy of duloxetine , fluoxetine and venlafaxine versus placebo in the treatment of Major Depressive Disorder ( MDD ) , and performed indirect comparisons through meta-regressions .
Duloxetine in the treatment of major depressive disorder: a double-blind clinical trial.
BACKGROUND Duloxetine hydrochloride , a dual reuptake inhibitor of serotonin and norepinephrine , was evaluated for therapeutic efficacy and safety/tolerability in the treatment of major depression . METHOD In an 8-week multicenter , double-blind , placebo-controlled study , 173 patients ( aged 18 - 65 years ) with DSM-IV major depressive disorder were r and omly allocated to receive placebo ( N = 70 ) , duloxetine ( N = 70 ) , or fluoxetine , 20 mg q.d . ( N = 33 ) . Duloxetine dose was titrated in the first 3 weeks in a forced-titration regimen from 40 mg ( 20 mg b.i.d . ) to 120 mg/day ( 60 mg b.i.d . ) . Patients were required to have a Clinical Global Impressions (CGI)-Severity of Illness scale score of at least moderate severity ( > or = 4 ) and a 17-item Hamilton Rating Scale for Depression ( HAM-D-17 ) total score of at least 15 . Patients could not have had any current primary DSM-IV Axis I diagnosis other than major depressive disorder , or any anxiety disorder as a primary diagnosis within the past year , excluding specific phobias . The primary efficacy measurement was the HAM-D-17 total score , and secondary measures included the Montgomery-Asberg Depression Rating Scale , CGI-Severity of Illness and CGI-Improvement , and Patient Global Impression of Improvement . Safety was evaluated by recording the occurrence of discontinuation rates and treatment-emergent adverse events and by measurement of vital signs and laboratory analytes . RESULTS Duloxetine was superior to placebo in change on the HAM-D-17 ( p = .009 ) . Estimated probabilities of response and remission were 64 % and 56 % , respectively , for duloxetine , compared with 52 % and 30 % for fluoxetine and 48 % and 32 % for placebo . Duloxetine was numerically superior to fluoxetine on the primary and most of the secondary outcome measures . In general , duloxetine was well tolerated ; 76 % of patients achieved the maximum dose , and insomnia and asthenia were the only adverse events reported statistically significantly ( p < .05 ) more frequently by duloxetine-treated patients compared with placebo-treated patients . CONCLUSION These data indicate that duloxetine is efficacious for the treatment of major depressive disorder and is well tolerated and safe
Conclusion Fluoxetine was not statistically different in either tolerability or efficacy when compared with duloxetine .
Venlafaxine was significantly superior to duloxetine in all analyses except dropout rate .
In the absence of relevant data from head-to-head comparison trials , results suggest that venlafaxine is superior compared with duloxetine and that duloxetine does not differentiate from fluoxetine
Background Data comparing duloxetine with existing antidepressant treatments is limited .
A comparison of duloxetine with fluoxetine has been performed but no comparison with venlafaxine , the other antidepressant in the same therapeutic class with a significant market share , has been undertaken .
In the absence of relevant data to assess the place that duloxetine should occupy in the therapeutic arsenal , indirect comparisons are the most rigorous way to go .
We conducted a systematic review of the efficacy of duloxetine , fluoxetine and venlafaxine versus placebo in the treatment of Major Depressive Disorder ( MDD ) , and performed indirect comparisons through meta-regressions .