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 .
Placebo-controlled inpatient comparison of venlafaxine and fluoxetine for the treatment of major depression with melancholic features
The objective of this study was to compare venlafaxine and fluoxetine with placebo in treating major depressive disorder with melancholic features . Adult in patients with Diagnostic and Statistical Manual of Mental Disorders , fourth edition major depressive disorder with melancholia and 21-item Hamilton Depression Rating Scale ( HAM-D21 ) scores ≥24 ( n=289 ) were r and omized to receive ( double-blind ) venlafaxine 225–375 mg/day , fluoxetine 60–80 mg/day , or placebo for 6 weeks . The primary outcome measures were HAM-D21 total score , HAM-D depressed mood item , Montgomery Åsberg Depression Rating Scale total score and the Clinical Global Impressions-Severity ( CGI-S ) and Improvement ( CGI-I ) scores . Last observation carried forward ( LOCF ) was the primary analysis method . In the LOCF analysis , venlafaxine was statistically superior to placebo on the CGI-S ( venlafaxine −1.7 , placebo −1.1 ; P=0.003 ) and the HAM-D depressed mood item ( venlafaxine −1.6 , placebo −1.1 ; P=0.010 ) ; and to fluoxetine on the CGI-S ( −1.2 ; P=0.012 ) . No significant differences were observed on the other 12 LOCF primary efficacy comparisons . Increases in pulse and blood pressure , dry mouth , constipation , and lightheadedness were significantly more common with venlafaxine than fluoxetine . Venlafaxine was statistically superior to placebo on two of five primary and two of five secondary outcome measures and to fluoxetine on one primary and one secondary outcome measure ( LOCF ) . Venlafaxine was not superior to fluoxetine or placebo in providing remission
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 .