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 .
A Randomized Trial of Combined Citalopram and Naltrexone for Nonabstinent Outpatients With Co-Occurring Alcohol Dependence and Major Depression
Abstract Despite the high rate of co-occurrence of major depression and alcohol dependence , the role of pharmacotherapy in their treatment remains unclear . In the new era of naltrexone for alcohol dependence , it is notable that only 1 study to date has examined the efficacy of antidepressant medication prescribed concurrently with naltrexone . We aim ed to determine whether combining naltrexone with citalopram produced better treatment outcomes than naltrexone alone in patients with co-occurring alcohol dependence and depression , and to investigate whether either sex or depression type ( independent or substance-induced depression ) moderated treatment response . Participants were 138 depressed alcohol-dependent adults who were not required to be abstinent at the commencement of the trial . They were r and omized to 12 weeks of citalopram or placebo , plus naltrexone and clinical case management .  Treatment was well attended , and medications were reasonably well tolerated with high adherence rates . Substantial improvements in both mood and drinking occurred in both groups , with no significant differences between groups on any of the mood or drinking outcome measures , whether or not other variables were controlled for . No interaction effect was found for independent/substance-induced depression status , whereas there was a marginal effect found by sex , with greater improvement in 1 drinking outcome measure ( percent days abstinent ) in women taking citalopram . These findings suggest that citalopram is not a clinical ly useful addition to naltrexone and clinical case management in this treatment population . Independent/substance-induced depression status did not predict treatment response . Findings for sex were equivocal
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 .