A Meta-Analysis of Fluoxetine Outcome in the Treatment of Depression

Greenberg, Roger P.; Bornstein, Robert F.; Zborowski, Michael J.; Fisher, Seymour; Greenberg, Michael D.

doi:10.1097/00005053-199410000-00003

Cited by 98 publications

(63 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…28,29 Another argument that has been put forward, for example by Kirsch,6 as support for the placebo-breaking-the-blind hypothesis is that an analysis based on six trials comparing the SSRI fluoxetine with placebo showed side effects to correlate significantly with efficacy. 9 However, this study did not analyze the association between side effects and response in individual patients but used trial level meta-analysis. Of note is also that a more recent trialbased meta-analysis, including a much larger set of studies (n = 68), failed to replicate the correlation.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 However, whereas these studies have been based on the assumption that there may be marked inter-trial differences with respect to the propensity of the participants to experience selective serotonin reuptake inhibitor (SSRI)-induced side effects that translate into corresponding differences in response rate, it may be argued that the difference in propensity to side effects of possible relevance in this context should reside between individuals rather than between trial populations. For this reason, and considering that patient-level mega-analyses and metaanalyses of trial-level data may differ significantly in outcome, 11 a more informative approach to address this problem may be to compare the response in patients reporting and not reporting adverse events, respectively.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression

et al. 2017

View full text Add to dashboard Cite

It has been suggested that the superiority of antidepressants over placebo in controlled trials is merely a consequence of side effects enhancing the expectation of improvement by making the patient realize that he/she is not on placebo. We explored this hypothesis in a patient-level post hoc-analysis including all industry-sponsored, Food and Drug Administration-registered placebocontrolled trials of citalopram or paroxetine in adult major depression that used the Hamilton Depression Rating Scale (HDRS) and included a week 6 symptom assessment (n = 15). The primary analyses, which compared completers on active treatment without early adverse events to completers on placebo (with or without adverse events) with respect to reduction in the HDRS depressed mood item showed larger symptom reduction in patients given active treatment, the effect sizes being 0.48 for citalopram and 0.33 for paroxetine. In actively treated subjects reporting early adverse events, who also outperformed those given placebo, the severity of the adverse events did not predict response. Several sensitivity analyses, for example, including (i) those using change of the sum of all HDRS-17 items as effect parameter, (ii) those excluding all subjects with adverse events (that is, also those on placebo) and (iii) those based on the intention-to-treat population, were all in line with the primary analyses. The finding that both paroxetine and citalopram are clearly superior to placebo also when not producing adverse events, as well as the lack of association between adverse event severity and response, argue against the theory that antidepressants outperform placebo solely or largely because of their side effects.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression

et al. 2017

View full text Add to dashboard Cite

show abstract

“…et al, 1995). For comparison, the mean effect size in meta-analyses of other studies of fluoxetine in the treatment of depression is around 0.4 (Greenberg et al, 1994). Results of longer studies, and larger samples, are awaited.…”

Section: Naltrexone/nalmefenementioning

confidence: 99%

Medication in the treatment of alcohol dependence

Chick¹

1996

Adv. psychiatr. treat

View full text Add to dashboard Cite

Social, cultural, emotional and biological influences determine whether people drink to excess and whether they then experience harm or cause harm to others (Cook, 1994). Psychosocial treatments for alcohol dependence are only modestly successful, with most studies finding that at least 50% of patients return to harmful drinking in the following year. In the past decade there has been new evidence for the role of pharmacological treatments in reducing harm from drinking and in preventing relapse.

show abstract

“…Die dadurch induzierten höheren Erwartungen an die Wirksamkeit des Präparats würden die Placeboe ekte bei SSRI-Gabe verstärken und so zu einer Überschät-zung der antidepressiven Wirksamkeit der SSRI führen. Bisher konnte nur für Fluoxetin in einer älteren Metaanalyse, in die nur sechs randomisierte, kontrollierte Studien eingeschlossen wurden, ein enger Zusammenhang zwischen UAW und SSRI-Wirksamkeit dokumentiert werden, wie er sich aus Kirschs Argumentation ergibt [2]. …”

unclassified

Wirksamkeit unabhängig von Nebenwirkungen

Mergl¹

2016

InFo Neurologie

View full text Add to dashboard Cite

A Meta-Analysis of Fluoxetine Outcome in the Treatment of Depression

Cited by 98 publications

References 0 publications

Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression

Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression

Medication in the treatment of alcohol dependence

Wirksamkeit unabhängig von Nebenwirkungen

Contact Info

Product

Resources

About