Are SSRI antidepressants a clinically homogeneous class of compounds?

Sacchetti, Emilio; Conte, G; Guarneri, L.

doi:10.1016/s0140-6736(94)91310-2

Cited by 26 publications

(8 citation statements)

References 2 publications

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“…A good response to a tricyclic such as clomipramine in patients with a diagnosis of depression is in 95% of cases a predictor of a good response to another primarily serotonergic agent such as amitriptyline (Mattes, 1994;Sacchetti et al, 1994). A few studies comparing different SRIs have shown that we cannot consider the SRIs a homogenous category, such as tricyclics, but as a team with different players; within the category of the so-called SSRIs, the percentage of concordance in treating depression is less than 75% (Sacchetti et al, 1994;Salzman, 1996).…”

Section: Number Type and Duration Of Failed Trialsmentioning

confidence: 99%

“…A few studies comparing different SRIs have shown that we cannot consider the SRIs a homogenous category, such as tricyclics, but as a team with different players; within the category of the so-called SSRIs, the percentage of concordance in treating depression is less than 75% (Sacchetti et al, 1994;Salzman, 1996). Because a first-line SSRI treatment in OCD has not been established, the choice of first treatment is currently based only on clinician judgment.…”

Section: Number Type and Duration Of Failed Trialsmentioning

confidence: 99%

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Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Pallanti

Quercioli

2006

Progress in Neuro-Psychopharmacology and Biological Psychiatry

337

190

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While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40 -60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of nonresponsive patients, and they are difficult to cluster due to ambiguities in diagnostic criteria, possibility of subtypes and a high rate of comorbidity. Moreover, the findings of current studies of ''so-called'' non-responsive cases are currently non-generalizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of the research in this area are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multisite data collection for future research trials. The authors reviewed also the more recent therapeutic pharmacological and psychological lines for the treatment of refractoriness in OCD. D

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Section: Number Type and Duration Of Failed Trialsmentioning

confidence: 99%

Section: Number Type and Duration Of Failed Trialsmentioning

confidence: 99%

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Pallanti

Quercioli

2006

Progress in Neuro-Psychopharmacology and Biological Psychiatry

337

190

View full text Add to dashboard Cite

show abstract

“…A good response to a tricyclic such as clomipramine in patients with a diagnosis of depression is in 95 % of cases a predictor of a good response to another primarily serotonergic agent such as amitriptyline (Mattes, 1994 ;Sacchetti et al, 1994). A few studies comparing different SRIs have shown that we cannot consider the SRIs as a homogenous category, such as tricyclics, but as a team with different players ; within the category of the so-called SSRIs the percentage of concordance in treating depression is less than 75 % (Sacchetti et al, 1994 ;Salzman, 1996).…”

Section: Number Type Duration Of Failed Trialsmentioning

confidence: 99%

“…A few studies comparing different SRIs have shown that we cannot consider the SRIs as a homogenous category, such as tricyclics, but as a team with different players ; within the category of the so-called SSRIs the percentage of concordance in treating depression is less than 75 % (Sacchetti et al, 1994 ;Salzman, 1996). Because a first-line SSRI treatment in OCD has not been established, the choice of first treatment is currently based only on the clinician's judgement.…”

Section: Number Type Duration Of Failed Trialsmentioning

confidence: 99%

Treatment non-response in OCD: methodological issues and operational definitions

Pallanti

Hollander

Bienstock

et al. 2002

Int. J. Neuropsychopharm.

352

199

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While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40-60 % of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of non-responsive patients, and they are difficult to cluster due to ambiguities in the diagnostic criteria, possibility of subtypes, and a high rate of comorbidity. Moreover, the findings of current studies of so-called ' non-responsive ' cases are currently nongeneralizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of this paper are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multi-site data collection for future research trials.

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“…In adults, lack of clinical response to one SSRI does not imply that the patient will not respond to treatment with another. [133][134][135][136] There are currently 4 SSRIs that are marketed in the US. These are fluoxetine, sertraline, paroxetine and fluvoxamine.…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris)mentioning

confidence: 99%

Pharmacological Treatment of Depression in Children and Adolescents

1999

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Major depression is a common disorder during childhood and adolescence. Over the past decade, many new antidepressants have been marketed in the US. In adults, these newer agents have been shown to be as effective as the prototypic tricyclic antidepressants (TCAs). Further, when compared with the TCAs these medications are better tolerated and are safer in overdose. Although TCAs are effective in the treatment of depressed adults, controlled clinical trials have not demonstrated their efficacy in either children or adolescents. In addition, concerns about the safety of TCAs and the monoamine oxidase inhibitors has left disappointingly few pharmacological treatment options available for depressed children and adolescents. For this reason, clinicians have begun to prescribe the newer agents for this population, despite the fact that relatively little is known about their disposition, safety or effectiveness in the young. Investigators have begun to examine whether the use of newer antidepressant medications such as fluoxetine, sertraline, paroxetine, fluvoxamine, nefazodone, and venlafaxine is truly indicated for children and adolescents with major depression. Pharmacokinetic studies of sertraline, paroxetine and nefazodone have been performed in depressed youths. The results of these studies have provided data for rational administration strategies for these agents. They have also provided evidence that these agents may be well tolerated in children and adolescents. Further evidence that these agents are often well tolerated when prescribed to depressed youths has been obtained from both open-label and double-blind studies. Published studies have generally shown that open-label treatment with these newer agents often leads to symptom amelioration in paediatric patients with major depression. Since high rates of placebo response are often seen in depressed children and adolescents, results from these studies cannot be interpreted to suggest that these medications have true antidepressant efficacy in this population. At present, the results of only two such studies have been published. The results of one of these trials are difficult to interpret because of methodological considerations. The other study reported that treatment with fluoxetine was superior to placebo. This paper critically reviews what has been published about the pharmacological treatment of depressed paediatric patients and provides some guidance to the use of antidepressants in this patient population, paying particular attention to what is known about the newer antidepressants as well as considering directions for future research.

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Are SSRI antidepressants a clinically homogeneous class of compounds?

Cited by 26 publications

References 2 publications

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Treatment non-response in OCD: methodological issues and operational definitions

Pharmacological Treatment of Depression in Children and Adolescents

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