Comparison of fluvoxamine and amitriptyline in depressed outpatients

Remick, Ronald A.; Reesal, Robin T.; Oakander, Margaret A; Allen, Judy R M; Claman, Jeffery; Ramírez, Carmen Eulalia Quesada; Perry, Katherine; Keller, Fritz-Eugen

doi:10.1016/s0011-393x(05)80168-7

Cited by 13 publications

(4 citation statements)

References 6 publications

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“…We had replies from the authors of 23 trials. Among them, we were able to obtain unpublished data from 15 trials including 17 comparisons (Ansseau 1991a; Ansseau 1991b; Barge-Schaapveld 1995; Cassano 1986; Dalery 2003; Hackett 1998a; Hackett 1998b; Kasper 1990; Kato 2006; Nathan 1990; Nemeroff1995; Otsubo 2005; Rechlin 1994; Remick 1994; Rossini 2005; Schoemaker 2002; Ueda 2002).…”

Section: Resultsmentioning

confidence: 99%

“…Sixteen studies reported this outcome. Among them, imputation methods were used for 11 studies (Claghorn 1996; de Wilde 1983; Feighner 1989; Guy 1984; Harris 1991a; Lydiard 1989; March 1990; Mullin 1988; Rahman 1991; Remick 1994; Tourigny-Rivard 1996). There was no strong evidence that fluvoxamine was either superior or inferior to TCAs except desipraminein terms of this dichotomous outcome in head-to-head comparisons.…”

Section: Resultsmentioning

confidence: 99%

“…Substantial heterogeneity existed between trials comparing fluvoxamine to amitriptyline, based on four trials (I 2 = 70 %, P = 0.02, Analysis 1.2). Visual inspection revealed that, among these studies, three smaller ones using the imputation methods for response (Harris 1991a; Kostiukova 2003; Remick 1994) reported results favourable to amitriptyline. However, because of the small number of trials, sources of the heterogeneity cannot be further explained.…”

Section: Resultsmentioning

confidence: 99%

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Fluvoxamine versus other anti-depressive agents for depression

Omori

Watanabe

Nakagawa

et al. 2010

Cochrane Database of Systematic Reviews

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Background Fluvoxamine, one of the oldest selective serotonin reuptake inhibitors (SSRIs), is prescribed to patients with major depression in many countries. Several studies have previously reviewed the efficacy and tolerability of fluvoxamine for the treatment of major depression. However, these reviews are now outdated. Objectives Our objective is to evaluate the effectiveness, tolerability and side effect profile of fluvoxamine for major depression in comparison with other anti-depressive agents, including tricyclics (TCAs), heterocyclics, other SSRIs, SNRIs, other newer agents and other conventional psychotropic drugs. Search methods We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register. Trial databases and ongoing trial registers in North America, Europe, Japan and Australia, were handsearched for randomised controlled trials. We checked reference lists of the articles included in the review, previous systematic reviews and major textbooks of affective disorder for published reports and citations of unpublished research. The date of last search was 31 August 2008. Selection criteria We included all randomised controlled trials, published in any language, that compared fluvoxamine with any other active antidepressants in the acute phase treatment of major depression. Data collection and analysis Two independent review authors inspected citations and abstracts, obtained papers, extracted data and assessed the risk of bias of included studies. We analysed dichotomous data using odds ratios (ORs) and continuous data using the standardised mean difference (SMD). A random effects model was used to combine studies. Main results A total of 54 randomised controlled trials (n = 5122) were included. No strong evidence was found to indicate that fluvoxamine was either superior or inferior to other antidepressants regarding response, remission and tolerability. However, differing side effect profiles were evident, especially with regard to gastrointestinal side effects of fluvoxamine when compared to other antidepressants. For example, fluvoxamine was generally associated with a higher incidence of vomiting/nausea (versus imipramine, OR 2.23, CI 1.59 to 3.14; versus clomipramine, OR 2.13, CI 1.06 to 4.27; versus amitriptyline, OR 2.86, CI 1.31 to 2.63). Authors’ conclusions We found no strong evidence that fluvoxamine was either superior or inferior to any other antidepressants in terms of efficacy and tolerability in the acute phase treatment of depression. However, differing side effect profiles were evident. Based on these findings, we conclude that clinicians should focus on practical or clinically relevant considerations, including these differences in side effect profiles.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Fluvoxamine versus other anti-depressive agents for depression

Omori

Watanabe

Nakagawa

et al. 2010

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

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“…There was significant statistical heterogeneity for the response between trials comparing fluvoxamine to amitriptyline based on four trials (I-squared = 71.2%, P = 0.02). Visual inspection showed that, amongst these studies, three smaller ones using the imputation methods for response (Harris, et al, 1991;Kostiukova, et al, 2003;Remick, et al, 1994) reported results favourable to amitriptyline. However, because of the small number of trials, sources of the heterogeneity cannot be further explained.…”

Section: Treatment Effectivenessmentioning

confidence: 99%

Efficacy, tolerability and side-effect profile of fluvoxamine for major depression: meta-analysis

et al. 2008

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Fluvoxamine, one of the oldest selective serotonin reuptaking inhibitors, is commonly prescribed to patients with major depression. Several studies have reviewed the efficacy and tolerability of fluvoxamine for the treatment of major depression. However, these reviews are outdated, have not been systematic and/or suffered from several methodological weaknesses. We conducted a systematic review to synthesize the best available evidence on the efficacy of fluvoxamine for adult patients suffering from major depression in comparison with other active antidepressive agents. Relevant randomized controlled trials were identified through a comprehensive search. The primary outcome was a relative risk of response, and the secondary outcome was a relative risk of remission. Tolerability and side-effect profile were also examined. Fifty-three trials were included. There were no large differences between fluvoxamine and any other antidepressants in terms of efficacy and tolerability. There is evidence of differing side effect profiles, especially when comparing gastrointestinal side effects between fluvoxamine and tricyclics. Clinicians should focus on practically or clinically relevant differences including those in side-effect profiles.

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