Specificity profile of venlafaxine and sertraline in major depression:
metaregression of double-blind, randomized clinical trials.
Author(s): Gibiino S(1), Marsano A, Serretti A.
Affiliation(s): Author information:
(1)Department of Biomedical and NeuroMotor Sciences, University of Bologna,
Italy.
Publication date & source: 2014, Int J Neuropsychopharmacol. , 17(1):1-8
Despite the well-known efficacy of selective serotonin reuptake inhibitors
(SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) in the treatment
of major depressive disorder, there is a lack of indications for each drug in
different groups of patients. The aim of this study is to investigate the
possible role of clinical sociodemographic factors as moderators of clinical
response to venlafaxine (SNRI) and sertraline (SSRI). Research was performed on
Medline and EMBASE for randomized control trials in English focused on sertraline
and venlafaxine in the treatment of major depressive disorder and 59 studies were
included. Clinical efficacy of each treatment was assessed on the basis of
Hamilton Depressive Rating Scale and Montgomery-Asberg Depression Rating Scale. A
metaregression analysis was performed to evaluate the role of clinical and
sociodemographic factors as moderators of outcome, calculating the effect of each
variable with the random-effects method. Gender, ethnicity and duration of
depressive episode could have a role in prediction of clinical response to both
antidepressants. Venlafaxine seems to have better effects in females and in
Caucasian patients. Sertraline seems to be more efficacious in the treatment of
females. Both drugs were more efficacious in patients who suffered a shorter
episode of illness. Our results could represent an interesting point of view in
the perspective of choosing the most suitable therapy based on clinical and
social features for each patient. Metaregression is a retrospective analysis,
based on the cumulative results of previous studies, so the lack of original data
could represent the main limitation in this report and in the interpretation of
the results obtained.
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