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Related Experiment Videos

Third-generation antidepressants: do they offer advantages over the SSRIs?

J S Olver1, G D Burrows, T R Norman

  • 1Department of Psychiatry, University of Melbourne, Austin & Repatriation Medical Centre, West Heidelberg, Victoria, Australia.

CNS Drugs
|December 12, 2001
PubMed
Summary

Third-generation antidepressants show similar efficacy and speed of onset to SSRIs. While not superior, these newer antidepressants offer equivalent safety to SSRIs and improved safety over older agents.

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Area of Science:

  • Pharmacology
  • Psychiatry
  • Clinical Medicine

Background:

  • Third-generation antidepressants, including venlafaxine, reboxetine, nefazodone, and mirtazapine, offer varied mechanisms beyond serotonin reuptake inhibition.
  • Claims suggest improved efficacy, faster onset, and greater safety compared to selective serotonin reuptake inhibitors (SSRIs).

Purpose of the Study:

  • To review the evidence supporting claims of enhanced efficacy, speed of onset, and safety for third-generation antidepressants versus previous medications.
  • To critically evaluate the comparative effectiveness and safety profiles of newer antidepressant agents.

Main Methods:

  • Systematic review of thirty active comparator studies involving third-generation antidepressant agents.
  • Analysis focused on efficacy, speed of onset, relapse prevention, and safety compared to other antidepressants.

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Main Results:

  • No convincing differences in overall efficacy, relapse prevention, or speed of onset were found between third-generation agents and comparators.
  • Isolated reports suggested improvements for venlafaxine, reboxetine, and mirtazapine in specific instances.
  • Third-generation antidepressants demonstrated equivalent safety to SSRIs and maintained safety advantages over first-generation agents.

Conclusions:

  • Third-generation antidepressants do not appear to offer superior efficacy or speed of onset compared to existing treatments like SSRIs.
  • These newer agents provide comparable safety to SSRIs and are safer than first-generation antidepressants.