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The efficacy, safety and tolerability of antidepressants in late life depression: a meta-analysis
N Mittmann1, N Herrmann, T R Einarson
1Division of Clinical Pharmacology, Sunnybrook Health Science Centre, University of Toronto, Canada.
Background:
To determine the efficacy, safety and tolerability of antidepressants in depressed elderly patients.
Methods:
Search for randomized controlled double-blind studies evaluating atypical antidepressants (ATYPs), reversible inhibitors of monoamine oxidase-A, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants in moderate/severe depressed patients > or = 60 years for > or = four weeks. The random effects model (single-arm; comparative) was used to aggregate efficacy, safety and dropout.
Results:
No difference in single-arm aggregation of outcomes for four antidepressant classes. Comparative analyses showed no statistical difference between outcomes, except SSRIs had a higher response rate than ATYPs.
Conclusion:
Elderly show no differences in antidepressant class outcomes.
Limitations:
Heterogeneity and lack of power.
Clinical Relevance:
There is little advantage for antidepressant classes over another in the aged.