3 ms·

Key bit: "In head-to-head studies, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than ot

Key bit: "In head-to-head studies, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than other antidepressants (range of ORs 1·19–1·96), whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least efficacious drugs (0·51–0·84)."

fernly 9y ago
Also significant, the next sentence, "For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43–0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates." It appears that agomelatine[1] and vortioxetine[2] are effective and well-tolerated. Good to know. [1] https://en.wikipedia.org/wiki/Agomelatine https://en.wikipedia.org/wiki/Agomelatine : "...avoids the weight gain, sexual dysfunction, and severe withdrawal associated with the most commonly used classes of antidepressants..." [2] https://en.wikipedia.org/wiki/Vortioxetine https://en.wikipedia.org/wiki/Vortioxetine : "...Incidence of sexual dysfunction is higher in patients taking vortioxetine than in people taking placebos but appears to be lower than in people taking most other antidepressants..."
- contingencies 9y ago
  I didn't read the paper but going off your comment and the parent - escitalopram was in both lists, whereas vortioxetine wasn't. http://en.wikipedia.org/wiki/Escitalopram http://en.wikipedia.org/wiki/Escitalopram
joveian 9y ago
However, agomelatine was not approved in the US due to clinical trials not showing effectiveness (withdrawn by the drug company after phase III), although regular melatonin is super easily available here and I've heard some people say it helps. For a good analysis it is important to get access to unpublished studies submitted to the FDA. I don't have links but I think there are a couple that have done that. Edit: Looks like they did include some unpublished studies at least.

fernly 9y ago

Also significant, the next sentence, "For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43–0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates." It appears that agomelatine[1] and vortioxetine[2] are effective and well-tolerated. Good to know. [1] https://en.wikipedia.org/wiki/Agomelatine https://en.wikipedia.org/wiki/Agomelatine : "...avoids the weight gain, sexual dysfunction, and severe withdrawal associated with the most commonly used classes of antidepressants..." [2] https://en.wikipedia.org/wiki/Vortioxetine https://en.wikipedia.org/wiki/Vortioxetine : "...Incidence of sexual dysfunction is higher in patients taking vortioxetine than in people taking placebos but appears to be lower than in people taking most other antidepressants..."

contingencies 9y ago
I didn't read the paper but going off your comment and the parent - escitalopram was in both lists, whereas vortioxetine wasn't. http://en.wikipedia.org/wiki/Escitalopram http://en.wikipedia.org/wiki/Escitalopram

joveian 9y ago

However, agomelatine was not approved in the US due to clinical trials not showing effectiveness (withdrawn by the drug company after phase III), although regular melatonin is super easily available here and I've heard some people say it helps. For a good analysis it is important to get access to unpublished studies submitted to the FDA. I don't have links but I think there are a couple that have done that. Edit: Looks like they did include some unpublished studies at least.