Current Psychiatry Reports

, Volume 14, Issue 4, pp 360–369

How Should Primary Care Doctors Select Which Antidepressants to Administer?

  • Gerald Gartlehner
  • Kylie Thaler
  • Seth Hill
  • Richard A. Hansen
Psychiatry in Primary Care (BN Gaynes, Section Editor)

DOI: 10.1007/s11920-012-0283-x

Cite this article as:
Gartlehner, G., Thaler, K., Hill, S. et al. Curr Psychiatry Rep (2012) 14: 360. doi:10.1007/s11920-012-0283-x

Abstract

Clinicians can choose among various second-generation antidepressants for treating depressive disorders, such as major depressive disorder, subsyndromal depression, or dysthymia. Systematic reviews indicate that available drugs differ in frequency of administration, costs, and the risks of some adverse events but have similar efficacy for treating major depressive disorder. Furthermore, evidence does not support the choice of one antidepressant over another based on accompanying symptoms, such anxiety, insomnia, or pain. Available studies provide little guidance for clinicians about the benefits of second-generation antidepressants for treating dysthymia and subsyndromal depression. Evidence is also unclear about the comparative risks of serious adverse events, such as suicidality, seizures, fractures, increased bleeding, or serotonin syndrome. This article summarizes the best available evidence regarding comparative benefits and harms of second-generation antidepressants for treating depressive disorders.

Keywords

Major depressive disorder Dysthymia Subsyndromal depression Second-generation antidepressants Treating depressive disorders Primary care 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Gerald Gartlehner
    • 1
    • 2
  • Kylie Thaler
    • 1
  • Seth Hill
    • 3
  • Richard A. Hansen
    • 3
  1. 1.Department of Evidence-based Medicine and Clinical EpidemiologyDanube UniversityKremsAustria
  2. 2.RTI InternationalDurhamUSA
  3. 3.Harrison School of Pharmacy, Department of Pharmacy Care SystemsAuburn UniversityAuburnUSA

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