Current Psychiatry Reports

, Volume 14, Issue 4, pp 360–369 | Cite as

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)


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.


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



Dr. Gartlehner has received research support from Agency for Healthcare Research and Quality (AHRQ).

Dr. Thaler has received research support from AHRQ.

Mr. Hill has received research support from AHRQ and Foundation for the National Institutes of Health (FNIH).

Dr. Hansen has received research support from AHRQ and FNIH, and has served as a consultant for Novartis and Takeda.


Recently published papers of particular interest have been highlighted as: • Of importance •• Of outstanding importance

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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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