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Third-Generation Antidepressants

Do They Offer Advantages Over the SSRIs?

CNS Drugs volume 15, pages 941–954 (2001)Cite this article

Abstract

Third-generation antidepressants are a group of antidepressant agents of variable action, not confined to serotonin reuptake inhibition. These agents include venlafaxine, reboxetine, nefazodone and mirtazapine. Claims have been made for these agents in terms of improved efficacy, faster speed of onset of effect and greater safety in the treatment of depression compared with previous medications, such as the selective serotonin reuptake inhibitors (SSRIs). This article reviews the evidence for these improvements.

Thirty active comparator studies were reviewed involving the third-generation antidepressant agents. While there were isolated reports of improvements over comparator agents for venlafaxine, reboxetine and mirtazepine, there were no convincing differences between third-generation agents and comparators in terms of overall efficacy, relapse prevention and speed of onset. The third-generation antidepressants were, however, of equivalent safety to SSRIs and maintained improvements in safety over first-generation agents

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Acknowledgements

No funding was received for the preparation of this article. Dr Graham Burrows has given advice to a number of pharmaceutical companies involved in the production of psychotropic drugs including Organon, Bristol-Myers Squibb, Wyeth-Ayerst and Pharmacia. Dr Trevor Norman has received funding from Bristol-Myers Squibb for research projects and has been a funded speaker for Organon, Bristol-Myers Squibb and Wyeth-Ayerst, and has advised Bristol-Myers Squibb.

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  1. Department of Psychiatry, University of Melbourne, Austin & Repatriation Medical Centre, Locked Bag 1, Bank-sia Street, West Heidelberg, Victoria, 3081, Australia

    James S. Olver, Graham D. Burrows &  Trevor R. Norman

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  1. James S. Olver
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  2. Graham D. Burrows
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Correspondence to Trevor R. Norman.

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Olver, J.S., Burrows, G.D. & Norman, T.R. Third-Generation Antidepressants. CNS Drugs 15, 941–954 (2001). https://doi.org/10.2165/00023210-200115120-00004

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Keywords

  • Fluoxetine
  • Imipramine
  • Venlafaxine
  • Mirtazapine
  • Nefazodone