January 29, 2009

Study: Zoloft, Lexapro Most Tolerated By Patients

Researchers have concluded that Pfizer Inc's Zoloft and Forrest Laboratories Inc's Lexapro are superior antidepressant drugs compared to 12 other new drugs in their class.

Doctors previously considered there to be very little difference between various antidepressants due to previous research, including one 2006 US government study that concluded that patients with major depression fared equally as well on various antidepressant drugs.

However, after analyzing data from 117 studies consisting of almost 26,000 patients between 1991 and 2007, an international team of researchers found that Zoloft and Lexapro were the two most tolerated antidepressants among patients.

"Such findings have enormous implications," Sagar Parikh, psychiatrist at the University of Toronto who was not involved in the study, wrote in a commentary in the journal Lancet, which published the review.

Additionally, they found that Pfizer's Edronax was the least effective.

Drugs were judged based on benefits, side effects, and cost.

Drugs included in the study were bupropion (Wellbutrin/Zyban), citalopram (Celexa), duloxetine (Cymbalta), escitalopram, fluoxetine (Prozac), fluvoxamine (Luvox), milnacipran (Savella), mirtazapine (Remeron), paroxetine (Paxil), reboxetine (Edronax/Vestra), sertraline, and venlafaxine (Effexor).

Parikh said the study's findings would help physicians "identify the four best treatments, identify individual side-effect profiles, explore costs and patients' preferences and collaborate in identifying the best treatment."

"The most important clinical implication of the results is that escitalopram (Lexapro) and sertraline (Zoloft) might be the best choice when starting a treatment for moderate to severe major depression, because they have the best possible balance between efficacy and acceptability," Dr. Andrea Cipriani,

"The bottom line is that there is a rational hierarchy when prescribing antidepressants," Dr. Andrea Cipriani, the study's lead author, of the University of Verona in Italy, told the Associated Press.

"Sertraline seems to be better than escitalopram because of its lower cost in most countries. However, in the absence of a full economic model, this recommendation cannot be made unequivocally, because several other costs are associated with the use of antidepressants," researchers said.

Depression is among leading causes for suicide and affects an estimated 121 million people worldwide.


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