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First published online June 18, 2008

Efficacy of venlafaxine compared with tricyclic antidepressants in depressive disorder: a meta-analysis

Abstract

Abstract
With respect to the pharmacological characteristic, venlafaxine is comparable with tricyclic antidepressants (TCAs), and venlafaxine might be comparable in efficacy. We performed a systematic review investigating the relative efficacy and tolerability of venlafaxine compared with TCAs (imipramine, clomipramine, amitriptyline, nortriptyline and desipramine). Relevant double-blind randomised trials were identified from systematic searches of electronic databases. An exact analysis of the estimated odds ratios of response of the TCA relative to venlafaxine showed no overall significance of treatment effect (P = 0.38). The odds ratios were not homogenous across studies (P = 0.0213). The average dose of venlafaxine was 103.5 mg/day and for the TCA 106.1 mg/day. An exact analysis of the estimated odds ratios of the withdrawals and side effects in the trials with a TCA relative to venlafaxine showed no overall significance of withdrawal. From our review, no significant difference in treatment effect between low dose of both venlafaxine and the TCAs could be found. In our opinion, because of the heterogeneity of the odds ratios, one cannot conclude that they are of equal efficacy.

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Published In

Article first published online: June 18, 2008
Issue published: August 2009

Keywords

  1. amitryptiline
  2. clomipramine
  3. depression
  4. imipramine
  5. tricyclic antidepressants
  6. venlafaxine

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PubMed: 18562424

Authors

Affiliations

WW van den Broek
Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands [email protected]
PGH Mulder
Department of Epidemiology and Biostatistics, Erasmus Medical Centre, Rotterdam, The Netherlands
E van Os
Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
TK Birkenhäger
Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
E Pluijms
Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
JA Bruijn
Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands

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