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Journal of Psychopharmacology
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research-article

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

WW van den Broek

Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands w.w.vandenbroek{at}erasmusmc.nl

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

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.

Key Words: amitryptiline • clomipramine • depression • imipramine • tricyclic antidepressants • venlafaxine

This version was published on August 1, 2009

Journal of Psychopharmacology, Vol. 23, No. 6, 708-713 (2009)
DOI: 10.1177/0269881108089821
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