A Meta-analysis On Clinical Efficacy And Safety Of Newly-developed Antidepressants:Fluoxetine,Paroxetine,Sertraline,Citalpram And Fluvoxamine In Patients With Deprssion

OBJECTIVESTo compare the efficacy and safety of newly-developed antidepressant fluoxetine, paroxetine, sertraline, citalopram and fluvoxamine in the patients with depression.METHODSMedline Database, Embase Database, Cochrane library, Ovid Database, Cochrane library, China Biological Medicine Database(CBM), WANFANG full-text Database, CNKI Database, and relative magazine were searched. Then Meta analysis was performed by RevMan5.0.RESULTS1. Efficacy was evaluated by the effect rate of the patients with depression by the end of6(or8) weeks. Citalopram showed more efficacy than sertraline, paroxetine showed more efficacy than sertraline, fluvoxamine showed more efficacy than paroxetine. And there were no significant difference between the effect rate of patients treated by other newly-developed antidepressants.2. Quick efficacy was evaluated by difference before treatment and in the 1st,2nd,4th and6th (or8th) week of treatment in HAMD scores in the two group. It shows paroxetine、sertraline、citalopram、fluvoxamine led to greater reduction in HAMD score than fluoxetine respectively after1and2weeks. Citalprom led to greater reduction in HAMD score than fluoxetine、paroxetine、sertraline.3. Safety was evaluated by the adverse reaction rate of the patients with depression by the end of6(or8) weeks. And9comparisons had significant differences between the adverse reaction rate of patients. Regarding dry mouth reaction rate, fluoxetine was significantly higher than paroxetine, citalopram was significantly higher than fluoxetine, citalopram was significantly higher than paroxetine. Regarding constipation reaction rate, citalopram was significantly higher than fluoxetine, sertraline was significantly higher than paroxetine, citalopram was significantly higher than paroxetine. Regarding somnolence reaction rate, sertraline was significantly higher than paroxetine, paroxetine was significantly higher than citalopram. Regarding nausea reaction rate, citalopram was significantly higher than sertraline. There no differences in drop rate of serious adverse reaction in any comparison by the end of6(or8) weeks.Conclusions1. There were no differences in clinical efficacy of these5SSRIs by the end of6(or8) weeks. 2. Comparing with paroxetine, sertraline, citalopram and fluvoxamine, fluoxetine showed disadvantage of quick efficacy. Citalopram has obvious advantage of quick efficacy over fluoxetine, paroxetine, sertraline.3. There were no differences in clinical safety of5SSRIs, but citalpram has higher adverse rate.