Second-generation antidepressant: Difference between revisions

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==Effectiveness==
==Effectiveness==
Regarding the use of second-generation antidepressant, [[clinical practice guideline]]s by the [[American College of Physicians]] recommend:<ref>{{Cite journal | volume = 149 | issue = 10
Regarding the use of second-generation antidepressants, [[clinical practice guideline]]s by the [[American College of Physicians]] recommend:<ref>{{Cite journal | volume = 149 | issue = 10
| pages = 734-750 | last = Gartlehner | first = Gerald | coauthors = Bradley N. Gaynes, Richard A. Hansen, Patricia Thieda, Angela DeVeaugh-Geiss, Erin E. Krebs, Charity G. Moore, Laura Morgan, Kathleen N. Lohr | title = Comparative Benefits and Harms of Second-Generation Antidepressants: Background Paper for the American College of Physicians | journal = Ann Intern Med
| pages = 734-750 | last = Gartlehner | first = Gerald | coauthors = Bradley N. Gaynes, Richard A. Hansen, Patricia Thieda, Angela DeVeaugh-Geiss, Erin E. Krebs, Charity G. Moore, Laura Morgan, Kathleen N. Lohr | title = Comparative Benefits and Harms of Second-Generation Antidepressants: Background Paper for the American College of Physicians | journal = Ann Intern Med
| accessdate = 2008-11-18 | date = 2008-11-18 | url = http://www.annals.org/cgi/content/abstract/149/10/734 }} </ref>
| accessdate = 2008-11-18 | date = 2008-11-18 | url = http://www.annals.org/cgi/content/abstract/149/10/734 }} </ref>
Line 29: Line 29:
* "when clinicians choose pharmacologic therapy to treat patients with acute major depression, they select second-generation antidepressants on the basis of adverse effect profiles, cost, and patient preferences"
* "when clinicians choose pharmacologic therapy to treat patients with acute major depression, they select second-generation antidepressants on the basis of adverse effect profiles, cost, and patient preferences"
* "second-generation antidepressants did not significantly differ in efficacy, effectiveness, or quality of life. [[Mirtazapine]] had a significantly faster onset of action"
* "second-generation antidepressants did not significantly differ in efficacy, effectiveness, or quality of life. [[Mirtazapine]] had a significantly faster onset of action"
* "when treating symptom clusters in patients with accompanying depression, second-generation antidepressants did not differ in efficacy in treating accompanying anxiety, pain, and somatization. Limited evidence suggests that some agents may be more effective in treating insomnia"
* "when treating symptom clusters in patients with accompanying depression, second-generation antidepressants did not differ in efficacy in treating accompanying [[anxiety]], [[pain]], and [[Somatoform disorder|somatization]]. Limited evidence suggests that some agents may be more effective in treating [[insomnia]]"
* "most of the second-generation antidepressants had similar adverse effects...paroxetine was associated with an increased risk for sexual dysfunction."
* "most of the second-generation antidepressants had similar adverse effects...paroxetine was associated with an increased risk for sexual dysfunction."


==References==
==References==
<references/>
<references/>

Revision as of 11:33, 18 November 2008

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Second-generation antidepressants are used to treat depression and are a "structurally and mechanistically diverse group of drugs that are not tricyclics or monoamine oxidase inhibitors. The most clinically important appear to act selectively on serotonergic systems, especially by inhibiting serotonin reuptake."[1]

Classification

Second-generation antidepressants are classified by the biogenic amine receptor that they affect.

Selective serotonin reuptake inhibitors(SSRI)

Serotonin 5-HT2–receptor agonist

Serotonin norepinephrine reuptake inhibitors (SNRI)

Norepinephrine uptake inhibitor

Dopamine reuptake inhibitor

Effectiveness

Regarding the use of second-generation antidepressants, clinical practice guidelines by the American College of Physicians recommend:[2] [3]

  • "when clinicians choose pharmacologic therapy to treat patients with acute major depression, they select second-generation antidepressants on the basis of adverse effect profiles, cost, and patient preferences"
  • "second-generation antidepressants did not significantly differ in efficacy, effectiveness, or quality of life. Mirtazapine had a significantly faster onset of action"
  • "when treating symptom clusters in patients with accompanying depression, second-generation antidepressants did not differ in efficacy in treating accompanying anxiety, pain, and somatization. Limited evidence suggests that some agents may be more effective in treating insomnia"
  • "most of the second-generation antidepressants had similar adverse effects...paroxetine was associated with an increased risk for sexual dysfunction."

References

  1. Anonymous (2024), Second-generation antidepressants (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Gartlehner, Gerald; Bradley N. Gaynes, Richard A. Hansen, Patricia Thieda, Angela DeVeaugh-Geiss, Erin E. Krebs, Charity G. Moore, Laura Morgan, Kathleen N. Lohr (2008-11-18). "Comparative Benefits and Harms of Second-Generation Antidepressants: Background Paper for the American College of Physicians". Ann Intern Med 149 (10): 734-750. Retrieved on 2008-11-18.
  3. Qaseem, Amir; Vincenza Snow, Thomas D. Denberg, Mary Ann Forciea, Douglas K. Owens, for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (2008-11-18). "Using Second-Generation Antidepressants to Treat Depressive Disorders: A Clinical Practice Guideline from the American College of Physicians". Ann Intern Med 149 (10): 725-733. Retrieved on 2008-11-18.