Mental health

Antidepressants (Tricyclic Antidepressants and Selective Serotonin Reuptake Inhibitors) in treatment of adults with depression

Question 1: Are antidepressants (Tricyclic Antidepressants (TCA) and Selective Serotonin Reuptake Inhibitors (SSRI)) better (more effective than/as safe as) than treatment as usual (placebo) in adults with depressive episode/disorder?

  • Population: adults with depressive episode/disorder
  • Interventions: antidepressant medicines: TCAs, SSRIs
  • Comparison: placebo
  • Outcomes:
    • treatment effectiveness in terms of reduction of symptoms
    • treatment effectiveness in terms of improvement in functioning
    • acceptability profile
    • suicide related outcomes.

Recommendation(s)

Antidepressants should not be considered for the initial treatment of adults with mild depressive episode.
Strength of recommendation: STANDARD

Tricyclic Antidepressants or fluoxetine should be considered in adults with moderate to severe depressive episode/disorder.
Strength of recommendation: STANDARD

If drug treatment is required in older people, tricyclic antidepressants should be avoided if possible.
Strength of recommendation: STANDARD

If drug treatment is required in women with depressive episode who are planning a pregnancy or pregnant or breastfeeding, tricyclic antidepressants or fluoxetine should be considered.
Strength of recommendation: STANDARD

Evidence profile

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