Newer antidepressants: a comparison of tolerability in general practice

Background. An increasing number of antidepressants have been released on t he United Kingdom marker: in recent years, and these are being prescribed m ore frequently in general practice. Clinical trials suggest that such agent s have similar efficacy and the choice of drug is probably based on tolerab ility, toxicity in overdose, and cost. Aim. To compare the tolerability and safety profile elf six, newly marketed antidepressants used in general practice. Method Studies have been conducted for six antidepressants: fluoxetine, ser traline, paroxetine, moclobemide, venlafaxine, and nefazodone, using the te chnique of prescription-event monitoring. Patients were identified using in cident dispensed prescription data. Questionnaires were sent to patients' g eneral practitioners six months after the dare of first prescription. Quest ionnaires asked for date of birth, sex, indication for prescribing each dru g, and all events entered in the patients' records after the date of first prescription. Results. Each cohort exceeded 10 000 patients. Nausea/vomiting was the most frequently reported event for all drugs. The difference in incidence rates for drowsiness/sedation, male sexual dysfunction, and hypertension is show n. Mortality data are also reported Conclusion. Frequently reported events were similar for all six drugs but t here were clinically and statistically significant differences for less fre quently reported events. The adjusted mortality rare was identical between the six drugs. This study provides valuable comparative data for six, widel y used antidepressants in general practice.