ReviewCNS drugs2015
Network Meta-Analysis and Cost-Effectiveness Analysis of New Generation Antidepressants.
Review in CNS drugs, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 227 citations in OpenAlex.
- Comparison of Cost-Effectiveness Between Digital Health Interventions and Pharmacotherapy for Depression: Systematic Review.Journal of medical Internet research · 2025Pooled it
- Cost Effectiveness of Pharmacological and Non-pharmacological Treatments for Depression in Low- and Middle-Income Countries: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- Pharmacological treatment of depression: A systematic review comparing clinical practice guideline recommendations.PloS one · 2020Pooled it
- Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Pooled it
- Interpersonal psychotherapy versus sertraline for women with posttraumatic stress disorder following recent sexual assault: a randomized clinical trial.European journal of psychotraumatology · 2022Trial
- Efficacy of Prolonged Exposure Therapy, Sertraline Hydrochloride, and Their Combination Among Combat Veterans With Posttraumatic Stress Disorder: A Randomized Clinical Trial.JAMA psychiatry · 2019Trial
- Efficacy and safety of escitalopram in treatment of severe depression in Chinese population.Metabolic brain disease · 2017Trial
- Comparing the Effects of Sertraline with Duloxetine for Depression Severity and Symptoms: A Double-Blind, Randomized Controlled Trial.Clinical drug investigation · 2016Trial
- Assessing remission in major depressive disorder using a functional-structural data fusion pipeline: A CAN-BIND-1 study.IBRO neuroscience reports · 2024Article
- Additional Clinical Benefit of Agomelatine Treatment for Major Depressive Disorder in Naturalistic Treatment Setting.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2023Article
- Trends in the Consumption of Antidepressant Drugs before and during the COVID-19 Pandemic in the Canary Islands, Spain: The Case of the Province of Las Palmas.Healthcare (Basel, Switzerland) · 2023Article
- Inflammation, Lifestyle Factors, and the Microbiome-Gut-Brain Axis: Relevance to Depression and Antidepressant Action.Clinical pharmacology and therapeutics · 2023Review
- [Effects of COVID-19 on the consumption of antidepressants in the Province of Santa Cruz de Tenerife, Canary Islands].Farmaceuticos comunitarios · 2023Article
- Medication economic burden of antidepressant non-adherence in Spain.Frontiers in pharmacology · 2023Article
- Agomelatine in the treatment of anhedonia, somatic symptoms, and sexual dysfunction in major depressive disorder.Frontiers in psychiatry · 2023Article
- Cost-utility analysis of esketamine and electroconvulsive therapy in adults with treatment-resistant depression.BMC psychiatry · 2021Article
- Considering the societal perspective in economic evaluations: a systematic review in the case of depression.Health economics review · 2020Review
- Analysis of Time-Course, Dose-Effect, and Influencing Factors of Antidepressants in the Treatment of Acute Adult Patients With Major Depression.The international journal of neuropsychopharmacology · 2020Article
- A simple model to solve a complex drug toxicity problem.Toxicology research · 2019Article
- Safety and effectiveness of escitalopram in an 8-week open study in Chinese patients with depression and anxiety.Neuropsychiatric disease and treatment · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMajor depressive disorder (MDD) impacts health, quality of life and workplace productivity. Antidepressant treatment is the primary therapeutic intervention. This study assessed the efficacy and tolerability of new generation antidepressants and their cost-effectiveness in the Singapore healthcare system.
methodsWe conducted a systematic search for head-to-head randomised controlled trials on ten antidepressants (agomelatine, duloxetine, escitalopram, fluvoxamine, fluoxetine, mirtazapine, paroxetine, sertraline, trazodone and venlafaxine) employed as monotherapy in acute MDD management. We performed a network meta-analysis to compare their relative efficacy. The outcome measures for efficacy were response and remission rate, and mean change in Hamilton Depression Rating Scale (HDRS) score; and for tolerability, study withdrawal rates due to adverse events. To evaluate their relative cost effectiveness, a decision tree simulating a cohort of MDD patients using antidepressant as monotherapy was constructed from a societal perspective over 6 months. We used effectiveness data from our network meta-analysis and local data on resource use for depression in Singapore. The incremental cost expected for each additional quality-adjusted life-year (QALY) gained was calculated and presented as the incremental cost-effectiveness ratio (ICER).
resultsWe identified 76 relevant articles for the network meta-analysis. Of the ten agents included in the analysis, mirtazapine and agomelatine were most efficacious in achieving response and remission, respectively. Mirtazapine and duloxetine resulted in the greatest magnitude of change in the HDRS score. Agomelatine, escitalopram and sertraline were the best tolerated of the drugs analysed, while duloxetine was the least well tolerated drug. Using a composite outcome of efficacy (response and remission rates) and tolerability, agomelatine, escitalopram and mirtazapine were the favoured treatments. In the cost-effectiveness analysis, apart from agomelatine, all the treatments were dominated by mirtazapine. Against mirtazapine, agomelatine was not cost effective given that its ICER exceeded the threshold value.
conclusionAgomelatine, escitalopram and mirtazapine had favourable balance between efficacy and tolerability. In addition, mirtazapine was a cost-effective option in the Singapore healthcare system.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.