Depression is a major cause of disability, and people suffering from depression may be overwhelmed by the wide range of clinically-proven antidepressants on the market. Escitalopam and sertraline have the best combined profile of efficacy and acceptability, according to a meta-analysis published in the January 29, 2009 early online edition of the journal Lancet .

 Investigators from the University of Verona in Italy and their international colleagues reviewed 117 trials including a total of 25,928 participants from 1991 to 2007, which compared 12 antidepressants for the acute treatment of major depression in adults. They found that mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine, fluoxetine, fluvoxamine, paroxetine, and reboxetine. Of all the other antidepressants tested, reboxetine was the least efficacious in the acute treatment of major depression. Escitalopram and sertraline had the best profile of acceptability, meaning that the fewest people discontinued treatment of these drugs.

This meta-analysis demonstrated that there were important differences among the commonly-prescribed antidepressants for both efficacy and acceptability. According to the investigators, when taking into account the balance among efficacy, acceptability, and cost, sertraline might be the best choice when starting treatment for moderate to severe major depression.

Source

Lancet. Early Online Publication, 29 January 2009.