Selective serotonin reuptake inhibitors and quality of life: a meta-analysis of randomized placebo-controlled trials

The benefit of selective serotonin reuptake inhibitors (SSRIs) in improving quality of life (QoL) has been investigated in randomized-controlled trials (RCTs) with equivocal results. This study explored whether SSRIs could improve QoL in individuals with medical, psychiatric, and neuropsychiatric conditions. RCTs were searched in PubMed, Embase, Scopus, Ovid, and Google Scholar. Data were synthesized via a meta-analysis. Subgroup and meta-regression analyses were performed. The sample size was 9,070. Compared with placebo, SSRIs showed statistically significant improvements in QoL in cancer ( d = 0.30), major depressive disorder ( d = 0.27), premenstrual dysphoric disorder ( d = 0.38), type 2 diabetes mellitus ( d = 0.48), persistent depressive disorder ( d = 0.32), and menopausal symptoms ( d = 0.40). Paroxetine exhibited the highest effect size. No significant improvements were noted in chronic obstructive pulmonary disease ( d = 0.65, P = 0.09), congestive heart failure ( d = 0.46, P = 0.27), and irritable bowel syndrome ( d = 0.26, P = 0.127). The reduction in depressive symptoms improved QoL. Small-study effects, high attrition rates, and demographic imbalances are limiting factors to recommend SSRIs to improve QoL. Future research should focus on QoL domains and pharmacological properties of each SSRI.