Key result
Escitalopram demonstrated better gastrointestinal tolerability than paroxetine (OR 0.62; 95% CI 0.43-0.87) and sertraline (OR 0.56; 95% CI 0.32-0.99) in patients with depression.
Why the study?
Digestive system symptoms are the most common adverse reactions to SSRIs leading to low compliance in patients with depression, making it important to compare the relative digestive side-effect risks of various SSRIs.
Does the choice of SSRI affect the risk of digestive system side effects in patients with depression?
Meta-Analysis (n=5,004)
Does the choice of SSRI affect the risk of digestive system side effects in patients with depression?
Answers are grounded in this paper and cite their sources.
Among SSRIs used for depression, fluoxetine appears to have the lowest risk of digestive system side effects, whereas sertraline has the highest risk.
Purpose: Selective serotonin reuptake inhibitors (SSRIs) are the preferred treatments for depression. The most common adverse drug reactions are symptoms involving the digestive system, leading to low compliance in patients with depression. Therefore, it is important to assess the safety of SSRIs with respect to the digestive system. Several meta-analyses have compared the risks of digestive side effects of SSRIs and other antidepressants. We aimed to compare the risks of various SSRIs (fluoxetine, escitalopram, citalopram, paroxetine, and sertraline) for adverse reactions of the digestive system. Methods: Systematic searches returned 30 randomized controlled trials (n = 5004) of five antidepressants and placebos. Results: Fluoxetine had the lowest probability of digestive side effects, ranking fifth at 0.548. Sertraline had the highest probability of digestive side effects, with a probability of 0.611. For gastrointestinal tolerability, escitalopram was better than paroxetine (odds ratio [OR] =0.62, 95% confidence interval [CI] 0.43-0.87) and sertraline (OR=0.56, 95% CI 0.32-0.99). Conclusion: Fluoxetine exhibited distinct advantages compared to other SSRIs, while sertraline had the greatest likelihood of digestive system side effects. These findings will help doctors understand the relative advantages of various antidepressants.
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Wang et al. (2022) conducted a meta-analysis in Depression (n=5,004). Selective serotonin reuptake inhibitors (fluoxetine, escitalopram, citalopram, paroxetine, sertraline) vs. Placebo or other SSRIs was evaluated on Gastrointestinal tolerability (escitalopram vs paroxetine) (OR 0.62, 95% CI 0.43-0.87). Escitalopram demonstrated better gastrointestinal tolerability than paroxetine (OR 0.62; 95% CI 0.43-0.87) and sertraline (OR 0.56; 95% CI 0.32-0.99) in patients with depression.
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