Escitalopram and Sertraline Are More Efficacious and Acceptable Than Ten Other New-Generation Antidepressants

Peter Yellowlees, MBBS, MD


July 31, 2009

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This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. Many second-generation antidepressants are now available to treat major depression, but how do we compare them for efficacy and acceptability? Nine investigators[1] from Oxford, England, and Verona, Italy, report in the Lancet in 2009a multiple-treatment meta-analysis of 117 randomized controlled trials that used 12 second-generation antidepressants in 25,928 participants with unipolar major depression. The main outcomes were the proportion of patients who responded to, or dropped out of, the allocated treatment, and analysis was done on an intention-to-treat basis. The authors concluded that there were clinically important differences among the 12 antidepressants for both efficacy and acceptability in favor of escitalopram and sertraline. They noted that sertraline, one of the early second-generation antidepressants, had the most favorable overall balance between benefits, acceptability, and cost. This article is selected from Medscape Best Evidence.[2] I'm Dr. Peter Yellowlees.


  1. Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009;373 :746-758

  2. Psychiatry Best Evidence, powered by McMaster Plus. Available at: Accessed July 6, 2009.