Duloxetine versus other anti-depressive agents for depression

Although pharmacological and psychological interventions are both effective for major depression, antidepressant drugs remain the mainstay of treatment in moderate to severe major depression. During the last 20 years, newer compounds (such as selective serotonin reuptake inhibitors and dual action agents like serotonin noradrenalin reuptake inhibitors) have progressively become the most commonly prescribed antidepressants. Duloxetine hydrochloride, the last antidepressant introduced in the market, is a selective serotonin noradrenergic reuptake inhibitor for oral administration. In the present review we assessed the evidence for the efficacy, acceptability and tolerability of duloxetine in comparison with all other antidepressants in the acute-phase treatment of major depression. Thirteen randomised controlled trials (about 5000 participants) were included in the present review. Duloxetine appears not to be a suitable option as one of the first-line antidepressant treatments for people with moderate to severe major depression, because it did perform worse than other reference compound including venlafaxine, escitalopram and sertraline. However, we found not many studies per comparison, so we are unable to say whether it is really better, worse or the same as many other drugs used in practice.