The study, published in the medical journal Lancet, reviewed 117 studies from 1991 to 2007 involving 25,928 people with major depression.
The researchers found that Zoloft (sertraline), Lexapro/Cipralex (escitalopram), Organon’s Remeron (mirtazapine) and Wyeth’s Effexor (venlafaxine) were significantly more efficacious than the other antidepressants examined, including Eli Lilly’s Cymbalta (duloxetine) and Prozac (fluoxetine), Solvay’s Luvox (fluvoxamine), GlaxoSmithKline’s Paxil/Seroxat (paroxetine) and Pfizer’s Edronax (reboxetine).
Overall, the study found that Zoloft and Lexapro were best when it came to both reducing symptoms after eight weeks and drop-out rates during the studies.
The study did not look at other factors often considered when a prescription is written for an antidepressant, such as side-effects of the drug, how well people functioned socially while on the treatments, or cost-effectiveness. Lexapro is closely chemically related to a prior antidepressant manufactured by the same company (Forest Labs), Celexa (citalopram).
Researchers said that sertraline (Zoloft) might be the best choice when starting treatment because of its treatment efficacy, being well-tolerated by patients, and its inexpensive costs. Zoloft has been available in generic form since 2006, when Pfizer’s patent on the drug expired.
Sagar Parikh, a psychiatrist at the University of Toronto wrote in a commentary in the journal, “Now a clinician can identify the four best treatments, identify individual side-effect profiles, explore costs and patients’ preferences and collaborate in identifying the best treatment.”
All of the drugs examined in the study are available in generic form except Cymbalta and Lexapro.