The efficacy, safety and tolerability of antidepressants in late life depression: a meta-analysis

Background: To determine the efficacy, safety and tolerability of antidepressants in depressed elderly patients. Methods: Search for randomized controlled double-blind studies evaluating atypical antidepressants (ATYPs), reversible inhibitors of monoamine oxidase-A, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants in moderate/severe depressed patients ≥60 years for ≥four weeks. The random effects model (single-arm; comparative) was used to aggregate efficacy, safety and dropout. Results: No difference in single-arm aggregation of outcomes for four antidepressant classes. Comparative analyses showed no statistical difference between outcomes, except SSRIs had a higher response rate than ATYPs. Conclusion: Elderly show no differences in antidepressant class outcomes. Limitations: Heterogeneity and lack of power. Clinical Relevance: There is little advantage for antidepressant classes over another in the aged.