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 > or = 60 years for > or = 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.