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Immediate-release and extended-release formulations of second-generation antidepressants for the treatment of major depressive disorder in adults

Published online by Cambridge University Press:  16 April 2020

M. Van Noord ,
G. Gartlehner ,
R. Hansen ,
L. Morgan ,
K. Thaler ,
L. Lux ,
U. Mager ,
B. Gaynes ,
P. Thieda  and
M. Strobelberger
...Show all authors
M. Van Noord
Affiliation:
The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
G. Gartlehner
Affiliation:
Danube University Krems, Krems, Austria
R. Hansen
Affiliation:
Auburn University, Auburn, AL
L. Morgan
Affiliation:
Research Triangle International, Raleigh, NC, USA
K. Thaler
Affiliation:
Danube University Krems, Krems, Austria
L. Lux
Affiliation:
Research Triangle International, Raleigh, NC, USA
U. Mager
Affiliation:
Danube University Krems, Krems, Austria
B. Gaynes
Affiliation:
The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
P. Thieda
Affiliation:
The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
M. Strobelberger
Affiliation:
Danube University Krems, Krems, Austria
S. Lloyd
Affiliation:
Research Triangle International, Raleigh, NC, USA
U. Reichenpfader
Affiliation:
Danube University Krems, Krems, Austria
K. Lohr
Affiliation:
Research Triangle International, Raleigh, NC, USA

Abstract

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Introduction

Extended-release formulations of antidepressants have been marketed as a strategy to increase patient adherence. Changes in the formulation of drugs, however, could be related to changes in efficacy and tolerability. Among second-generation antidepressants, bupropion, fluoxetine, mirtazapine, paroxetine, and venlafaxine are available in immediate- and extended-release formulations.

Objectives

To compare the efficacy, tolerability, and adherence of immediate- versus extended-release formulations of second-generation antidepressants for the treatment of major depressive disorder (MDD) in adults.

Aim

To provide an evidence base for clinicians when choosing immediate- or extended-release formulations of antidepressants for the treatment of MDD.

Methods

We conducted a comparative effectiveness review for the U.S. Agency for Healthcare Research and Quality searching PubMed, EMBASE, The Cochrane Library, and the International Pharmaceutical Abstracts up to May 2010. Two people independently reviewed the literature, abstracted data, and rated the risk of bias.

Results

Six RCTs and one observational study provided evidence about the comparative efficacy, tolerability, and adherence of bupropion SR (sustained release) versus bupropion XL (extended release), fluoxetine daily vs. fluoxetine weekly, paroxetine IR (immediate release) versus paroxetine CR (continuous release), and venlafaxine IR versus venlafaxine XR (extended release). Overall, no substantial differences in efficacy and safety could be detected. Open-label and observational evidence indicated better adherence for bupropion XL and fluoxetine weekly than for immediate-release medications. No differences in adherence could be detected between paroxetine IR and paroxetine CR.

Conclusions

Our findings indicate similar efficacy and tolerability between immediate- and extended-release formulations. Whether extended-release formulations lead to better adherence remains unclear.

Type
P03-120
Information
European Psychiatry , Volume 26 , Issue S2: Abstracts of the 19th European Congress of Psychiatry , March 2011 , pp. 1289
Copyright
Copyright © European Psychiatric Association 2011
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