How effective are tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) in patients with depression in primary care?
Most of the studies were supported by funds from pharmaceutical companies and were of short duration, typically 6 to 8 weeks. There was no dose information on SSRIs, and the authors were unable to comment on the appropriate duration of treatment for either TCAs or SSRIs.
Depression is very common in primary care, with a 12-month prevalence of 18.1%. There is considerable overlap with anxiety and substance use.1 It is a paradox that, while the vast majority of patients with clinical depression is dealt with in primary care, most of the research findings upon which decisions are made have come from secondary care patients.