Burke William J
Department of Psychiatry, University of Nebraska, Nebraska Medical Center, Omaha 68198-5580, USA.
J Clin Psychiatry. 2004;65 Suppl 4:37-45.
The issue of selectivity versus efficacy has now reappeared as newer agents have emerged that are less selective than the selective serotonin reuptake inhibitors (SSRIs) but more selective than the tricyclic antidepressants (TCAs). This article provides a critical examination of the clinical literature concerning what evidence there is for differential efficacy. Two broad areas will be discussed: (1) comparisons of SSRIs to TCAs and (2) comparisons of the SSRIs to a somewhat more selective compound (by comparison to the TCAs), venlafaxine. This review should caution one in accepting claims of superiority of any agent based on purported mechanism of action.
随着比选择性5-羟色胺再摄取抑制剂（SSRI）选择性更低但比三环类抗抑郁药（TCA）选择性更高的新型药物的出现，选择性与疗效的问题再次浮现。本文对有关不同疗效证据的临床文献进行了批判性审视。将讨论两个广泛领域：（1）SSRI与TCA的比较；（2）SSRI与一种选择性稍高的化合物（与TCA相比）文拉法辛的比较。本综述应提醒人们在基于所谓作用机制接受任何药物优越性的说法时保持谨慎。
