Acute therapy of depression.

The acute therapy (the initial 8 weeks of treatment) of depression (including the whole spectrum of "less than major," "major," and "more than major") has been reviewed comparing the old tricyclics with the new generations (especially mianserin, moclobemide, and the serotonin selective reuptake inhibitors (SSRIs), i.e., citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline). The Hamilton Rating Scale for Depression has been used to measure clinical efficacy. Statistically, the method of meta-analysis has been applied. The results showed that the SSRIs and moclobemide are equal to the tricyclics. Mianserin is inferior to tricyclics as well as to SSRIs. The antidepressive profile of the SSRIs is nonsedation but still with anxiolytic effects. The safety profile of the SSRIs is much more benign than that of the tricyclics.