@article{ref1,
title="Are SSRIs a cost-effective alternative to tricyclics?",
journal="British journal of psychiatry",
year="1996",
author="Hotopf, M. and Lewis, G. and Normand, C.",
volume="168",
number="4",
pages="404-409",
abstract="BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are more expensive than tricyclics. Reports have suggested that SSRIs are cost-effective because they are better tolerated and safer in overdose. METHOD: A systematic review of all randomised controlled trials (RCTs), meta-analyses, and cost-effectiveness studies comparing SSRIs and tricyclic antidepressants (TCAs). RESULTS: None of the RCTs provided an economic analysis and there were methodological problems in the majority which would preclude this approach. Meta-analyses suggest that clinical efficacy is equivalent but slightly fewer patients prescribed SSRIs drop out of RCTs. Cost-effectiveness studies have been based on crude 'modelling' approaches and over-estimate the difference in attrition rates and the cost of treatment failure. It appears impossible to evaluate the economic aspects of suicide because of its rarity. CONCLUSIONS: There is no evidence to suggest that SSRIs are more cost-effective than TCAs. The debate will only be concluded when a prospective cost-effectiveness study is done in the setting of a large primary care based RCT.<p /><p>Language: en</p>",
language="en",
issn="0007-1250",
doi="10.1192/bjp.168.4.404",
url="http://dx.doi.org/10.1192/bjp.168.4.404"
}