TY  - JOUR
PY  - 1996//
TI  - Are SSRIs a cost-effective alternative to tricyclics?
JO  - British journal of psychiatry
A1  - Hotopf, M.
A1  - Lewis, G.
A1  - Normand, C.
SP  - 404
EP  - 409
VL  - 168
IS  - 4
N2  - 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>
LA  - en
SN  - 0007-1250
UR  - http://dx.doi.org/10.1192/bjp.168.4.404
ID  - ref1
ER  -