Comparative Efficacy of Antidepressants in the Treatment of Major Depressive Disorder (MDD) in Adult’s

Major depressive disorder (MDD) is a debilitating mental health condition with a high prevalence among adults globally. Despite the availability of numerous antidepressant medications, the comparative efficacy and tolerability of these treatments remain unclear. This systematic review aims to analyze and compare the efficacy and safety profiles of antidepressants, including SSRIs, SNRIs, TCAs, and atypical antidepressants, in adult populations diagnosed with MDD. A thorough literature search spanning PubMed, EMBASE, PsycINFO, and the Cochrane Library was conducted, identifying randomized controlled trials (RCTs) published between January 2000 and December 2024. Key performance metrics, including response rates (≥50% symptom improvement), remission rates, and adverse event frequencies, were evaluated. Statistical analyses using random-effects models were performed to synthesize data from included studies. Preliminary findings indicate that while SSRIs and SNRIs demonstrate comparable efficacy in achieving symptom remission, SNRIs offer slightly higher response rates in severe MDD cases. Atypical antidepressants exhibit diverse tolerability profiles, with some showing lower rates of treatment-emergent adverse events. TCAs, although effective, are often associated with higher dropout rates due to their safety concerns. Additionally, patient-specific factors such as baseline severity, comorbidities, and prior treatment history emerged as significant moderators of treatment outcomes. This review underscores the importance of personalized treatment strategies in managing MDD and highlights key areas for future research, including head-to-head comparisons and the integration of biomarkers for treatment optimization. Findings are expected to provide valuable insights for clinicians in tailoring treatment regimens to improve patient outcomes.