# Radboud UMC review of 115 studies: three antidepressants stood out in long-term use

- Published: 2026-11-12 06:25 UTC
- Section: Life & Health › Medicine
- Tags: long-term depression treatment, antidepressant review, escitalopram, duloxetine, agomelatine, fluoxetine reference, treatment discontinuation, The Lancet Psychiatry, Radboud University Medical Center
- URL: https://realtech.media/news/rt-043e60f900df52e0f4077319_radboud_umc_review/

**Researchers compared long-term efficacy and dropout rates of antidepressants with fluoxetine as the reference. The authors say most other drugs need further study.**

![Radboud UMC review of 115 studies: three antidepressants stood out in long-term use](https://realtech.media/media/2026/11/b7a98aad6e3c9420.jpg)
*spiegel.de*

Researchers led by Henricus Ruhé and Paul van Haaren at Radboud University Medical Center in Nijmegen, the Netherlands, published a review in The Lancet Psychiatry comparing antidepressants in long-term treatment of depression, spiegel.de reports. [1] Three agents performed particularly well: escitalopram (brand name Cipralex), duloxetine (Cymbalta) and agomelatine (Valdoxan). [1]

## Data and method

The team found 54,231 reports on antidepressants in several databases. From these they selected 115 studies with 30,428 participants in total that allowed conclusions on long-term efficacy and patient acceptance. [1]

Fluoxetine, introduced in the US in 1988 as Prozac, served as the reference. The authors wrote that it was chosen because it was the first selective serotonin reuptake inhibitor (SSRI) to see wide use in clinical practice. [1]

Besides efficacy, the researchers examined how often patients discontinued treatment. The authors wrote that this matters in long-term therapy, because the value of a drug depends not only on symptom relief but also on whether patients are willing to continue. [1]

## Results and caveats

According to the analysis, patients taking escitalopram and duloxetine stopped treatment less often than those taking fluoxetine. Reboxetine and milnacipran were discontinued early particularly often. In an additional analysis, bupropion also showed more dropouts than fluoxetine. [1]

Bupropion and reboxetine performed worse overall in the study. For the remaining drugs, the team wrote, further studies are needed before firm conclusions can be drawn. [1]

Ruhé said the result does not mean that everyone with severe depression should now receive escitalopram. A physician weighs a drug's benefit against its side effects, and this balance differs from person to person, so the choice may differ for each patient. [1]

He nevertheless sees the study as a possible aid for physicians and patients: when antidepressant treatment is started, a drug should be chosen that contributes to recovery and also helps keep health stable in the long term. [1]

The authors also point to an earlier review. According to it, antidepressants combined with psychotherapy, or psychotherapy alone, offered a higher likelihood of lasting effect than antidepressants alone. [1]

## Sources

1. [spiegel.de](https://www.spiegel.de/wissenschaft/mensch/antidepressiva-welche-medikamente-in-langzeitbehandlungen-besonders-wirksam-sind-a-deb538b3-139e-4d5f-b28c-50ca962ba985)
2. [lomazoma.com](https://lomazoma.com/antidepressiva-im-langzeitcheck-drei-wirkstoffe-erweisen-sich-als-nachhaltig-wirksam)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-043e60f900df52e0f4077319_radboud_umc_review/