Drugs versus placebo for dysthymia

M, Silva de Lima; Bg, Soares

doi:10.1002/14651858.cd001130.pub2

Cited by 4 publications

(4 citation statements)

References 129 publications

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“…[6] This change reflects that separating between chronic and episodic depression may be more important than distinguishing between different subtypes of chronic depression according to the symptom severity. [7][8][9][10][11][12][13][14] Existing systematic reviews provide evidence for grouped interventions, e.g., drug classes and psychotherapy in general. [7][8][9][10][11][12][13][14] Existing systematic reviews provide evidence for grouped interventions, e.g., drug classes and psychotherapy in general.…”

Section: Introductionmentioning

confidence: 99%

“…[2] Evidence from clinical practice guidelines and systematic reviews suggests that pharmacological and psychotherapeutic interventions as well as a combination of both may be effective in the treatment of persistent depressive disorder, although findings are limited and somewhat inconclusive regarding the efficacy of psychotherapeutic treatments, the relative efficacy of pharmacological and psychotherapeutic treatments, and the comparison of combined treatments with monotherapies. [7][8][9][10][11][12][13][14] Existing systematic reviews provide evidence for grouped interventions, e.g., drug classes and psychotherapy in general. To date, clinical guidelines largely lack information concerning the relative efficacy of particular pharmacological agents, different types of psychotherapeutic treatments, and their unique combinations.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Acceptability of Acute Treatments for Persistent Depressive Disorder: A Network Meta-Analysis

et al. 2014

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and Acceptability of Acute Treatments for Persistent Depressive Disorder: A Network Meta-Analysis

et al. 2014

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Section: Introductionmentioning

confidence: 99%

“…Systematic reviews, meta-analyses and clinical guidelines show evidence for the efficacy of pharmacological interventions in the treatment of PDD [ 5 – 11 ]. However, only few definite benefits of one antidepressive treatment over another could be determined [ 5 , 9 – 13 ]. A network meta-analysis based on the same set of primary studies like the present one revealed that among sufficiently tested agents the selective serotonin reuptake inhibitors (SSRI) fluoxetine, paroxetine, and sertraline, the monoamine oxidase inhibitor (MAO-I) moclobemide, the tricyclic antidepressant (TCA) imipramine, the serotonin receptor antagonist ritanserin, the antipsychotic amisulpride and the complementary treatment acetyl-l-carnitine were significantly more effective than placebo with hardly any differences between them [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative Safety of Pharmacologic Treatments for Persistent Depressive Disorder: A Systematic Review and Network Meta-Analysis

et al. 2016

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We aimed to compare the safety of antidepressants for the treatment of persistent depressive disorder (PDD) with each other and with placebo. We conducted a systematic electronic search and included randomized controlled trials that investigated antidepressants for the treatment of PDD in adults. Outcomes were the incidence of experiencing any adverse event, specific adverse events and related treatment discontinuations. We analyzed the data using traditional and network meta-analyses. Thirty-four studies that comprised 4,769 patients and examined 20 individual agents in nine substance classes were included. Almost all analyzed substance classes were associated with higher discontinuation rates than placebo including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), antipsychotics, and the serotonin antagonist and reuptake inhibitor (SARI) trazodone. The odds of experiencing any adverse event were significantly higher for TCAs and serotonin noradrenaline reuptake inhibitors (SNRIs) compared to placebo. Pairwise comparisons among the substance classes revealed that more patients receiving TCAs or SNRIs experienced any adverse event and that more patients receiving TCAs or the SARI trazodone discontinued treatment. The complementary treatment with acetyl-l-carnitine showed lower rates of experiencing any adverse event and related discontinuations than all other comparators. TCAs were primarily associated with (anti-)cholinergic and sedating adverse events. SSRIs primarily showed gastrointestinal adverse events. Patients treated with the antipsychotic amisulpride were more likely to manifest weight gain and endocrine adverse events. The comparative evidence for further agents was insufficient or lacking. The identified safety differences may be used to inform the selection among the antidepressants.

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Antidepressants for the treatment of depression in people with cancer

Ostuzzi

Matcham

Dauchy

et al. 2015

Cochrane Database of Systematic Reviews

121

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Despite the impact of depression on people with cancer, available studies were very few and of low quality. This review found very low quality evidence for the effects of these drugs compared with placebo. On the basis of these results clear implications for practice cannot be made. The use of antidepressants in people with cancer should be considered on an individual basis and, considering the lack of head-to-head data, the choice of which agent should be prescribed may be based on the data on antidepressant efficacy in the general population of individuals with major depression, also taking into account that data on medically ill patients suggest a positive safety profile for the SSRIs. Large, simple, randomised, pragmatic trials comparing commonly used antidepressants versus placebo in people with cancer with depressive symptoms, with or without a formal diagnosis of a depressive disorder, are urgently needed to better inform clinical practice.

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Drugs versus placebo for dysthymia

Cited by 4 publications

References 129 publications

Efficacy and Acceptability of Acute Treatments for Persistent Depressive Disorder: A Network Meta-Analysis

Efficacy and Acceptability of Acute Treatments for Persistent Depressive Disorder: A Network Meta-Analysis

Comparative Safety of Pharmacologic Treatments for Persistent Depressive Disorder: A Systematic Review and Network Meta-Analysis

Antidepressants for the treatment of depression in people with cancer

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