The Role of the Magnesium Valproate in Therapy for Patients with Treatment-Resistant Depression (TRD): Meat-Analysis Results of Chinese Data

Abstract

Background: Major depressive disorder is a prevalent and disabling illnessv, approximately 70% of patients do not remit after first-line antidepressant treatment, and about 20% develop to treatment-resistant depression(TRD). Treatment of TRD have been one of clinical problems. Adjunctive valprovate was a most sued ways for treatment of TRD. The magnesium valproate was common drug for both episode and bipolar disorder in China and also was used for TRD. To systematically evaluate the difference in efficacy of magnesium valproate and antidepressants for therapy of treatment-resistant depression(TRD) in China. Methods: Searches were applied to the following electronic databases in china: Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG and Chinese Social Sciences Citation Index (VIP) databases. A total of 13 RCTs were included. A meta-analysis was performed of all the literatures germane to estimate the treatment-resistant depression patients treated with magnesium valproate combination with antidepressants and only antidepressants randomized controlled trials (RCTs) from 2010 to 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and the meta-analysis was conducted with Revman4.2 software. Results: A total of 13 RCTs were included for meta-analysis. The results of meta-analysis demonstrated by effective rate and depressive symptoms change between two groups of combination treatment with magnesium valproate and only antidepressant. The effective rate was higher in magnesium valproate combination with antidepressants group than that in antidepressants group(81/306, 35/298, Z=4.60, P=0.00001). The depressive scale was lower found in magnesium valproate combination with antidepressants group than that in antidepressants group after treatment (Z=16.20, P <0.00001). These results indicated that magnesium valproate combination with antidepressants maybe one better therapeutic way for TRD. Conclusion: The results indicate that magnesium valproate combination with antidepressants was better than antidepressants group in effective rate and improving depressive symptoms during treatment of patients with TRD. So these results may recommend to the patients with TRD though without the differences between groups.

Meta-analysis of Salt Valproate Prevent Switch Associated with Antidepressants in Chinese Depressive Patients

“…But valproate also was used for other type depression,such as TRD [2,3],depression with mixed future,with agitated or anxiety symptoms [26,27].It also hint valproate maybe effective in prevention of switch associated with antidepressant.In fact,the risk of switch associated with antidepressant in patients with depression was monotherapy by antidepressant and without use of mood stabilizer [12].…”

“…Valproate may be applied to depression for the following reasons: First, in the study, as an important intensive treatment, it is used in the treatment of depression [1]. Second, valproate can improve the symptoms of refractory depression [2,3]. Third, valproate is bene cial to the improvement of irritability, impulse and anxiety symptoms of irritable depression [4,5].…”

Effect of neuropsychiatric medications on mitochondrial function: For better or for worse

“…The atypical antidepressant tianeptine increases serotonin uptake in the brain and is a -opioid receptor agonist that can be used to treat depressive disorders, including in individuals with concomitant depression and anxiety symptoms (Gassaway et al, 2014;Kasper and McEwen, 2008;Wagstaff et al, 2001). Valproate is mainly used to treat bipolar disorders (Citrome, 2014;Liu, 2014), but has recently also been found to be an effective adjunctive treatment in individuals with treatment-resistant depression (Fengpei, 2018;Ghabrash et al, 2016).…”