scholarly journals Treatment-related changes of molecular biomarkers in major depressive disorder: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Courtney L. Irwin ◽  
◽  
Patrícia S. Coelho ◽  
Bruno Kluwe-Schiavon ◽  
Anabela Silva-Fernandes ◽  
...  
Keyword(s):  
Randomised Controlled Trials ◽  
English Language ◽  
Information Sources ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Major Depressive ◽  
Online Databases ◽  
Review Question ◽  
Randomised Controlled

Review question / Objective: The aim of this review is two-fold: first, we sought to identify candidate biomarkers that could provide information on whether an individual with MDD would respond positively to common non-pharmacological treatments, and secondly, to conduct a meta-analysis to determine whether one form of common non-pharmacological treatment (namely CBT, tDCS and TMS) would produce better results over another in regards to its influence on biomarker levels. Information sources: The information sources used were: three online databases (PubMed, Scopus, and PsycINFO) to identify English-language human randomised controlled trials unrestricted by year of publication.

scholarly journals Pharmacological treatment for unipolar psychotic depression

2006 ◽  
Vol 188 (5) ◽  
pp. 410-415 ◽  
Author(s):  
Jaap Wijkstra ◽  
Jeroen Lijmer ◽  
Ferdi J. Balk ◽  
John R. Geddes ◽  
Willem A. Nolen
Keyword(s):  
Systematic Review ◽  
Pharmacological Treatment ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Controlled Trials ◽  
Psychotic Depression ◽  
Pharmacological Treatments ◽  
Risks And Benefits ◽  
Randomised Controlled

BackgroundThe optimal pharmacological treatment of unipolar psychotic depression is uncertain.AimsTo compare the clinical effectiveness of pharmacological treatments for patients with unipolar psychotic depression.MethodSystematic review and meta-analysis of randomised controlled trials.ResultsTen trials were included in the review. We found no evidence that the combination of an antidepressant with an antipsychotic is more effective than an antidepressant alone. This combination was statistically more effective than an antipsychotic alone.ConclusionsAntidepressant mono-therapy and adding an antipsychotic if the patient does not respond, or starting with the combination of an antidepressant and an antipsychotic, both appear to be appropriate options for patients with unipolar psychotic depression. However, clinically the balance between risks and benefits may suggest the first option should be preferred for many patients. Starting with an antipsychotic alone appears to be inadequate.

scholarly journals Effects of ketamine in electroconvulsive therapy for major depressive disorder: meta-analysis of randomised controlled trials

2020 ◽  
Vol 33 (3) ◽  
pp. e100117
Author(s):  
Xiao-Mei Li ◽  
Zhan-Ming Shi ◽  
Pei-Jia Wang ◽  
Hua Hu
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Major Depressive ◽  
Randomised Controlled ◽  
Grade Approach

BackgroundThe use of ketamine in electroconvulsive therapy (ECT) has been examined in the treatment of major depressive disorder (MDD); however, there has been no systematic review and meta-analysis of related randomised controlled trials (RCTs).AimTo examine the efficacy and safety of ketamine augmentation of ECT in MDD treatment.MethodsTwo reviewers searched Chinese (China National Knowledge Infrastructure and Wanfang) and English (PubMed, PsycINFO, Embase and Cochrane Library) databases from their inception to 23 July 2019. The included studies' bias risk was evaluated using the Cochrane risk of bias assessment tool. The primary outcome of this meta-analysis was improved depressive symptoms at day 1 after a single ECT treatment session. Data were pooled to calculate the standardised mean difference and risk ratio with their 95% CIs using RevMan V.5.3. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the whole quality of evidence.ResultsFour RCTs (n = 239) compared ketamine alone or ketamine plus propofol (n = 149) versus propofol alone (n = 90) in patients with MDD who underwent a single ECT session. Three RCTs were considered as unclear risk with respect to random sequence generation using the Cochrane risk of bias. Compared with propofol alone, ketamine alone and the combination of ketamine and propofol had greater efficacy in the treatment of depressive symptoms at days 1, 3 and 7 after a single ECT session. Moreover, compared with propofol alone, ketamine alone and the combination of ketamine and propofol were significantly associated with increased seizure duration and seizure energy index. Compared with propofol, ketamine alone was significantly associated with increased opening-eye time. Based on the GRADE approach, the evidence level of primary and secondary outcomes ranged from very low (26.7%, 4/15) to ‘low’ (73.3%, 11/15).ConclusionCompared with propofol, there were very low or low evidence levels showing that ketamine alone and the combination of ketamine and propofol appeared to rapidly improve depressive symptoms of patients with MDD undergoing a single ECT session. There is a need for high-quality RCTs.

scholarly journals Sponsorship bias in the comparative efficacy of psychotherapy and pharmacotherapy for adult depression: Meta-analysis

2017 ◽  
Vol 210 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Ioana A. Cristea ◽  
Claudio Gentili ◽  
Pietro Pietrini ◽  
Pim Cuijpers
Keyword(s):  
Conflict Of Interest ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Comparative Efficacy ◽  
Industry Funding ◽  
Financial Conflict ◽  
Randomised Controlled

BackgroundSponsorship bias has never been investigated for non-pharmacological treatments like psychotherapy.AimsWe examined industry funding and author financial conflict of interest (COI) in randomised controlled trials directly comparing psychotherapy and pharmacotherapy in depression.MethodWe conducted a meta-analysis with subgroup comparisons for industry v. non-industry-funded trials, and respectively for trial reports with author financial COI v. those without.ResultsIn total, 45 studies were included. In most analyses, pharmacotherapy consistently showed significant effectiveness over psychotherapy,g= −0.11 (95% CI −0.21 to −0.02) in industry-funded trials. Differences between industry and non-industry-funded trials were significant, a result only partly confirmed in sensitivity analyses. We identified five instances where authors of the original article had not reported financial COI.ConclusionsIndustry-funded trials for depression appear to subtly favour pharmacotherapy over psychotherapy. Disclosure of all financial ties with the pharmaceutical industry should be encouraged.

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