OBJECTIVE: To examine the available scientific evidence for answers to clinically relevant questions on the effectiveness and tolerability of antidepressant drugs (ADs) for the long-term treatment of depression. METHOD: The Cochrane Library was searched up to July 2006. When no complete Cochrane review was available, we looked in PubMed for relevant systematic reviews or individual randomized controlled trials. RESULTS: There was no good evidence that increasing the dosage of the initial AD is an effective strategy for patients with no, or partial, response to acute-phase treatment. There was no good evidence that switching between chemical classes of antidepressant was more effective than switching within a class. There was limited support from randomized trials for several augmentation strategies. There was good evidence for the effectiveness of long-term therapy to prevent relapse in patients who remitted after acute-phase treatment. The application of principles of evidence-based medicine suggested that thoughtful, individualized application of evidence is more appropriate than general statements. CONCLUSIONS: Available evidence provides some support for the effectiveness of several augmentation strategies in the management of patients with no, or partial, response to acute-phase treatment and for the individualized application of groupwise robust evidence for maintenance treatment with ADs to prevent relapses. However, side effects of these long-term treatments with ADs are poorly studied and reported.
OBJECTIVE: To examine the available scientific evidence for answers to clinically relevant questions on the effectiveness and tolerability of antidepressant drugs (ADs) for the long-term treatment of depression. METHOD: The Cochrane Library was searched up to July 2006. When no complete Cochrane review was available, we looked in PubMed for relevant systematic reviews or individual randomized controlled trials. RESULTS: There was no good evidence that increasing the dosage of the initial AD is an effective strategy for patients with no, or partial, response to acute-phase treatment. There was no good evidence that switching between chemical classes of antidepressant was more effective than switching within a class. There was limited support from randomized trials for several augmentation strategies. There was good evidence for the effectiveness of long-term therapy to prevent relapse in patients who remitted after acute-phase treatment. The application of principles of evidence-based medicine suggested that thoughtful, individualized application of evidence is more appropriate than general statements. CONCLUSIONS: Available evidence provides some support for the effectiveness of several augmentation strategies in the management of patients with no, or partial, response to acute-phase treatment and for the individualized application of groupwise robust evidence for maintenance treatment with ADs to prevent relapses. However, side effects of these long-term treatments with ADs are poorly studied and reported.
Authors: Juan Suárez; Sophia Khom; Francisco Alén; Luis A Natividad; Florence P Varodayan; Reesha R Patel; Dean Kirson; Rocío Arco; Antonio Ballesta; Michal Bajo; Leticia Rubio; Rémi Martin-Fardon; Fernando Rodríguez de Fonseca; Marisa Roberto Journal: Addict Biol Date: 2019-07-24 Impact factor: 4.280
Authors: Kiyomi Shinohara; Orestis Efthimiou; Edoardo G Ostinelli; Anneka Tomlinson; John R Geddes; Andrew A Nierenberg; Henricus G Ruhe; Toshi A Furukawa; Andrea Cipriani Journal: BMJ Open Date: 2019-05-19 Impact factor: 2.692
Authors: Paul J Mills; Joel E Dimsdale; Suzi Hong; Geoffrey Van Den Brande; Laura Redwine; Barry H Greenberg; Thomas Rutledge Journal: Patient Prefer Adherence Date: 2008-02-02 Impact factor: 2.711
Authors: María Rubio-Valera; M Teresa Peñarrubia-María; Rita Fernández-Vergel; Andrea Cecilia Carvajal Tejadillo; Ana Fernández Sánchez; Ignacio Aznar-Lou; Marian March-Pujol; Antoni Serrano-Blanco Journal: Aten Primaria Date: 2015-09-26 Impact factor: 1.137