Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis
Depression is a common condition that has been frequently treated with psychotropics. To review systematically the evidence of efficacy and acceptability of antidepressant and benzodiazepine treatments for patients with minor depression. A systematic review and meta-analysis of double-blind randomis...
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| Veröffentlicht in: | British journal of psychiatry 2011-01, Vol.198 (1), p.11-16 |
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| creator | Barbui, Corrado Cipriani, Andrea Patel, Vikram Ayuso-Mateos, José L. van Ommeren, Mark |
| description | Depression is a common condition that has been frequently treated with psychotropics.
To review systematically the evidence of efficacy and acceptability of antidepressant and benzodiazepine treatments for patients with minor depression.
A systematic review and meta-analysis of double-blind randomised controlled trials comparing antidepressants or benzodiazepines v. placebo in adults with minor depression. Data were obtained from MEDLINE, CINAHL, EMBASE, PsycInfo, Cochrane Controlled Trials Register and pharmaceutical company websites. Risk of bias was assessed for the generation of the allocation sequence, allocation concealment, masking, incomplete outcome data, and sponsorship bias.
Six studies met inclusion criteria. Three studies compared paroxetine with placebo; fluoxetine, amitriptyline and isocarboxazid were studied in one study each. No studies compared benzodiazepines with placebo. In terms of failures to respond to treatment (6 studies, 234 patients treated with antidepressants and 234 with placebo) no significant difference between antidepressants and placebo was found (relative risk (RR) 0.94, 95% CI 0.81-1.08). In terms of acceptability, data extracted from two studies (93 patients treated with antidepressants and 93 with placebo) showed no statistically significant difference between antidepressants and placebo (RR=1.06, 95% CI 0.65-1.73). There was no statistically significant between-study heterogeneity for any of the reported analyses.
There is evidence showing there is unlikely to be a clinically important advantage for antidepressants over placebo in individuals with minor depression. For benzodiazepines, no evidence is available, and thus it is not possible to determine their potential therapeutic role in this condition. |
| doi_str_mv | 10.1192/bjp.bp.109.076448 |
| format | Article |
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To review systematically the evidence of efficacy and acceptability of antidepressant and benzodiazepine treatments for patients with minor depression.
A systematic review and meta-analysis of double-blind randomised controlled trials comparing antidepressants or benzodiazepines v. placebo in adults with minor depression. Data were obtained from MEDLINE, CINAHL, EMBASE, PsycInfo, Cochrane Controlled Trials Register and pharmaceutical company websites. Risk of bias was assessed for the generation of the allocation sequence, allocation concealment, masking, incomplete outcome data, and sponsorship bias.
Six studies met inclusion criteria. Three studies compared paroxetine with placebo; fluoxetine, amitriptyline and isocarboxazid were studied in one study each. No studies compared benzodiazepines with placebo. In terms of failures to respond to treatment (6 studies, 234 patients treated with antidepressants and 234 with placebo) no significant difference between antidepressants and placebo was found (relative risk (RR) 0.94, 95% CI 0.81-1.08). In terms of acceptability, data extracted from two studies (93 patients treated with antidepressants and 93 with placebo) showed no statistically significant difference between antidepressants and placebo (RR=1.06, 95% CI 0.65-1.73). There was no statistically significant between-study heterogeneity for any of the reported analyses.
There is evidence showing there is unlikely to be a clinically important advantage for antidepressants over placebo in individuals with minor depression. For benzodiazepines, no evidence is available, and thus it is not possible to determine their potential therapeutic role in this condition.</description><identifier>ISSN: 0007-1250</identifier><identifier>EISSN: 1472-1465</identifier><identifier>DOI: 10.1192/bjp.bp.109.076448</identifier><identifier>PMID: 21200071</identifier><identifier>CODEN: BJPYAJ</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Acceptability ; Adolescent ; Adult ; Amitriptylene ; Amitriptyline ; Antidepressant drugs ; Antidepressants ; Antidepressive Agents - therapeutic use ; Benzodiazepines ; Benzodiazepines - therapeutic use ; Bias ; Clinical trials ; Data Interpretation, Statistical ; Depression ; Depression - drug therapy ; Double-Blind Method ; Efficacy ; Female ; Fluoxetine ; Humans ; Male ; Masking ; Mental depression ; Mental health ; Meta-analysis ; Older people ; Outcome Assessment (Health Care) - statistics & numerical data ; Paroxetine ; Placebos ; Primary care ; Psychiatry ; Public health ; Randomized Controlled Trials as Topic ; Review ; Review Article ; Risk assessment ; Risk factors ; Sponsorship ; Statistical analysis ; Systematic review ; Websites</subject><ispartof>British journal of psychiatry, 2011-01, Vol.198 (1), p.11-16</ispartof><rights>Copyright © Royal College of Psychiatrists, 2011</rights><rights>2011 This article is published under (http://creativecommons.org/licenses/by-nc/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Royal College of Psychiatrists 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c600t-d51ef4dcde53537187060aade761487d1118c9884e1cdb17e1fe2c8accaf25653</citedby><cites>FETCH-LOGICAL-c600t-d51ef4dcde53537187060aade761487d1118c9884e1cdb17e1fe2c8accaf25653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S000712500000893X/type/journal_article$$EHTML$$P50$$Gcambridge$$Hfree_for_read</linktohtml><link.rule.ids>164,230,314,776,780,881,12825,27901,27902,30976,30977,55603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21200071$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barbui, Corrado</creatorcontrib><creatorcontrib>Cipriani, Andrea</creatorcontrib><creatorcontrib>Patel, Vikram</creatorcontrib><creatorcontrib>Ayuso-Mateos, José L.</creatorcontrib><creatorcontrib>van Ommeren, Mark</creatorcontrib><title>Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis</title><title>British journal of psychiatry</title><addtitle>Br J Psychiatry</addtitle><description>Depression is a common condition that has been frequently treated with psychotropics.
To review systematically the evidence of efficacy and acceptability of antidepressant and benzodiazepine treatments for patients with minor depression.
A systematic review and meta-analysis of double-blind randomised controlled trials comparing antidepressants or benzodiazepines v. placebo in adults with minor depression. Data were obtained from MEDLINE, CINAHL, EMBASE, PsycInfo, Cochrane Controlled Trials Register and pharmaceutical company websites. Risk of bias was assessed for the generation of the allocation sequence, allocation concealment, masking, incomplete outcome data, and sponsorship bias.
Six studies met inclusion criteria. Three studies compared paroxetine with placebo; fluoxetine, amitriptyline and isocarboxazid were studied in one study each. No studies compared benzodiazepines with placebo. In terms of failures to respond to treatment (6 studies, 234 patients treated with antidepressants and 234 with placebo) no significant difference between antidepressants and placebo was found (relative risk (RR) 0.94, 95% CI 0.81-1.08). In terms of acceptability, data extracted from two studies (93 patients treated with antidepressants and 93 with placebo) showed no statistically significant difference between antidepressants and placebo (RR=1.06, 95% CI 0.65-1.73). There was no statistically significant between-study heterogeneity for any of the reported analyses.
There is evidence showing there is unlikely to be a clinically important advantage for antidepressants over placebo in individuals with minor depression. For benzodiazepines, no evidence is available, and thus it is not possible to determine their potential therapeutic role in this condition.</description><subject>Acceptability</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Amitriptylene</subject><subject>Amitriptyline</subject><subject>Antidepressant drugs</subject><subject>Antidepressants</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Benzodiazepines</subject><subject>Benzodiazepines - therapeutic use</subject><subject>Bias</subject><subject>Clinical trials</subject><subject>Data Interpretation, Statistical</subject><subject>Depression</subject><subject>Depression - drug therapy</subject><subject>Double-Blind Method</subject><subject>Efficacy</subject><subject>Female</subject><subject>Fluoxetine</subject><subject>Humans</subject><subject>Male</subject><subject>Masking</subject><subject>Mental depression</subject><subject>Mental health</subject><subject>Meta-analysis</subject><subject>Older people</subject><subject>Outcome Assessment (Health Care) - statistics & numerical data</subject><subject>Paroxetine</subject><subject>Placebos</subject><subject>Primary care</subject><subject>Psychiatry</subject><subject>Public health</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Review</subject><subject>Review Article</subject><subject>Risk assessment</subject><subject>Risk factors</subject><subject>Sponsorship</subject><subject>Statistical analysis</subject><subject>Systematic review</subject><subject>Websites</subject><issn>0007-1250</issn><issn>1472-1465</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>IKXGN</sourceid><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk1v1DAQhi0EokvhB3BBkTj0lMXj2I7DAQlV5UOqxAXOlmNPWq8SO9jZou2vr5ddyoeE6os9mmfeGY9eQl4CXQN07E2_mdf9vAbarWkrOVePyAp4y2rgUjwmK0ppWwMT9IQ8y3lTwoaz9ik5YcD2OViR64th8NbYXRWHyoTFO5wT5lyeucSu6jHcRufNLc4-YK58qCYfYqqOoI_hbZV3ecHJLN5WCW88_vhZOuFiahPMuMs-PydPBjNmfHG8T8m3Dxdfzz_Vl18-fj5_f1lbSelSOwE4cGcdikY0LaiWSmqMw1YCV60DAGU7pTiCdT20CAMyq4y1ZmBCiuaUvDvoztt-QmcxLMmMek5-Mmmno_H670zw1_oq3uiGAueSFYGzo0CK37eYFz35bHEcTcC4zboTXIJUoB4klRCq6wDowyRjopxmP_7rf8hN3Kayw6xZA0IyXuYsFBwom2LOCYf7_wHVe2voYg3dzyXs9MEapebVn4u5r_jlhQI0R1Ez9cm7K_zd-_-ydzsnyJI</recordid><startdate>201101</startdate><enddate>201101</enddate><creator>Barbui, Corrado</creator><creator>Cipriani, Andrea</creator><creator>Patel, Vikram</creator><creator>Ayuso-Mateos, José L.</creator><creator>van Ommeren, Mark</creator><general>Cambridge University Press</general><general>Royal College Of Psychiatrists</general><scope>IKXGN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7TK</scope><scope>7XB</scope><scope>88G</scope><scope>88J</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>M2M</scope><scope>M2O</scope><scope>M2R</scope><scope>M2S</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201101</creationdate><title>Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis</title><author>Barbui, Corrado ; 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To review systematically the evidence of efficacy and acceptability of antidepressant and benzodiazepine treatments for patients with minor depression.
A systematic review and meta-analysis of double-blind randomised controlled trials comparing antidepressants or benzodiazepines v. placebo in adults with minor depression. Data were obtained from MEDLINE, CINAHL, EMBASE, PsycInfo, Cochrane Controlled Trials Register and pharmaceutical company websites. Risk of bias was assessed for the generation of the allocation sequence, allocation concealment, masking, incomplete outcome data, and sponsorship bias.
Six studies met inclusion criteria. Three studies compared paroxetine with placebo; fluoxetine, amitriptyline and isocarboxazid were studied in one study each. No studies compared benzodiazepines with placebo. In terms of failures to respond to treatment (6 studies, 234 patients treated with antidepressants and 234 with placebo) no significant difference between antidepressants and placebo was found (relative risk (RR) 0.94, 95% CI 0.81-1.08). In terms of acceptability, data extracted from two studies (93 patients treated with antidepressants and 93 with placebo) showed no statistically significant difference between antidepressants and placebo (RR=1.06, 95% CI 0.65-1.73). There was no statistically significant between-study heterogeneity for any of the reported analyses.
There is evidence showing there is unlikely to be a clinically important advantage for antidepressants over placebo in individuals with minor depression. For benzodiazepines, no evidence is available, and thus it is not possible to determine their potential therapeutic role in this condition.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>21200071</pmid><doi>10.1192/bjp.bp.109.076448</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acceptability Adolescent Adult Amitriptylene Amitriptyline Antidepressant drugs Antidepressants Antidepressive Agents - therapeutic use Benzodiazepines Benzodiazepines - therapeutic use Bias Clinical trials Data Interpretation, Statistical Depression Depression - drug therapy Double-Blind Method Efficacy Female Fluoxetine Humans Male Masking Mental depression Mental health Meta-analysis Older people Outcome Assessment (Health Care) - statistics & numerical data Paroxetine Placebos Primary care Psychiatry Public health Randomized Controlled Trials as Topic Review Review Article Risk assessment Risk factors Sponsorship Statistical analysis Systematic review Websites |
| title | Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis |
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