Efficacy and safety of eight enhanced therapies for treatment-resistant depression: A systematic review and network meta-analysis of RCTs.

Autor: Guo Q; Outpatient department, Peking University Sixth Hospital, Beijing, China; School of Nursing, Peking University, Beijing, China. Electronic address: guoqinghua6@bjmu.edu.cn., Guo L; Outpatient department, Peking University Sixth Hospital, Beijing, China., Wang Y; Department of Nursing, Peking University Sixth Hospital, Beijing, China. Electronic address: wangyong751006@163.com., Shang S; School of Nursing, Peking University, Beijing, China. Electronic address: mei916@263.net.
Jazyk: angličtina
Zdroj: Psychiatry research [Psychiatry Res] 2024 Sep; Vol. 339, pp. 116018. Date of Electronic Publication: 2024 Jun 20.
DOI: 10.1016/j.psychres.2024.116018
Abstrakt: Background: Treatment-Resistant Depression (TRD) challenges psychiatric treatment, with existing guidelines covering only a subset of augmentation strategies.
Methods: A network meta-analysis following PRISMA guidelines examined the efficacy and safety of TRD treatments, analyzing 72 randomized controlled trials from eight databases, assessing response and remission rates, tolerability, and safety through the Cochrane Risk of Bias Tool and CINeMA framework.
Findings: Including 12,105 participants, the analysis highlighted ECT, Ketamine, Esketamine, and Psilocybin as superior first-line treatments due to their optimal balance between effectiveness and tolerability. Brexpiprazole and Quetiapine showed no significant efficacy over placebo in response rates, while Esketamine and Psilocybin exhibited lower tolerability.
Interpretation: The results advocate for ECT, Ketamine, Esketamine, and Psilocybin as preferred treatments for TRD, guiding clinical practice with evidence-based recommendations for enhancing treatment outcomes. This study underscores the importance of considering both efficacy and safety in selecting augmentation strategies for TRD.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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