Antidepressant responses in direct comparisons of melancholic and non-melancholic depression
| Autor: | Juan Undurraga, Leonardo Tondo, Gustavo H. Vazquez, Ross J. Baldessarini |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pharmacology
Depressive Disorder medicine.medical_specialty business.industry Antidepressive Agents Tricyclic Melancholic depression medicine.disease 030227 psychiatry 03 medical and health sciences Psychiatry and Mental health 0302 clinical medicine hemic and lymphatic diseases Outcome Assessment Health Care Melancholia Humans Medicine Antidepressant Pharmacology (medical) Serotonin and Noradrenaline Reuptake Inhibitors medicine.symptom business Psychiatry Selective Serotonin Reuptake Inhibitors 030217 neurology & neurosurgery |
| Zdroj: | Journal of Psychopharmacology. 34:1335-1341 |
| ISSN: | 1461-7285 0269-8811 |
| Popis: | Background: Efforts to develop less heterogeneous, more clinically useful diagnostic categories for depressive disorders include renewed interest in the concept of melancholia (Mel). However, clinical or biological differentiation of Mel from other (nonMel) episodes of depression has been questioned, and it remains unclear whether pharmacological responses proposed to be characteristic of Mel are supported by available research. Methods: We carried out a systematic review seeking treatment trials reports comparing Mel and nonMel depressed subjects for meta-analyses of their differences in responses (a) to antidepressants overall, (b) to tricyclic (TCAs) or serotonin-enhancing agents (serotonin reuptake inhibitors/serotonin–norepinephrine reuptake inhibitors) and (c) with placebo treatment. Results: We identified 25 trials in 16 reports comparing 2597 Mel with 5016 nonMel subjects. Overall, responses to antidepressant treatment did not differ between Mel (39.4%) and nonMel (42.2%) subjects. However, all subjects responded better to TCAs (50.6%) than SRIs (30.0%; pConclusions: Antidepressant responses were similar in Mel and nonMel depressed patients. Mel subjects responded 25% less with placebo but were more severely depressed initially, and there was preferential response to TCAs in both Mel and nonMel subjects. The findings provide little support for proposed differences in responses to particular treatments among Mel versus nonMel depressed patients, and underscore the need to match for illness severity in making such comparisons. |
| Databáze: | OpenAIRE |
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