Evaluation of the effect of insulin sensitivity-enhancing lifestyle- and dietary-related adjuncts on antidepressant treatment response: A systematic review and meta-analysis
| Autor: | Gráinne Cousins, Fiona Boland, Brian P. Kirby, Benedict K. Ryan, Olaitan J. Jeremiah |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment Psychological intervention Biological psychiatry 03 medical and health sciences 0302 clinical medicine Insulin resistance Endocrinology Internal medicine Endocrine system medicine Vitamin D and neurology Adjuncts lcsh:Social sciences (General) lcsh:Science (General) Depression (differential diagnoses) Psychiatry Pharmacology Multidisciplinary business.industry Depression Insulin Antidepressants medicine.disease Insulin sensitivity Lifestyle Dietary supplements 030104 developmental biology Meta-analysis Systematic review Antidepressant lcsh:H1-99 business 030217 neurology & neurosurgery Research Article lcsh:Q1-390 |
| Zdroj: | Heliyon, Vol 6, Iss 9, Pp e04845-(2020) Heliyon |
| ISSN: | 2405-8440 |
| Popis: | Background Depression is associated with insulin resistance (IR). However, the potential beneficial effect, on antidepressant treatment response, of adjunctive therapy with insulin sensitivity-enhancing lifestyle and dietary interventions (exercise; supplementation with: vitamin D, magnesium, zinc, probiotics or omega-3 fatty acids) has not been systematically explored. Aims To determine the effect of the above stated adjuncts on antidepressant treatment response in clinically depressed patients via a systematic review and meta-analysis. Methods RCTs which assessed the effect, on antidepressant treatment response of adjunctive therapy with any of the interventions in comparison with treatment as usual were included. Results The interventions had a significant antidepressant effect, with SMD for follow-up (end of study) scores and change (from baseline) scores being -0.88, [95% CI: -1.19 to -0.57; P < 0.001] and -1.98 [95% CI -2.86 to -1.10; P < 0.001], respectively. The odds ratio (OR) for remission was 2.28 (95% CI 1.42 to 3.66; P < 0.001). The number-needed-to-treat (NNT) for remission was 6. Subgroup analysis of the follow-up scores revealed age effect: SMD significant in those with mean age ≤50 (-1.02 SMD; 95% CI: -1.40 to -0.64; p < 0.001) and insignificant in those with mean age >50 (-0.38 SMD (95% CI: -0.82 to 0.05; P = 0.08)). Also, the interventions were more beneficial among outpatients- SMD: -0.97 (95% CI: -1.32 to -0.62; P < 0.001) compared to inpatients- SMD: -0.34 (95% CI: -0.88 to 0.20; P = 0.22). Sensitivity analysis did not change the results. Conclusion The finding that antidepressant treatment response may be improved using insulin sensitivity-enhancing lifestyle and dietary adjuncts is worthy of further exploration. Psychiatry; Biological Psychiatry; Depression; Pharmacology; Endocrinology; Endocrine System; depression; Adjuncts; Insulin sensitivity; Lifestyle; Dietary Supplements; Antidepressants; systematic review. |
| Databáze: | OpenAIRE |
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