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A meta-analysis of early sustained response rates between antidepressants and placebo for the treatment of major depressive disorder.
J Clin Psychopharmacol 2006; 26(1):56-60JC

Abstract

CONTEXT

Pattern analysis suggests that "true" drug response is characterized by clinical improvement that is not subsequently followed by a worsening of symptoms (sustained clinical response). To date, several reports demonstrate that early response rates are equivalent between antidepressant-treated and placebo-treated groups of patients with major depressive disorder, suggesting that patients who demonstrate significant and sustained symptom improvement during the first 2 weeks of treatment are not responding to the antidepressant itself, but to nonspecific, placebo-like factors.

OBJECTIVE

To compare early sustained response rates between antidepressant- and placebo-treated adults with major depressive disorder.

DATA SOURCES

Medline/Pubmed were searched. No year of publication limits were used.

STUDY SELECTION

Randomized, double-blind, placebo-controlled antidepressant trials or pooled reports/meta-analyses of such trials reporting early sustained response rates for major depressive disorder. The decision to include studies in the meta-analysis was performed by 2 reviewers.

DATA EXTRACTION

Data were extracted with the use of a precoded form.

DATA SYNTHESIS

Analyses were performed on the proportion of patients who achieved a sustained response the first 2 weeks of treatment, as well as the first week of treatment. A random-effects model with fixed drug effects was used to combine the studies and make comparisons of sustained early response rates between antidepressant- and placebo-treated groups. Data from 8 reports involving a total of 7121 major depressive disorder patients (4076 randomized to treatment with an antidepressant and 3045 randomized to placebo) were analyzed. Antidepressant-treated patients were more likely to demonstrate sustained clinical response by 2 weeks (odds ratio 2.06, 95% CI: 1.52-2.8) or 1 week of treatment (odds ratio 1.50, 95% CI: 1.08-2.08) than placebo-treated patients.

CONCLUSIONS

The results of the present analysis suggest that "true" drug response can occur the first 2 week as well as the first week of treatment of major depressive disorder with conventional antidepressants.

Authors+Show Affiliations

Depression Clinical and Research Program, Massachusetts General Hospital,Harvard Medical School, Boston, MA 02114, USA. gpapakostas@patners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16415707

Citation

Papakostas, George I., et al. "A Meta-analysis of Early Sustained Response Rates Between Antidepressants and Placebo for the Treatment of Major Depressive Disorder." Journal of Clinical Psychopharmacology, vol. 26, no. 1, 2006, pp. 56-60.
Papakostas GI, Perlis RH, Scalia MJ, et al. A meta-analysis of early sustained response rates between antidepressants and placebo for the treatment of major depressive disorder. J Clin Psychopharmacol. 2006;26(1):56-60.
Papakostas, G. I., Perlis, R. H., Scalia, M. J., Petersen, T. J., & Fava, M. (2006). A meta-analysis of early sustained response rates between antidepressants and placebo for the treatment of major depressive disorder. Journal of Clinical Psychopharmacology, 26(1), pp. 56-60.
Papakostas GI, et al. A Meta-analysis of Early Sustained Response Rates Between Antidepressants and Placebo for the Treatment of Major Depressive Disorder. J Clin Psychopharmacol. 2006;26(1):56-60. PubMed PMID: 16415707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A meta-analysis of early sustained response rates between antidepressants and placebo for the treatment of major depressive disorder. AU - Papakostas,George I, AU - Perlis,Roy H, AU - Scalia,Margaret J, AU - Petersen,Timothy J, AU - Fava,Maurizio, PY - 2006/1/18/pubmed PY - 2007/4/4/medline PY - 2006/1/18/entrez SP - 56 EP - 60 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 26 IS - 1 N2 - CONTEXT: Pattern analysis suggests that "true" drug response is characterized by clinical improvement that is not subsequently followed by a worsening of symptoms (sustained clinical response). To date, several reports demonstrate that early response rates are equivalent between antidepressant-treated and placebo-treated groups of patients with major depressive disorder, suggesting that patients who demonstrate significant and sustained symptom improvement during the first 2 weeks of treatment are not responding to the antidepressant itself, but to nonspecific, placebo-like factors. OBJECTIVE: To compare early sustained response rates between antidepressant- and placebo-treated adults with major depressive disorder. DATA SOURCES: Medline/Pubmed were searched. No year of publication limits were used. STUDY SELECTION: Randomized, double-blind, placebo-controlled antidepressant trials or pooled reports/meta-analyses of such trials reporting early sustained response rates for major depressive disorder. The decision to include studies in the meta-analysis was performed by 2 reviewers. DATA EXTRACTION: Data were extracted with the use of a precoded form. DATA SYNTHESIS: Analyses were performed on the proportion of patients who achieved a sustained response the first 2 weeks of treatment, as well as the first week of treatment. A random-effects model with fixed drug effects was used to combine the studies and make comparisons of sustained early response rates between antidepressant- and placebo-treated groups. Data from 8 reports involving a total of 7121 major depressive disorder patients (4076 randomized to treatment with an antidepressant and 3045 randomized to placebo) were analyzed. Antidepressant-treated patients were more likely to demonstrate sustained clinical response by 2 weeks (odds ratio 2.06, 95% CI: 1.52-2.8) or 1 week of treatment (odds ratio 1.50, 95% CI: 1.08-2.08) than placebo-treated patients. CONCLUSIONS: The results of the present analysis suggest that "true" drug response can occur the first 2 week as well as the first week of treatment of major depressive disorder with conventional antidepressants. SN - 0271-0749 UR - https://www.unboundmedicine.com/medline/citation/16415707/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=16415707 DB - PRIME DP - Unbound Medicine ER -