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A meta-analysis of early sustained response rates between antidepressants and placebo for the treatment of major depressive disorder.

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.

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  • Authors+Show Affiliations

    ,

    Depression Clinical and Research Program, Massachusetts General Hospital,Harvard Medical School, Boston, MA 02114, USA. gpapakostas@patners.org

    , , ,

    Source

    MeSH

    Antidepressive Agents
    Depressive Disorder, Major
    Humans
    Placebo Effect
    Randomized Controlled Trials as Topic
    Time Factors

    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 -