Comparative Safety of Pharmacologic Treatments for Persistent Depressive Disorder: A Systematic Review and Network Meta-Analysis
| العنوان: | Comparative Safety of Pharmacologic Treatments for Persistent Depressive Disorder: A Systematic Review and Network Meta-Analysis |
|---|---|
| المؤلفون: | Hannes Mohr, Martin Härter, Alessa von Wolff, Levente Kriston, Yvonne Nestoriuc, Ramona Meister, Lars P. Hölzel |
| المصدر: | PLoS ONE, Vol 11, Iss 5, p e0153380 (2016) PLoS ONE |
| بيانات النشر: | Public Library of Science (PLoS), 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | medicine.medical_treatment, Serotonin antagonist and reuptake inhibitor, lcsh:Medicine, Biochemistry, law.invention, Mathematical and Statistical Techniques, 0302 clinical medicine, Randomized controlled trial, law, Medicine and Health Sciences, Antipsychotics, 030212 general & internal medicine, lcsh:Science, Multidisciplinary, Depression, Pharmaceutics, Drugs, Neurochemistry, Antidepressants, Neurotransmitters, Antidepressive Agents, Research Design, Anesthesia, Physical Sciences, Statistics (Mathematics), Research Article, medicine.drug, Biogenic Amines, Serotonin, medicine.medical_specialty, Clinical Research Design, Research and Analysis Methods, 03 medical and health sciences, Drug Therapy, Internal medicine, Mental Health and Psychiatry, medicine, Humans, Amisulpride, Statistical Methods, Adverse effect, Antipsychotic, Pharmacology, Mood Disorders, business.industry, lcsh:R, Biology and Life Sciences, Trazodone, Discontinuation, lcsh:Q, Adverse Events, business, Reuptake inhibitor, Mathematics, Reuptake Inhibitors, 030217 neurology & neurosurgery, Meta-Analysis, Neuroscience |
| الوصف: | We aimed to compare the safety of antidepressants for the treatment of persistent depressive disorder (PDD) with each other and with placebo. We conducted a systematic electronic search and included randomized controlled trials that investigated antidepressants for the treatment of PDD in adults. Outcomes were the incidence of experiencing any adverse event, specific adverse events and related treatment discontinuations. We analyzed the data using traditional and network meta-analyses. Thirty-four studies that comprised 4,769 patients and examined 20 individual agents in nine substance classes were included. Almost all analyzed substance classes were associated with higher discontinuation rates than placebo including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), antipsychotics, and the serotonin antagonist and reuptake inhibitor (SARI) trazodone. The odds of experiencing any adverse event were significantly higher for TCAs and serotonin noradrenaline reuptake inhibitors (SNRIs) compared to placebo. Pairwise comparisons among the substance classes revealed that more patients receiving TCAs or SNRIs experienced any adverse event and that more patients receiving TCAs or the SARI trazodone discontinued treatment. The complementary treatment with acetyl-l-carnitine showed lower rates of experiencing any adverse event and related discontinuations than all other comparators. TCAs were primarily associated with (anti-)cholinergic and sedating adverse events. SSRIs primarily showed gastrointestinal adverse events. Patients treated with the antipsychotic amisulpride were more likely to manifest weight gain and endocrine adverse events. The comparative evidence for further agents was insufficient or lacking. The identified safety differences may be used to inform the selection among the antidepressants. |
| اللغة: | English |
| تدمد: | 1932-6203 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bc20fcc34420b01c2fbc972aaacb1438Test http://europepmc.org/articles/PMC4871495?pdf=renderTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....bc20fcc34420b01c2fbc972aaacb1438 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
|---|