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Treatment of depression with atypical features: A meta-analytic approach
Abstract
The present meta-analysis addressed the empirical evidence regarding the treatment of major depression with atypical features. The superiority of monoamine oxidase inhibitors (MAOIs) compared with other antidepressants in the treatment of major depression with atypical features has been frequently reported. According to the CONSORT Statement, studies included in our meta-analysis had to meet several criteria, especially a double-blind, controlled condition and an operational diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-III or DSM-IV criteria, respectively. Four databases for research-based evidence were used in a systematic review: Medline, Embase, Psyndex and PsycInfo. Only eight publications met inclusion/exclusion criteria, resulting in 11 comparisons. Our results contrast an effect size of 0.45 (95% confidence interval) for a comparison of MAOIs vs. placebo with an effect size of 0.02 (95% confidence interval: - 0.10-0.14) for a comparison of MAOIs vs. selective serotonin reuptake inhibitors. The effect size for MAOIs vs. tricyclic antidepressants was 0.27 (95% confidence interval: 0.16-0.42). MAOIs may be more effective for atypical major depressive disorder than tricyclic antidepressants. Most clinical research has been conducted on irreversible MAOIs. Additional studies testing more recently developed antidepressants (including reversible MAOIs) with an improved safety profile would be warranted. The available data are insufficient for a direct comparison between MAOIs and selective serotonin reuptake inhibitors.
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“Individuals with atypical depression often have a more unrelenting course of depression [13], in part because they show a poorer response to antidepressants [14].”
From The menace of obesity to depression and anxiety prevalence (2022) · cites this paper as [14]
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Metadata
- Authors
- Henkel, V., Mergl, R., Allgaier, A.-K., Kohnen, R., Möller, H.-J., & Hegerl, U.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Corresponding author
- Mergl, Roland
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2006-01
- Volume
- 141
- Issue
- 1
- Pages
- 89-101
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W1986750404
- Cited by
- 161
- References
- 99
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 9 · 2023: 6 · 2022: 8 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 10 · 2016: 10 · 2015: 13 · 2014: 9 · 2013: 8 · 2012: 13
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- atypical depression, major depressive disorder, monoamine oxidase inhibitors, antidepressant treatment, selective serotonin reuptake inhibitors, tricyclic antidepressants, placebo comparison, treatment efficacy
- MeSH terms
- Antidepressive Agents, Major Depressive Disorder, Double-Blind Method, Humans, Monoamine Oxidase Inhibitors, Phenelzine, Severity of Illness Index, Sertraline, Moclobemide
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