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Cited by 172Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Meta-analysis of Major Depressive Disorder Relapse and Recurrence With Second-Generation Antidepressants

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Hansen, Richard, Gaynes, Bradley, Thieda, Patricia, Gartlehner, Gerald, Deveaugh-Geiss, Angela, Krebs, Erin, Lohr, Kathleen·2008·Psychiatric Services
DOI 10.1176/ps.2008.59.10.1121PMC PMC2840386
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Abstract

OBJECTIVE: This meta-analysis reviewed data on the efficacy and effectiveness of second-generation antidepressants for preventing major depression relapse and recurrence during continuation and maintenance phases of treatment, respectively. METHODS: MEDLINE, EMBASE, and PsycINFO, the Cochrane Library, and International Pharmaceutical Abstracts were searched for the period of January 1980 through April 2007 for reviews, randomized controlled trials, meta-analyses, and observational studies on the topic. Two persons independently reviewed abstracts and full-text articles using a structured data abstraction form to ensure consistency in appraisal and data extraction. RESULTS: Four comparative trials and 23 placebo-controlled trials that addressed relapse or recurrence prevention were included. Results of comparative trials have not demonstrated statistically significant differences between duloxetine and paroxetine, fluoxetine and sertraline, fluvoxamine and sertraline, and trazodone and venlafaxine. Pooled data for the class of second-generation antidepressants compared with placebo suggested a relatively large effect size that persists over time. For preventing both relapse and recurrence, the number of patients needed to treat is five (95% confidence interval of 4 to 6). Differences in the length of open-label treatment before randomization, drug type, and trial duration did not affect pooled estimates of relapse rates. Across all trials, 7% of patients randomly assigned to receive active treatment and 5% of patients randomly assigned to receive a placebo discontinued treatment because of adverse events. CONCLUSIONS: This review demonstrates the overall benefits of continuation- and maintenance-phase treatment of major depression with second-generation antidepressants and emphasizes the need for additional studies of comparative differences among drugs.

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Research works printed but not linked: 3

  1. [7]Centre for Reviews and Dissemination. Undertaking systematic reviews of research on effectiveness: CRD's guidance for those carrying out or commissioning reviews. CRD Report Number 4. 2nd edition. York, United Kingdom: 2001. [Google Scholar]
  2. [8]Egger M, Smith GD, Altman DG. Systematic Reviews in Health Care. 2nd edition. 2001. [Google Scholar]
  3. [41]Gartlehner G, Hansen RA, Thieda P, et al. Comparative effectiveness of pharmacologic treatment of depression. (Prepared by RTI-UNC under Contract No. 290-02-0016, TO #7) Rockville, MD: Agency for Healthcare Research and Quality; 2006. Apr, Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm. [Google Scholar]

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Authors
Hansen, R., Gaynes, B., Thieda, P., Gartlehner, G., Deveaugh-Geiss, A., Krebs, E., & Lohr, K.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • RTI International (US)
Corresponding author
Hansen, Richard
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2008-10
Volume
59
Issue
10
Pages
1121-1130
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/ps.2008.59.10.1121
PMC
PMC2840386
OpenAlex
W4236472310
Cited by
172
References
45
Citations by year
2026: 5 · 2025: 4 · 2024: 7 · 2023: 4 · 2022: 5 · 2021: 8 · 2020: 13 · 2019: 9 · 2018: 7 · 2017: 16 · 2016: 5 · 2015: 32 · 2014: 7 · 2013: 6 · 2012: 13
FWCI
1.04
Type
journal article
Language
en
Open access
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • IUScholarWorks (Indiana University) (submittedVersion)
Funders
  • Pfizer
  • GlaxoSmithKline
  • RTI International
  • Shire
  • National Institutes of Health
  • Agency for Healthcare Research and Quality (290-02-0016)
  • University of North Carolina at Chapel Hill
  • National Institute of Mental Health
  • National Center for Research Resources (K12RR023248)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
major depressive disorder, depression relapse, depression recurrence, second-generation antidepressants, continuation treatment, maintenance therapy, duloxetine, paroxetine, fluoxetine, sertraline, fluvoxamine, trazodone, venlafaxine, antidepressant efficacy, adverse events
MeSH terms
Adult, Aged, Aged, 80 and over, Depressive Disorder, Major, Major Depressive Disorder, Humans, Middle Aged, Recurrence, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Antidepressive Agents, Second-Generation

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