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

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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: 14

Gaynes is with the Department of Psychiatry, Ms., Thieda is with Cecil G
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not reported
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not applicable
Clinical Global Impression of Severity (possible scores range from 1 to 7, with lower scores indicating normalcy or mild illness and higher scores indicating more severe illness)
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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: Hansen, Richard
Gaynes, Bradley
Gartlehner, Gerald
Krebs, Erin
Lohr, Kathleen
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: green
www.ncbi.nlm.nih.gov
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 (medical) › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › 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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Meta-analysis of Major Depressive Disorder Relapse and Recurrence With Second-Generation Antidepressants

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