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Examining the Evidence on Augmentation with Atypical Antipsychotics

Published online by Cambridge University Press:  07 November 2014

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Extract

There is mounting evidence to suggest that the efficacy of all available antidepressants when used as monotherapy to treat major depressive disorder (MDD) is, at best, modest. For example, a meta-analysis of all double-blind placebo-controlled studies of antidepressants published since 1980 revealed response rates of 53% for antidepressants versus 36% for placebo (difference in response rate of 16.8%) (Slide 1). To make matters worse, if one is to assume that “negative trials” (ie, trials which do not demonstrate the superiority of a drug over placebo) are less likely to be published than “positive trials” (trials which demonstrate the superiority of a drug versus placebo), it is quite possible that the margin of efficacy of antidepressants when compared to placebo is ≤16.8%. Thus, if one were to include all unpublished along with published double-blind, placebo-controlled trials of antidepressants for MDD, this efficacy margin could be ≤10%.

Type
Expert Roundtable Supplement
Information
CNS Spectrums , Volume 12 , Issue S22: Augmentation Strategies in the Treatment of Major Depressive Disorder , December 2007 , pp. 10 - 12
Copyright
Copyright © Cambridge University Press 2007

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