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Accepted version

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2024-03-01

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cc-by-nc-nd (c) Elsevier Ltd, 2024
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/209827

Pharmacological treatments for psychotic depression: a systematic review and network meta-analysis

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https://doi.org/10.1016/S2215-0366(24)00006-3

Abstract

Background: There are no recommendations based on the efficacy of specific drugs for the treatment of psychotic depression. To address this evidence gap, we did a network meta-analysis to assess and compare the efficacy and safety of pharmacological treatments for psychotic depression. Methods: In this systematic review and network meta-analysis, we searched ClinicalTrials.gov, CENTRAL, Embase, PsycINFO, PubMed, Scopus, and Web of Science from inception to Nov 23, 2023 for randomised controlled trials published in any language that assessed pharmacological treatments for individuals of any age with a diagnosis of a major depressive episode with psychotic features, in the context of major depressive disorder or bipolar disorder in any setting. We excluded continuation or maintenance trials. We screened the study titles and abstracts identified, and we extracted data from relevant studies after full-text review. If full data were not available, we requested data from study authors twice. We analysed treatments for individual drugs (or drug combinations) and by grouping them on the basis of mechanisms of action. The primary outcomes were response rate (ie, the proportion of participants who responded to treatment) and acceptability (ie, the proportion who discontinued treatment for any reason). We calculated risk ratios and did separate frequentist network meta-analyses by using random-effects models. The risk of bias of individual studies was assessed with the Cochrane risk-of-bias tool and the confidence in the evidence with the Confidence-In-Network-Meta-Analysis (CINeMA). This study was registered with PROSPERO, CRD42023392926.

Subject

Depressió psíquica, Medicaments, Metaanàlisi, Ressenyes sistemàtiques (Investigació mèdica), Antipsicòtics, Antidepressius

Subject (English)

Mental depression, Drugs, Meta-analysis, Systematic reviews (Medical research), Antipsychotic drugs, Antidepressants

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citation

OLIVA, Vincenzo, et al. Pharmacological treatments for psychotic depression: a systematic review and network meta-analysis. The Lancet Psychiatry. 2024. Vol. 11, num. 3, pags. 210-220. ISSN 2215-0366. [consulted: 17 of August of 2026]. Available at: https://hdl.handle.net/2445/209827

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