Primary outcomes were efficacy (response rate) and acceptability (treatment discontinuations due to any cause). We assessed the studies' risk of bias in accordance to the Cochrane Handbook for Systematic Reviews of Interventions, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. In network meta-analysis, we used group-level data. We extracted data following a predefined hierarchy. We excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression or patients with a serious concomitant medical illness. We included placebo-controlled and head-to-head trials of 21 antidepressants used for the acute treatment of adults (≥18 years old and of both sexes) with major depressive disorder diagnosed according to standard operationalised criteria. We searched Cochrane Central Register of Controlled Trials, CINAHL, Embase, LILACS database, MEDLINE, MEDLINE In-Process, PsycINFO, the websites of regulatory agencies, and international registers for published and unpublished, double-blind, randomised controlled trials from their inception to Jan 8, 2016. We did a systematic review and network meta-analysis.
#Porus 21 feb 2018 update#
Therefore, we aimed to update and expand our previous work to compare and rank antidepressants for the acute treatment of adults with unipolar major depressive disorder. Prescription of these agents should be informed by the best available evidence. Pharmacological and non-pharmacological treatments are available however, because of inadequate resources, antidepressants are used more frequently than psychological interventions. Major depressive disorder is one of the most common, burdensome, and costly psychiatric disorders worldwide in adults. 11 Department of Psychiatry, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.10 Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, and Department of Statistics, Stanford University, Stanford, CA, USA Meta-Research Innovation Center at Stanford, Stanford University, Stanford, CA, USA.9 School of Social and Community Medicine, University of Bristol, Bristol, UK.8 Behavioral Health and Neurosciences Division, VA Portland Health Care System, Portland, OR, USA Department of Psychiatry and Department Pharmacology, Oregon Health & Science University, Portland, OR, USA.7 Department of Psychiatry, University of Oxford, Oxford, UK Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.6 Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.5 Department of Psychiatry, University of Oxford, Oxford, UK Oxford Centre for Human Brain Activity, Department of Psychiatry, Warneford Hospital, Oxford, UK.
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4 School of Medicine, Paris Descartes University, Paris, France INSERM, UMR1153 Epidemiology and Statistics, Sorbonne Paris Cité Research Center, METHODS Team, Paris, France Cochrane France, Paris, France.3 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.Electronic address: 2 Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan. 1 Department of Psychiatry, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
#Porus 21 feb 2018 pdf#
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