PECULIARITIES OF STUDYING THE EFFICACY OF ANTIDEPRESSANTS BASED ON META-ANALYZES
DOI:
https://doi.org/10.11603/1681-2786.2021.4.12862Keywords:
efficacy of antidepressants, depression, meta-analyzes, depressive episodeAbstract
Purpose: to explore the features of existing research on the efficacy of antidepressants over the past decade, the possibility of randomized controlled trials, the limitations of scales for assessing depression and factors in clinical practice.
Materials and Methods. Databases PubMed, MedLine, EMBASE, CINAHL, PsycINFO were used. The search included publications up to 2020. The studies were included provided that they met all of the following criteria: studies over the past ten years which are only relevant, parallel, double-blind, placebo-controlled studies of antidepressants aimed at identifying the therapeutic effect of different groups of antidepressants.
Results. Network meta-analysis of data on the comparative efficacy of antidepressants provides an opportunity to summarize and interpret the evidence base, as well as to understand the relative benefits of a drug. In terms of efficacy, all antidepressants were more effective than placebo. Some antidepressants, such as escitalopram, mirtazapine, paroxetine, and agomelatine, show a more significant response to therapy and a lower rate of early discontinuation than other antidepressants. Conversely, reboxetine, trazodone, and fluvoxamine were less effective and less tolerated than other antidepressants, making them less desirable drugs. Evaluations of the effect of therapy in the study of A. Cipriani et al. are consistent with previous reviews on the same topic, but it is much more accurate, as a large amount of data provides statistical significance.
Conclusions. It is obvious that in the analyzed works similar results of a high degree of provability are received. At the same time, attention should be paid to some of the limitations of the work that lead to further research. Thus, despite the limitations, the data of the above network meta-analyzes are the most complete evidence base for the selection of the first drug for the treatment of depressive episode in adults. Such data are consistent with the numerous results of the drug in real clinical practice.
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