Comparative efficacy and acceptability of first-generation and second-generation antidepressants in the acute treatment of major depression: protocol for a network meta-analysis.
- Furukawa TA Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Salanti G Department of Clinical Research, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland Institute of Primary Health Care (BIHAM), University of Bern, Switzerland Department of Hygiene and Epidemiology, University of Ioannina, Ioannina, Greece.
- Atkinson LZ Department of Psychiatry, University of Oxford, Oxford, UK.
- Leucht S Department of Psychiatry and Psychotherapy, TU- Munich, Munchen, Germany.
- Ruhe HG Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands University Center for Psychiatry, University of Groningen, Groningen, The Netherlands.
- Turner EH Behavioral Health and Neurosciences Division, VA Portland Health Care System, Portland, Oregon, USA Departments of Psychiatry and Pharmacology, Oregon Health & Science University, Portland, Oregon, USA.
- Chaimani A Department of Hygiene and Epidemiology, University of Ioannina, Ioannina, Greece.
- Ogawa Y Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Takeshima N Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Hayasaka Y Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Imai H Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Shinohara K Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Suganuma A Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Watanabe N Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
- Stockton S Department of Psychiatry, University of Oxford, Oxford, UK.
- Geddes JR Department of Psychiatry, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
- Cipriani A Department of Psychiatry, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
- 2016-07-13
Published in:
- BMJ open. - 2016
Antidepressants
Major depression
Network meta-analysis
Systematic review
Antidepressive Agents
Antidepressive Agents, Second-Generation
Bayes Theorem
Depressive Disorder, Major
Humans
Network Meta-Analysis
Treatment Outcome
English
INTRODUCTION
Many antidepressants are indicated for the treatment of major depression. Two network meta-analyses have provided the most comprehensive assessments to date, accounting for both direct and indirect comparisons; however, these reported conflicting interpretation of results. Here, we present a protocol for a systematic review and network meta-analysis aimed at updating the evidence base and comparing all second-generation as well as selected first-generation antidepressants in terms of efficacy and acceptability in the acute treatment of major depression.
METHODS AND ANALYSIS
We will include all randomised controlled trials reported as double-blind and comparing one active drug with another or with placebo in the acute phase treatment of major depression in adults. We are interested in comparing the following active agents: agomelatine, amitriptyline, bupropion, citalopram, clomipramine, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, nefazodone, paroxetine, reboxetine, sertraline, trazodone, venlafaxine, vilazodone and vortioxetine. The main outcomes will be the proportion of patients who responded to or dropped out of the allocated treatment. Published and unpublished studies will be sought through relevant database searches, trial registries and websites; all reference selection and data extraction will be conducted by at least two independent reviewers. We will conduct a random effects network meta-analysis to synthesise all evidence for each outcome and obtain a comprehensive ranking of all treatments. To rank the various treatments for each outcome, we will use the surface under the cumulative ranking curve and the mean ranks. We will employ local as well as global methods to evaluate consistency. We will fit our model in a Bayesian framework using OpenBUGS, and produce results and various checks in Stata and R. We will also assess the quality of evidence contributing to network estimates of the main outcomes with the GRADE framework.
ETHICS AND DISSEMINATION
This review does not require ethical approval.
PROSPERO REGISTRATION NUMBER
CRD42012002291.
Many antidepressants are indicated for the treatment of major depression. Two network meta-analyses have provided the most comprehensive assessments to date, accounting for both direct and indirect comparisons; however, these reported conflicting interpretation of results. Here, we present a protocol for a systematic review and network meta-analysis aimed at updating the evidence base and comparing all second-generation as well as selected first-generation antidepressants in terms of efficacy and acceptability in the acute treatment of major depression.
METHODS AND ANALYSIS
We will include all randomised controlled trials reported as double-blind and comparing one active drug with another or with placebo in the acute phase treatment of major depression in adults. We are interested in comparing the following active agents: agomelatine, amitriptyline, bupropion, citalopram, clomipramine, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, nefazodone, paroxetine, reboxetine, sertraline, trazodone, venlafaxine, vilazodone and vortioxetine. The main outcomes will be the proportion of patients who responded to or dropped out of the allocated treatment. Published and unpublished studies will be sought through relevant database searches, trial registries and websites; all reference selection and data extraction will be conducted by at least two independent reviewers. We will conduct a random effects network meta-analysis to synthesise all evidence for each outcome and obtain a comprehensive ranking of all treatments. To rank the various treatments for each outcome, we will use the surface under the cumulative ranking curve and the mean ranks. We will employ local as well as global methods to evaluate consistency. We will fit our model in a Bayesian framework using OpenBUGS, and produce results and various checks in Stata and R. We will also assess the quality of evidence contributing to network estimates of the main outcomes with the GRADE framework.
ETHICS AND DISSEMINATION
This review does not require ethical approval.
PROSPERO REGISTRATION NUMBER
CRD42012002291.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1136/bmjopen-2015-010919
- PMID 27401359
- Persistent URL
- https://folia.unifr.ch/global/documents/241693
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