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Antidepressants for depression in physically ill people
Lauren Rayner1, Annabel Price, Alison Evans
1Department of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, Denmark Hill, London, UK, SE5 9PJ.
The Cochrane Database of Systematic Reviews
|March 19, 2010
Summary
Antidepressants effectively treat depression in patients with physical illnesses, showing superior results compared to placebo. However, potential biases may exaggerate these findings, necessitating further research into specific antidepressant efficacy and acceptability.
Area of Science:
- Clinical Medicine
- Psychiatry
- Pharmacology
Background:
- Depression frequently co-occurs with physical illnesses, negatively impacting patient outcomes.
- Antidepressant efficacy in physically ill populations requires further investigation.
- Previous reviews indicated antidepressant effectiveness, prompting an update with newer trial data.
Purpose of the Study:
- To evaluate the efficacy of antidepressant medications for treating depression in individuals with co-existing physical conditions.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searches included major databases and trial registers up to December 2009.
- Efficacy assessed at multiple time points; acceptability and tolerability evaluated via dropout rates and adverse events.
Main Results:
- Fifty-one studies with 3603 participants were included; 44 contributed to efficacy analysis.
- Antidepressants demonstrated significantly higher efficacy than placebo at 6-8 weeks (OR 2.33, p<0.00001).
- Higher dropout rates and side effects like dry mouth and sexual dysfunction were noted with antidepressants.
Conclusions:
- Antidepressants are more effective than placebo for depression in physical illness.
- Publication and reporting biases may inflate observed effect sizes.
- Further research is needed to compare specific antidepressants and their acceptability in this patient group.
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