Effects of antidepressant medicines on preventing relapse of unipolar depression: a pooled analysis of parametric survival curves.

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Title: Effects of antidepressant medicines on preventing relapse of unipolar depression: a pooled analysis of parametric survival curves.
Authors: Zhou, Dongdong, Lv, Zhen, Shi, Lei, Zhou, Xiaoxin, Lin, Qingxia, Chen, Xiaorong, Wan, Liyang, Li, Yao, Ran, Liuyi, Huang, Yan, Wang, Gaomao, Li, Daqi, Wang, Wo, Liu, Chuan, Kuang, Li
Source: Psychological Medicine. Jan2022, Vol. 52 Issue 1, p48-56. 9p.
Subjects: Prevention of mental depression, Disease relapse prevention, Antidepressants, Statistics, Patient aftercare, Experimental design, Randomized controlled trials, Placebos, Descriptive statistics, Data analysis, Probability theory
Abstract: Background: Major depressive disorder is characterized by a high risk of relapse. We aimed to compare the prophylactic effects of different antidepressant medicines (ADMs). Methods: PubMed, Cochrane Central Register of Controlled Trials, Embase and the Web of Science were searched on 4 July 2019. A pooled analysis of parametric survival curves was performed using a Bayesian framework. The main outcomes were hazard ratios (HRs), relapse-free survival and mean relapse-free months. Results: Forty randomized controlled trials were included. The 1-year relapse-free survival for ADM (76%) was significantly better than that for placebo (56%). Most of the relapse difference (86.5%) occurred in the first 6 months. Most HRs were not constant over time. Proof of benefit after 6 months of follow-up was not established partially because of small differences between the drug and placebo after 6 months. Almost all studies used an 'enriched' randomized discontinuation design, which may explain the high relapse rates in the first 6 months after randomization. Conclusions: The superiority of ADM v. placebo was mainly attributed to the difference in relapse rates that occurred in the first 6 months. Our analysis provided evidence that the prophylactic efficacy was not constant over time. A beneficial effect was observed, but the prevention of new episodes after 6 months was questionable. These findings may have implications for clinical practice. [ABSTRACT FROM AUTHOR]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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Items – Name: Title
  Label: Title
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  Data: Effects of antidepressant medicines on preventing relapse of unipolar depression: a pooled analysis of parametric survival curves.
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  Data: <searchLink fieldCode="AR" term="%22Zhou%2C+Dongdong%22">Zhou, Dongdong</searchLink><br /><searchLink fieldCode="AR" term="%22Lv%2C+Zhen%22">Lv, Zhen</searchLink><br /><searchLink fieldCode="AR" term="%22Shi%2C+Lei%22">Shi, Lei</searchLink><br /><searchLink fieldCode="AR" term="%22Zhou%2C+Xiaoxin%22">Zhou, Xiaoxin</searchLink><br /><searchLink fieldCode="AR" term="%22Lin%2C+Qingxia%22">Lin, Qingxia</searchLink><br /><searchLink fieldCode="AR" term="%22Chen%2C+Xiaorong%22">Chen, Xiaorong</searchLink><br /><searchLink fieldCode="AR" term="%22Wan%2C+Liyang%22">Wan, Liyang</searchLink><br /><searchLink fieldCode="AR" term="%22Li%2C+Yao%22">Li, Yao</searchLink><br /><searchLink fieldCode="AR" term="%22Ran%2C+Liuyi%22">Ran, Liuyi</searchLink><br /><searchLink fieldCode="AR" term="%22Huang%2C+Yan%22">Huang, Yan</searchLink><br /><searchLink fieldCode="AR" term="%22Wang%2C+Gaomao%22">Wang, Gaomao</searchLink><br /><searchLink fieldCode="AR" term="%22Li%2C+Daqi%22">Li, Daqi</searchLink><br /><searchLink fieldCode="AR" term="%22Wang%2C+Wo%22">Wang, Wo</searchLink><br /><searchLink fieldCode="AR" term="%22Liu%2C+Chuan%22">Liu, Chuan</searchLink><br /><searchLink fieldCode="AR" term="%22Kuang%2C+Li%22">Kuang, Li</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. Jan2022, Vol. 52 Issue 1, p48-56. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Prevention+of+mental+depression%22">Prevention of mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse+prevention%22">Disease relapse prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Antidepressants%22">Antidepressants</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+aftercare%22">Patient aftercare</searchLink><br /><searchLink fieldCode="DE" term="%22Experimental+design%22">Experimental design</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Placebos%22">Placebos</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Probability+theory%22">Probability theory</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Major depressive disorder is characterized by a high risk of relapse. We aimed to compare the prophylactic effects of different antidepressant medicines (ADMs). Methods: PubMed, Cochrane Central Register of Controlled Trials, Embase and the Web of Science were searched on 4 July 2019. A pooled analysis of parametric survival curves was performed using a Bayesian framework. The main outcomes were hazard ratios (HRs), relapse-free survival and mean relapse-free months. Results: Forty randomized controlled trials were included. The 1-year relapse-free survival for ADM (76%) was significantly better than that for placebo (56%). Most of the relapse difference (86.5%) occurred in the first 6 months. Most HRs were not constant over time. Proof of benefit after 6 months of follow-up was not established partially because of small differences between the drug and placebo after 6 months. Almost all studies used an 'enriched' randomized discontinuation design, which may explain the high relapse rates in the first 6 months after randomization. Conclusions: The superiority of ADM v. placebo was mainly attributed to the difference in relapse rates that occurred in the first 6 months. Our analysis provided evidence that the prophylactic efficacy was not constant over time. A beneficial effect was observed, but the prevention of new episodes after 6 months was questionable. These findings may have implications for clinical practice. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1017/S0033291720001610
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        Text: English
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        PageCount: 9
        StartPage: 48
    Subjects:
      – SubjectFull: Prevention of mental depression
        Type: general
      – SubjectFull: Disease relapse prevention
        Type: general
      – SubjectFull: Antidepressants
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      – SubjectFull: Statistics
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      – SubjectFull: Patient aftercare
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      – SubjectFull: Experimental design
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      – SubjectFull: Randomized controlled trials
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      – SubjectFull: Placebos
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Data analysis
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      – SubjectFull: Probability theory
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      – TitleFull: Effects of antidepressant medicines on preventing relapse of unipolar depression: a pooled analysis of parametric survival curves.
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              Text: Jan2022
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              Y: 2022
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