Articles related to ANTIDEPRESSANTS

Aripiprazole supplementation of existing antidepressants in older adults with treatment-resistant depression significantly improved wellbeing over 10 weeks compared to switching to bupropion, and it was also associated with a numerically higher incidence of remission. Changes in wellbeing and the occurrence of remission with lithium augmentation or a switch to nortriptyline were comparable among patients in whom augmentation or a switch to bupropion failed.

The updated guidelines recommend, in brief:

The analysis found similar benefits for most nonpharmacologic treatments and antidepressants as first-step treatments in MDD. As 1st-line therapy, cognitive behavioral therapies (CBTs) were similar in response to second-generation antidepressants (SGAs) in terms of benefit and remission rates, but discontinuation for adverse events was higher with SGAs. The complementary and alternative medicine interventions St. Johns Wart and acupuncture were also similar to SGAs in terms of response and remission. However, the combination of acupuncture and SGAs yielded higher remission rates. Exercise was also similar to SGAs in remission rates; adding exercise to SGAs gave no added benefit. Antidepressants had a higher risk of discontinuation because of adverse events. For second-step therapies, different switching and augmentation strategies provided similar symptomatic relief.

In an analysis of 26 reviews covering 8 antidepressant classes and 22 pain conditions, no review provided a high level of evidence for the effectiveness of antidepressants for chronic pain. The strongest evidence may be for SNRIs for back pain, postoperative pain, neuropathic pain, and fibromyalgia.

Clinically significant anxiolytic and antidepressant benefits were seen in anxious depression patients after TMS in all samples, with average reductions in GAD-7 and PHQ-9 scores of 50% or more. The PHQ-9 scores for both the anxious and nonanxious depression groups improved equally. The worried group, however, scored higher both at the beginning of the study and after TMS, leading to significantly lower categorical rates of response and remission in depressive symptoms. The shift in anxiety and depressive symptoms substantially correlated among individuals who had anxious depression.

This meta analysis of antidepressants in MDD included 34 double-blind, randomized, placebo-controlled studies covering 20 antidepressants. Outcomes were 6-month relapse rates and tolerability measures. Fourteen of the agents had better relapse rates than placebo. Four — desvenlafaxine, paroxetine, venlafaxine, and vortioxetine — displayed the best efficacy and tolerability.