Abstract
Introduction: Major Depressive Disorder (MDD) is a common debilitating illness worldwide. The vast majority of patients with MDD will not achieve remission with first-line treatment and despite the availability of different treatment modalities, at least one-third of patients experience treatment-resistant depression (TRD). There continues to be a paucity of research focused on treatment options for patients with TRD thus treatment decisions are largely based on patient and clinician preference as opposed to evidence-based practice. Herein we propose a systematic review and network meta-analysis of available pharmacological and psychological augmentation treatments for TRD, to inform evidence-based management of TRD.
Methods and analysis: We plan to conduct a search of electronic databases (MEDLINE and ISIWEB) of all dates from inception for randomized controlled trials of pharmacological and psychological augmentation interventions for adults with TRD. Articles for review will be included based upon consensus from two authors. Pharmaceutical companies will be contacted for access to any unpublished data. A network meta-analysis will compare the effectiveness pharmacological adjunctive agents for TRD using a pre-post analysis, assuming consistency and transitivity. The protocol has been registered with PROSPERO: CRD42019132588
Ethics and Dissemination: This project does not require research ethics board approval. The dissemination plan is to present findings at international scientific meetings and publishing results in a peer-reviewed academic journal.
Strengths and Limitations of the study:
• This will be the most comprehensive review of published and unpublished data of pharmacological and psychological augmentation treatments for TRD.
• The results will provide the highest level of evidence to inform clinicians on the best choice of treatment from among the available pharmacological and psychological interventions for TRD.
• The reporting of the protocol has been guided by PRISMA and has been registered with International Prospective Register of Systematic Reviews.
• The study does not include brain stimulation interventions and trials of agents used as monotherapy.
Methods and analysis: We plan to conduct a search of electronic databases (MEDLINE and ISIWEB) of all dates from inception for randomized controlled trials of pharmacological and psychological augmentation interventions for adults with TRD. Articles for review will be included based upon consensus from two authors. Pharmaceutical companies will be contacted for access to any unpublished data. A network meta-analysis will compare the effectiveness pharmacological adjunctive agents for TRD using a pre-post analysis, assuming consistency and transitivity. The protocol has been registered with PROSPERO: CRD42019132588
Ethics and Dissemination: This project does not require research ethics board approval. The dissemination plan is to present findings at international scientific meetings and publishing results in a peer-reviewed academic journal.
Strengths and Limitations of the study:
• This will be the most comprehensive review of published and unpublished data of pharmacological and psychological augmentation treatments for TRD.
• The results will provide the highest level of evidence to inform clinicians on the best choice of treatment from among the available pharmacological and psychological interventions for TRD.
• The reporting of the protocol has been guided by PRISMA and has been registered with International Prospective Register of Systematic Reviews.
• The study does not include brain stimulation interventions and trials of agents used as monotherapy.
| Original language | English |
|---|---|
| Article number | e028538 |
| Pages (from-to) | 1-5 |
| Journal | BMJ Open |
| Volume | 9 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 14 May 2019 |
Keywords
- adult psychiatry
- clinical pharmacology