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Pharmacological augmentation in unipolar depression: a guide to the guidelines

Research output: Contribution to journalReview article

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Pharmacological augmentation in unipolar depression: a guide to the guidelines. / Taylor, Rachael; Marwood, Lindsey; Oprea, Emanuella; De Angel, Valeria; Mather, Sarah; Valentini, Beatrice; Zahn, Roland; Young, Allan; Cleare, Anthony.

In: International Journal of Neuropsychopharmacology, 13.05.2020.

Research output: Contribution to journalReview article

Harvard

Taylor, R, Marwood, L, Oprea, E, De Angel, V, Mather, S, Valentini, B, Zahn, R, Young, A & Cleare, A 2020, 'Pharmacological augmentation in unipolar depression: a guide to the guidelines', International Journal of Neuropsychopharmacology.

APA

Taylor, R., Marwood, L., Oprea, E., De Angel, V., Mather, S., Valentini, B., ... Cleare, A. (2020). Pharmacological augmentation in unipolar depression: a guide to the guidelines. International Journal of Neuropsychopharmacology.

Vancouver

Taylor R, Marwood L, Oprea E, De Angel V, Mather S, Valentini B et al. Pharmacological augmentation in unipolar depression: a guide to the guidelines. International Journal of Neuropsychopharmacology. 2020 May 13.

Author

Taylor, Rachael ; Marwood, Lindsey ; Oprea, Emanuella ; De Angel, Valeria ; Mather, Sarah ; Valentini, Beatrice ; Zahn, Roland ; Young, Allan ; Cleare, Anthony. / Pharmacological augmentation in unipolar depression: a guide to the guidelines. In: International Journal of Neuropsychopharmacology. 2020.

Bibtex Download

@article{dc1efc6275bf4654a3d803be5245ed2d,
title = "Pharmacological augmentation in unipolar depression: a guide to the guidelines",
abstract = "Background: Pharmacological augmentation is a recommended strategy for patients with treatment-resistant depression (TRD). A range of guidelines provide advice on treatment selection, prescription, monitoring and discontinuation, but variation in the content and quality of guidelines may limit the provision of objective, evidence-based care. This is of importance given the side effect burden and poorer long-term outcomes associated with polypharmacy and TRD. This review provides a definitive overview of pharmacological augmentation recommendations by assessing the quality of guidelines for depression and comparing the recommendations made. Methods: A systematic literature search identified current treatment guidelines for depression published in English. Guidelines were quality assessed using the AGREE II tool. Data relating to the prescription of pharmacological augmenters were extracted from those developed with sufficient rigour, and the included recommendations compared. Results: 1696 records were identified, 19 guidelines were assessed for quality, and 10 were included. Guidelines differed in their quality, the stage at which augmentation was recommended, the agents included, and the evidence base cited. Lithium and atypical antipsychotics were recommended by all 10, though the specific advice was not consistent. Of the 15 augmenters identified, no others were universally recommended. Conclusions: This review provides a comprehensive overview of current pharmacological augmentation recommendations for major depression and will support clinicians in selecting appropriate treatment guidance. Although some variation can be accounted for by date of guideline publication, and limited evidence from clinical trials, there is a clear need for greater consistency across guidelines to ensure patients receive consistent evidence-based care.",
author = "Rachael Taylor and Lindsey Marwood and Emanuella Oprea and {De Angel}, Valeria and Sarah Mather and Beatrice Valentini and Roland Zahn and Allan Young and Anthony Cleare",
year = "2020",
month = "5",
day = "13",
language = "English",
journal = "International Journal of Neuropsychopharmacology",
issn = "1461-1457",
publisher = "Oxford University Press",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Pharmacological augmentation in unipolar depression: a guide to the guidelines

AU - Taylor, Rachael

AU - Marwood, Lindsey

AU - Oprea, Emanuella

AU - De Angel, Valeria

AU - Mather, Sarah

AU - Valentini, Beatrice

AU - Zahn, Roland

AU - Young, Allan

AU - Cleare, Anthony

PY - 2020/5/13

Y1 - 2020/5/13

N2 - Background: Pharmacological augmentation is a recommended strategy for patients with treatment-resistant depression (TRD). A range of guidelines provide advice on treatment selection, prescription, monitoring and discontinuation, but variation in the content and quality of guidelines may limit the provision of objective, evidence-based care. This is of importance given the side effect burden and poorer long-term outcomes associated with polypharmacy and TRD. This review provides a definitive overview of pharmacological augmentation recommendations by assessing the quality of guidelines for depression and comparing the recommendations made. Methods: A systematic literature search identified current treatment guidelines for depression published in English. Guidelines were quality assessed using the AGREE II tool. Data relating to the prescription of pharmacological augmenters were extracted from those developed with sufficient rigour, and the included recommendations compared. Results: 1696 records were identified, 19 guidelines were assessed for quality, and 10 were included. Guidelines differed in their quality, the stage at which augmentation was recommended, the agents included, and the evidence base cited. Lithium and atypical antipsychotics were recommended by all 10, though the specific advice was not consistent. Of the 15 augmenters identified, no others were universally recommended. Conclusions: This review provides a comprehensive overview of current pharmacological augmentation recommendations for major depression and will support clinicians in selecting appropriate treatment guidance. Although some variation can be accounted for by date of guideline publication, and limited evidence from clinical trials, there is a clear need for greater consistency across guidelines to ensure patients receive consistent evidence-based care.

AB - Background: Pharmacological augmentation is a recommended strategy for patients with treatment-resistant depression (TRD). A range of guidelines provide advice on treatment selection, prescription, monitoring and discontinuation, but variation in the content and quality of guidelines may limit the provision of objective, evidence-based care. This is of importance given the side effect burden and poorer long-term outcomes associated with polypharmacy and TRD. This review provides a definitive overview of pharmacological augmentation recommendations by assessing the quality of guidelines for depression and comparing the recommendations made. Methods: A systematic literature search identified current treatment guidelines for depression published in English. Guidelines were quality assessed using the AGREE II tool. Data relating to the prescription of pharmacological augmenters were extracted from those developed with sufficient rigour, and the included recommendations compared. Results: 1696 records were identified, 19 guidelines were assessed for quality, and 10 were included. Guidelines differed in their quality, the stage at which augmentation was recommended, the agents included, and the evidence base cited. Lithium and atypical antipsychotics were recommended by all 10, though the specific advice was not consistent. Of the 15 augmenters identified, no others were universally recommended. Conclusions: This review provides a comprehensive overview of current pharmacological augmentation recommendations for major depression and will support clinicians in selecting appropriate treatment guidance. Although some variation can be accounted for by date of guideline publication, and limited evidence from clinical trials, there is a clear need for greater consistency across guidelines to ensure patients receive consistent evidence-based care.

M3 - Review article

JO - International Journal of Neuropsychopharmacology

JF - International Journal of Neuropsychopharmacology

SN - 1461-1457

ER -

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