Lithium or an atypical antipsychotic drug in the management of treatment resistant depression: a systematic review and economic evaluation

Edwards S, Hamilton V, Nherera L, Trevor N
Record ID 32011001128
English
Authors' objectives: To estimate the clinical effectiveness and cost-effectiveness of augmentation of selective serotonin reuptake inhibitor (SSRI) antidepressant therapy with either lithium or an AAP drug in the management of people with treatment-resistant unipolar depression, defined as failure to respond to two or more antidepressant drugs in their current episode of depression.
Authors' recommendations: Augmentation of SSRIs with lithium or AAP is likely to be beneficial in people with TRD. Clinical evaluation based on the limited evidence identified in this research indicates no statistically significant difference between the two augmentation strategies. Cost-effectiveness analyses suggest that augmentation with lithium is less expensive and more effective than augmentation with AAP. However, the uncertainty in the clinical estimates of discontinuation and treatment response is reflected in the model results. A RCT comparing the two augmentation strategies, reporting relevant outcomes, including QoL, is needed.
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/2599
Year Published: 2013
URL for published report: http://www.journalslibrary.nihr.ac.uk/hta/volume-17/issue-54
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Antidepressive Agents
  • Cost-Benefit Analysis
  • Depressive Disorder
  • Lithium Compounds
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: <p>2013 Queen's Printer and Controller of HMSO</p>
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