Nonpharmacological versus pharmacological treatments for adult patients with major depressive disorder
Gartlehner G, Gaynes BN, Amick HR, Asher G, Morgan LC, CokerSchwimmer E, Forneris C, Boland E, Lux LJ, Gaylord S, Bann C, Pierl CB, Lohr KN
Record ID 32015001215
English
Authors' objectives:
To compare the benefits and harms of second-generation antidepressants (SGAs), psychological, complementary and alternative medicine, and exercise treatment options as firststep interventions for adult outpatients with acute-phase major depressive disorder (MDD), and as second-step interventions for patients with MDD who did not achieve remission after a first treatment attempt with SGAs.
Authors' recommendations:
Overall, the available evidence indicates that SGAs and CBT do not differ significantly in symptomatic relief as first-step treatments for adult outpatients with moderate to severe MDD. SGAs, in general, lead to a higher risk of adverse events than nonpharmacological treatment options. The evidence is insufficient to form conclusions about differences in serious adverse events, such as suicidal ideas and behavior. Given comparable effectiveness, the choice of the initial treatment of MDD should consider results of previous treatments, patient preferences, and feasibility (e.g., costs, likely adherence, and availability) following a discussion of the advantages and disadvantages of each treatment option, including risks of particular adverse effects and potential drug interactions. Such shared and informed decisionmaking might enhance treatment adherence and improve treatment outcomes for patients with MDD, especially because treatment continuity is one of the main challenges in treating such patients.
Details
Project Status:
Completed
Year Published:
2015
URL for published report:
http://www.effectivehealthcare.ahrq.gov/ehc/products/568/2155/major-depressive-disorder-report-151202.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Humans
- Adult
- Depressive Disorder, Major
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.