What do systematic reviews say?

Antidepressants vs any other pharmacological intervention

It is very uncertain whether antidepressants changes treatment acceptability ‐dropouts compared with any other pharmacological intervention (very low certainty).

• Antidepressant treatment for postnatal depression 2021 · Cochrane Headline outcomes only
  RR 1.74 [0.99, 3.06]
  Studies not reported
  Very low

Augmentation of current antidepressant (SSRI/SNRI) with mirtazapine (30 mg/d) vs augmentation of current antidepressant (various) with placebo

Augmentation of current antidepressant (SSRI/SNRI) with mirtazapine… showed no clear difference in dropouts compared with augmentation of current antidepressant (SSRI/SNRI) therapy with… (high certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 0.5 [0.15, 1.62]
  1 study · 480 participants
  High

Augmentation of current antidepressant (SSRI) with busiprone (20 mg/d to 60 mg/d) vs placebo plus antidepressant

Augmentation of current antidepressant (SSRI) with busiprone (20… showed no clear difference in dropouts compared with augmentation of current antidepressant (SSRI) with placebo (low certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 0.6 [0.23, 1.53]
  1 study · 108 participants
  Low

Augmentation of current antidepressant (fluoxetine 20 mg/d) with mianserin (60 mg/d) vs placebo plus antidepressant

Augmentation of current antidepressant (fluoxetine 20 mg/d) with… showed no clear difference in dropouts compared with augmentation of current antidepressant (fluoxetine 20 mg/d) with… (low certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 1.02 [0.38, 2.72]
  1 study · 70 participants
  Low

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with olanzapine (5 mg/d to 20 mg/d) vs augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with placebo

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60… showed no clear difference in dropouts compared with augmentation of current antidepressant (fluoxetine 20 mg/d to 60… (low certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 0.33 [0.04, 2.69]
  1 study · 20 participants
  Low

Antidepressants vs antidepressants

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  Very low

Antidepressants vs placebo

It is very uncertain whether antidepressant changes overall dropouts compared with placebo (very low certainty).

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  RR 1.24 [0.34, 4.51]
  1 study · 27 participants
  Very low

Antidepressants vs antipsychotics

It is very uncertain whether antidepressant changes overall dropouts compared with antipsychotic (very low certainty).

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  RR 1.79 [0.18, 18.02]
  1 study · 36 participants
  Very low

Augmentation of current antidepressant (SSRI) with ziprasidone (40 mg/d to 160 mg/d) vs augmentation of current antidepressant (SSRI) with placebo or continue on SSRI monotherapy

Augmentation of current antidepressant (SSRI) with ziprasidone (40… probably leads to higher dropouts ‐ Any dose compared with augmentation of current antidepressant (SSRI) with placebo or… (moderate certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 1.6 [1.01, 2.55]
  2 studies · 199 participants
  Moderate

Augmentation of current antidepressant (various) with cariprazine (1 mg/d to 4.5 mg/d) vs augmentation of current antidepressant (various) with placebo

Augmentation of current antidepressant (various) with cariprazine (1… probably leads to higher dropouts ‐ any dose compared with augmentation of current antidepressant (various) with placebo (moderate certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 1.68 [1.16, 2.41]
  1 study · 821 participants
  Moderate

Augmentation of current antidepressant (various) with quetiapine (150 mg/d to 300 mg/d) vs augmentation of current antidepressant (various) with placebo

Augmentation of current antidepressant (various) with quetiapine… showed no clear difference in dropouts ‐ Any dose compared with augmentation of current antidepressant (various) with placebo (moderate certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 1.33 [0.9, 1.95]
  3 studies · 997 participants
  Moderate

Antidepressants vs antidepressants

The review found no eligible studies for this question.

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Antidepressants vs antipsychotics

The review found no eligible studies for this question.

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Antidepressants vs placebo

The review found no eligible studies for this question.

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Antidepressant plus antipsychotic vs placebo

It is very uncertain whether antidepressant plus antipsychotic changes overall dropouts compared with placebo (very low certainty).

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  RR 0.75 [0.48, 1.18]
  2 studies · 148 participants
  Very low

Antidepressant plus antipsychotic vs placebo/no adjunctive treatment + antipsychotics

It is very uncertain whether antidepressant plus antipsychotic changes overall dropouts compared with placebo plus antipsychotic (very low certainty).

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  RR 0.79 [0.63, 1.01]
  4 studies · 447 participants
  Very low

Antidepressant plus antipsychotic vs placebo plus antidepressant

It is very uncertain whether antidepressant plus antipsychotic changes overall dropouts compared with placebo plus antidepressant (very low certainty).

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  RR 0.91 [0.55, 1.5]
  4 studies · 245 participants
  Very low
• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  RR 1.04 [0.52, 2.07]
  3 studies · 157 participants
  Very low

Antidepressant plus antipsychotic vs placebo

The review found no eligible studies for this question.

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Antidepressant plus antipsychotic vs placebo/no adjunctive treatment + antipsychotics

The review found no eligible studies for this question.

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Antidepressant plus antipsychotic vs placebo plus antidepressant

The review found no eligible studies for this question.

• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found
• Pharmacological treatment for psychotic depression 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found