What do systematic reviews say?

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

Switching to mianserin (60 mg/d) vs continuing on current antidepressant (fluoxetine 20 mg/d)

Switching to mianserin (60 mg/d) showed no clear difference in dropouts compared with continuing on current antidepressant (fluoxetine 20 mg/d) (low certainty).

• Pharmacological interventions for treatment‐resistant depression in adults 2019 · Cochrane Headline outcomes only
  RR 2.08 [0.94, 4.59]
  1 study · 72 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

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 (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

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

Psychological therapies vs other antidepressants

All psychological therapies showed no clear difference in dropouts for any reason compared with other antidepressants (low certainty).

• Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults 2016 · Cochrane Headline outcomes only
  RR 1.55 [0.91, 2.65]
  3 studies · 180 participants
  Low

Psychological therapies vs benzodiazepines

It is very uncertain whether all psychological therapies changes dropouts for any reason compared with benzodiazepines (very low certainty).

• Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults 2016 · Cochrane Headline outcomes only
  RR 1.12 [0.54, 2.36]
  3 studies · 116 participants
  Very low

Psychological therapies vs antidepressants alone or antidepressants and benzodiazepines

It is very uncertain whether all psychological therapies changes dropouts for any reason compared with antidepressants alone or antidepressants and benzodiazepines (very low certainty).

• Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults 2016 · Cochrane Headline outcomes only
  RR 1.08 [0.77, 1.51]
  13 studies · 909 participants
  Very low

Psychological therapies vs SSRI

All psychological therapies showed no clear difference in dropouts for any reason compared with SSRI (low certainty).

• Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults 2016 · Cochrane Headline outcomes only
  RR 1.33 [0.8, 2.22]
  6 studies · 334 participants
  Low

Psychological therapies vs tricyclic antidepressants (TCAs)

All psychological therapies showed no clear difference in dropouts for any reason compared with tricyclic antidepressants (low certainty).

• Psychological therapies versus pharmacological interventions for panic disorder with or without agoraphobia in adults 2016 · Cochrane Headline outcomes only
  RR 0.83 [0.53, 1.3]
  5 studies · 430 participants
  Low

Escitalopram vs placebo

• Early pharmacological interventions for prevention of post‐traumatic stress disorder (PTSD) in individuals… 2024 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 31 participants
  Very low

Hydrocortisone vs placebo

Hydrocortisone showed no clear difference in dropouts due to adverse events at 3 months compared with placebo (low certainty).

• Early pharmacological interventions for prevention of post‐traumatic stress disorder (PTSD) in individuals… 2024 · Cochrane Headline outcomes only
  RR 3.19 [0.13, 75.43]
  2 studies · 182 participants
  Low