Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

233 questions · 238 findings · 13 reviews · Common Mental Disorders

No studies found 56 · 23.5%GRADE not reported 7 · 2.9%Very low 84 · 35.3%Low 62 · 26.1%Moderate 22 · 9.2%High 7 · 2.9%

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

Proportions of participants responding to treatment ≥ 50% reduction in depression score from baseline to end of treatment. A larger RR indicates greater response to treatment in the SAMe group · treatment‐resistant depression in adults

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60… showed no clear difference in response (≥50% reduction in MADRS score) compared with augmentation of current antidepressant (fluoxetine 20 mg/d to 60… (low certainty).

1 finding from 1 review

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

Response (> 50% improvement on 29‐item HAM‐D SIGH‐SAD) · treatment‐resistant depression in adults

Switching to mianserin (60 mg/d) showed no clear difference in response (≥ 50% improvement in HAM‐D score) compared with continuing on current antidepressant (fluoxetine 20 mg/d) (low certainty).

1 finding from 1 review

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

Remission ‐ not measured · treatment‐resistant depression in adults

The review found no eligible studies for this question.

1 finding from 1 review

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

Quality of life ‐ not measured · treatment‐resistant depression in adults

The review found no eligible studies for this question.

1 finding from 1 review

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

Dropouts ‐ Any dose · treatment‐resistant depression in adults

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).

1 finding from 1 review

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

Response (≥ 50% reduction in MADRS or HAM‐D score) ‐ Any dose · treatment‐resistant depression in adults

Augmentation of current antidepressant (various) with quetiapine… probably leads to higher response (≥ 50% reduction in MADRS or HAM‐D score) ‐ Any dose compared with augmentation of current antidepressant (various) with placebo (moderate certainty).

1 finding from 1 review

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

Remission · treatment‐resistant depression in adults

Augmentation of current antidepressant (various) with quetiapine… probably leads to higher remission (MADRS score ≤ 8/HAM‐D score ≤ 7) ‐ Any dose compared with augmentation of current antidepressant (various) with placebo (moderate certainty).

1 finding from 1 review

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

Dropouts ‐ Any dose · treatment‐resistant depression in adults

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).

1 finding from 1 review

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

Response (≥ 50% reduction in MADRS or HAM‐D score) ‐ Any dose · treatment‐resistant depression in adults

Augmentation of current antidepressant (SSRI) with ziprasidone (40… probably leads to higher response (≥ 50% reduction in MADRS/HAM‐D score) ‐ Any dose compared with augmentation of current antidepressant (SSRI) with placebo or… (moderate certainty).

1 finding from 1 review

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

Remission (HAM‐D total score ≤ 8) · treatment‐resistant depression in adults

Switching to mianserin (60 mg/d) showed no clear difference in remission (HAM‐D total score ≤ 8) compared with continuing on current antidepressant (fluoxetine 20 mg/d) (low certainty).

1 finding from 1 review

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

Remission · treatment‐resistant depression in adults

Augmentation of current antidepressant (SSRI) with ziprasidone (40… showed no clear difference in remission (clinician‐rated) ‐ Any dose compared with augmentation of current antidepressant (SSRI) with placebo or… (moderate certainty).

1 finding from 1 review

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

Quality of life ‐ not measured · treatment‐resistant depression in adults

The review found no eligible studies for this question.

1 finding from 1 review

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

Leaving the study early · treatment‐resistant depression in adults

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).

1 finding from 1 review

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

Proportions of participants responding to treatment ≥ 50% reduction in depression score from baseline to end of treatment. A larger RR indicates greater response to treatment in the SAMe group · treatment‐resistant depression in adults

Augmentation of current antidepressant (fluoxetine 20 mg/d) with… may leads to higher response (≥ 50% reduction in HAM‐D score) compared with augmentation of current antidepressant (fluoxetine 20 mg/d) with… (low certainty).

1 finding from 1 review

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

Remission · treatment‐resistant depression in adults

Augmentation of current antidepressant (fluoxetine 20 mg/d) with… may leads to higher remission (HAM‐D total score ≤ 7) compared with augmentation of current antidepressant (fluoxetine 20 mg/d) with… (low certainty).

1 finding from 1 review