Cochrane · systematic review · CD008373
Pharmacological treatment for depression during opioid agonist treatment for opioid dependence
Pani, PP, Vacca, R, Trogu, E, et al. · Cochrane Database of Systematic Reviews · 2010 · Cochrane Library
Drugs and AlcoholAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
17
current version
GRADE rated
17
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 6 · 35.3%Moderate 8 · 47.1%High 3 · 17.6%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antidepressants compared to placebo according to any definition for depression during opioid agonist treatment for opioid dependence
Population: patients with depression during opioid agonist treatment for opioid dependence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dropout ‐ All studies objective Antidepressants vs placebo according to any definition | RR 1.15 [0.88, 1.51] | 6 studies · 406 participants | Low Downgraded: risk of bias, inconsistency |
Dropout ‐ Studies with low risk of bias Antidepressants vs placebo according to any definition | RR 1.4 [1, 1.96] | 4 studies · 325 participants | High |
Severity of depression dichotomous measures ‐ >50% reduction in depressive severity from baseline Antidepressants vs placebo according to any definition | RR 0.96 [0.54, 1.71] | 1 study · 95 participants | Low Downgraded: imprecision |
Severity of depression dichotomous measures ‐ "very much" or "much" improved on the Clinical Global Impression Scale Antidepressants vs placebo according to any definition | RR 1.92 [1.26, 2.94] | 2 studies · 183 participants | Low Downgraded: risk of bias |
Severity of depression continuous measures ‐ HDRS total score at the end of the treatment Antidepressants vs placebo according to any definition | no estimate extracted | 5 studies · 346 participants | Low Downgraded: risk of bias, inconsistency |
Adverse events ‐ Withdrawn for medical reasons Antidepressants vs placebo according to any definition | RR 2.9 [1.23, 6.86] | 4 studies · 311 participants | Moderate Downgraded: risk of bias, inconsistency |
Antidepressants compared to placebo for operationally defined depression for depression during opioid agonist treatment for opioid dependence
Population: patients with depression during opioid agonist treatment for opioid dependence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dropout Antidepressants vs placebo | RR 1.2 [0.88, 1.64] | 4 studies · 322 participants | Moderate Downgraded: risk of bias |
Severity of depression dichotomous measures ‐ "very much" or "much" improved on the Clinical Global Impression scale Antidepressants vs placebo | RR 2.03 [1.17, 3.53] | 1 study · 137 participants | Low Downgraded: imprecision |
Severity of depression dichotomous measures ‐ >50% reduction in depressive severity from baseline Antidepressants vs placebo | RR 0.96 [0.54, 1.71] | 1 study · 95 participants | Low Downgraded: imprecision |
Severity of depression continuous measures ‐ HDRS total score at the end of the treatment Antidepressants vs placebo | no estimate extracted | 3 studies · 276 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse events ‐ Withdrawn for medical reasons Antidepressants vs placebo | RR 3.03 [1.2, 7.68] | 3 studies · 276 participants | Moderate Downgraded: risk of bias, imprecision |
Different class of antidepressant for depression during opioid agonist treatment for opioid dependence
Population: patients with depression during opioid agonist treatment for opioid dependence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Drupout ‐ Tricyclics versus placebo | RR 1.01 [0.74, 1.37] | 3 studies · 218 participants | Moderate Downgraded: risk of bias |
Drupout ‐ SSRI versus placebo | RR 1.53 [0.91, 2.56] | 3 studies · 188 participants | Moderate Downgraded: risk of bias |
Severity of depression dichotomous measures ‐ Tricyclics versus placebo: "very much" or "much" improvement on the Clinical Global Impression scale | RR 1.92 [1.26, 2.94] | 2 studies · 183 participants | Moderate Downgraded: risk of bias |
Severity of depression continuous measures ‐ HDRS total score at the end of the treatment: Tricyclics versus placebo | no estimate extracted | 3 studies · 207 participants | Moderate Downgraded: risk of bias |
Adverse events ‐ Withdrawn for medical reasons: Tricyclics versus placebo | RR 3.11 [1.06, 9.12] | 2 studies · 172 participants | High |
Adverse events ‐ Withdrawn for medical reasons: SSRI versus placebo | RR 2.55 [0.61, 10.75] | 2 studies · 139 participants | High |