Cochrane · systematic review · CD010682
Antidepressants for people with epilepsy and depression
Maguire, MJ, Marson, AG, Nevitt, SJ · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
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
42
current version
GRADE rated
21
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 21 · 50%Very low 5 · 11.9%Low 9 · 21.4%Moderate 7 · 16.7%High 0 · 0%
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
Current version onlyParoxetine compared to doxepin for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Paroxetine vs doxepin | RR 1.16 [0.88, 1.52] | 1 study · 67 participants | Moderate Downgraded: imprecision |
Mean depression scores (HAMD scores; lower = better) Paroxetine vs doxepin | no estimate extracted | 1 study · 67 participants | Moderate Downgraded: imprecision |
Seizure frequency Paroxetine vs doxepin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawals Paroxetine vs doxepin | RR 0.15 [0.01, 2.74] | 1 study · 67 participants | Moderate Downgraded: imprecision |
Cognitive functioning Paroxetine vs doxepin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life Paroxetine vs doxepin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects Paroxetine vs doxepin | no estimate extracted | 1 study · 67 participants | Moderate Downgraded: imprecision |
Amitriptyline compared to nomifensine for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Amitriptyline vs nomifensine | RR 0.55 [0.28, 1.06] | 1 study · 28 participants | Low Downgraded: imprecision |
Mean depression scores Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Seizure frequency Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawals Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Cognitive functioning Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Venlafaxine compared to no treatment for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Venlafaxine vs no treatment | RR 3.25 [1.19, 8.9] | 1 study · 64 participants | Low Downgraded: risk of bias, imprecision |
Mean depression scores (HAMD scores; lower = better) Venlafaxine vs no treatment | no estimate extracted | 1 study · 64 participants | Low Downgraded: risk of bias, imprecision |
Seizure frequency Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawals Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Cognitive functioning Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Sertraline compared to cognitive behavioural therapy for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Sertraline vs cognitive behavioural therapy | no estimate extracted | 0 studies · 0 participants | Ungraded |
Mean depression scores (BDI scores; lower = better) Sertraline vs cognitive behavioural therapy | no estimate extracted | 1 study · 117 participants | Moderate Downgraded: risk of bias |
Seizure frequency Sertraline vs cognitive behavioural therapy | no estimate extracted | 1 study · 96 participants | Low Downgraded: risk of bias, imprecision |
Withdrawals Sertraline vs cognitive behavioural therapy | RR 1.26 [0.64, 2.46] | 1 study · 140 participants | Moderate Downgraded: risk of bias |
Cognitive functioning Sertraline vs cognitive behavioural therapy | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life (QOLIE‐89 scale; lower = better) Sertraline vs cognitive behavioural therapy | no estimate extracted | 1 study · 118 participants | Moderate Downgraded: risk of bias |
Adverse effects Sertraline vs cognitive behavioural therapy | no estimate extracted | 1 study · 118 participants | Low Downgraded: risk of bias |
Citalopram (before and after treatment) for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms | no estimate extracted | 45 participants | Low Downgraded: risk of bias |
Mean depression scores (HAMD scores; lower = better) | no estimate extracted | 88 participants | Low Downgraded: risk of bias, inconsistency |
Seizure frequency | no estimate extracted | 88 participants | Very low Downgraded: risk of bias, inconsistency |
Withdrawals | no estimate extracted | 88 participants | Low Downgraded: risk of bias |
Cognitive functioning | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects | no estimate extracted | 88 participants | Low Downgraded: risk of bias |
Selective serotonin reuptake inhibitors compared to cognitive behavioural therapy for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Selective serotonin reuptake inhibitors vs cognitive behavioural therapy | no estimate extracted | 0 studies · 0 participants | Ungraded |
Mean depression scores (BDI scores; lower = better) Selective serotonin reuptake inhibitors vs cognitive behavioural therapy | no estimate extracted | 15 participants | Very low Downgraded: risk of bias, imprecision |
Seizure frequency Selective serotonin reuptake inhibitors vs cognitive behavioural therapy | no estimate extracted | 15 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals Selective serotonin reuptake inhibitors vs cognitive behavioural therapy | RR 0.44 [0.05, 3.85] | 15 participants | Very low Downgraded: risk of bias, imprecision |
Cognitive functioning Selective serotonin reuptake inhibitors vs cognitive behavioural therapy | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life ‐ QOLIE‐31 scale Selective serotonin reuptake inhibitors vs cognitive behavioural therapy | no estimate extracted | 15 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects ‐ adverse event profile Selective serotonin reuptake inhibitors vs cognitive behavioural therapy | no estimate extracted | 0 studies · 0 participants | Ungraded |
Paroxetine compared to doxepin for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Paroxetine vs doxepin | RR 1.16 [0.88, 1.52] | 1 study · 67 participants | Moderate Downgraded: imprecision |
Mean depression scores ‐ HAMD scores Paroxetine vs doxepin | no estimate extracted | 1 study · 67 participants | Moderate Downgraded: imprecision |
Seizure frequency Paroxetine vs doxepin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawals (specific reasons) Paroxetine vs doxepin | RR 0.15 [0.01, 2.74] | 1 study · 67 participants | Moderate Downgraded: imprecision |
Cognitive functioning Paroxetine vs doxepin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life Paroxetine vs doxepin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects Paroxetine vs doxepin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Amitriptyline compared to nomifensine for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Amitriptyline vs nomifensine | RR 0.55 [0.28, 1.06] | 1 study · 28 participants | Moderate Downgraded: imprecision |
Seizure frequency Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawals Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Cognitive functioning Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects Amitriptyline vs nomifensine | no estimate extracted | 0 studies · 0 participants | Ungraded |
Venlafaxine compared to no treatment for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
> 50% reduction in depressive symptoms Venlafaxine vs no treatment | RR 3.25 [1.19, 8.9] | 1 study · 64 participants | Moderate Downgraded: imprecision |
Mean depression scores ‐ HAMD Venlafaxine vs no treatment | no estimate extracted | 1 study · 64 participants | Moderate Downgraded: imprecision |
Seizure frequency Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawals Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Cognitive functioning Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects Venlafaxine vs no treatment | no estimate extracted | 0 studies · 0 participants | Ungraded |
Citalopram (before and after) for people with epilepsy and depression
Population: people with epilepsy and depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean depression scores ‐ HAMD | no estimate extracted | 2 studies · 88 participants | Low Downgraded: risk of bias |
Mean monthly seizure frequency | no estimate extracted | 2 studies · 88 participants | Very low Downgraded: risk of bias, inconsistency |