Pharmacological treatments for psychotic depression: a systematic review and network meta-analysis
Analysis of 16 RCTs (n=1161) found combination of SSRI and 2nd-generation antipsychotic (particularly fluoxetine and olanzapine) to be an optimal treatment, with a greater treatment response vs placebo (risk ratio 1.91, CI 1.27–2.85). Combined treatment outperformed monotherapies
Source:
The Lancet Psychiatry
SPS commentary:
A commentary considered the implications of the meta-analysis findings for clinical practice, including in different patient groups, along with possible limitations of the research. Authors acknowledge that this is a challenging condition to treat with limited evidence to guide on choice of pharmacological agents. Electroconvulsive therapy (ECT) is a recognised treatment but for various reasons, including patient choice, pharmacotherapy is often used instead. This is the first meta-analytic evidence to inform the choice of specific drugs for the treatment of psychotic depression.