Specificity profile of paroxetine in major depressive disorder: meta-regression of double-blind, randomized clinical trials

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Specificity profile of paroxetine in major depressive disorder : meta-regression of double-blind, randomized clinical trials. / Serretti, Alessandro; Gibiino, Sara; Drago, Antonio.

I: Journal of Affective Disorders, Bind 132, Nr. 1-2, 07.2011, s. 14-25.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Serretti, Alessandro ; Gibiino, Sara ; Drago, Antonio. / Specificity profile of paroxetine in major depressive disorder : meta-regression of double-blind, randomized clinical trials. I: Journal of Affective Disorders. 2011 ; Bind 132, Nr. 1-2. s. 14-25.

Bibtex

@article{1867efccad754037be7525587c520004,
title = "Specificity profile of paroxetine in major depressive disorder: meta-regression of double-blind, randomized clinical trials",
abstract = "BACKGROUND: Meta-analyses and reviews are powerful tools to inform clinicians on overall effects of their therapeutic choices, but do not provide practically useful clinical profiles for each drug optimal efficacy. Therefore clinicians in everyday practice have to rely mainly on personal or anecdotic experience. The aim of present study was to define the most suitable sociodemographic and disease-related profile for the use of paroxetine as an antidepressant treatment.METHODS: MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for randomized controlled trials (RCT) in English focused on {"}paroxetine{"} and {"}depressive disorder{"} or {"}major depression{"}. We also considered reviews and meta-analyses focusing on paroxetine. Fifty-five total unique RCTs were included and sociodemographic and clinical data as moderator of efficacy measures (standardized mean difference based on Hamilton Depressive Rating Scale and Montgomery-Asberg Depression Rating Scale) were investigated via meta-regression analysis.RESULTS: Paroxetine was significantly characterized by better response in females and in Caucasians, whilst for patients who have been ill for a longer time before treatment, the smaller was the antidepressant effect. Other disease-related variables were not found to be significant moderators in clinical outcome.LIMITATIONS: Meta-regression may lack sufficient sensibility to detect specific subtle features, so a failure to find significant effect is not definitive evidence of a lack of effect.CONCLUSIONS: Our results, though significant, were generally observed with small estimate values, their clinical relevance is subtle since each feature is expected to influence marginally the whole outcome, and probably a more pronounced effect could result only by analyzing very large samples.",
keywords = "Adult, Antidepressive Agents, Second-Generation, Depressive Disorder, Major, Double-Blind Method, Evidence-Based Medicine, Female, Humans, Male, Middle Aged, Paroxetine, Personality Inventory, Randomized Controlled Trials as Topic, Regression Analysis, Sex Factors, Treatment Outcome",
author = "Alessandro Serretti and Sara Gibiino and Antonio Drago",
note = "Copyright {\textcopyright} 2010 Elsevier B.V. All rights reserved.",
year = "2011",
month = jul,
doi = "10.1016/j.jad.2010.08.018",
language = "English",
volume = "132",
pages = "14--25",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier BV",
number = "1-2",

}

RIS

TY - JOUR

T1 - Specificity profile of paroxetine in major depressive disorder

T2 - meta-regression of double-blind, randomized clinical trials

AU - Serretti, Alessandro

AU - Gibiino, Sara

AU - Drago, Antonio

N1 - Copyright © 2010 Elsevier B.V. All rights reserved.

PY - 2011/7

Y1 - 2011/7

N2 - BACKGROUND: Meta-analyses and reviews are powerful tools to inform clinicians on overall effects of their therapeutic choices, but do not provide practically useful clinical profiles for each drug optimal efficacy. Therefore clinicians in everyday practice have to rely mainly on personal or anecdotic experience. The aim of present study was to define the most suitable sociodemographic and disease-related profile for the use of paroxetine as an antidepressant treatment.METHODS: MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for randomized controlled trials (RCT) in English focused on "paroxetine" and "depressive disorder" or "major depression". We also considered reviews and meta-analyses focusing on paroxetine. Fifty-five total unique RCTs were included and sociodemographic and clinical data as moderator of efficacy measures (standardized mean difference based on Hamilton Depressive Rating Scale and Montgomery-Asberg Depression Rating Scale) were investigated via meta-regression analysis.RESULTS: Paroxetine was significantly characterized by better response in females and in Caucasians, whilst for patients who have been ill for a longer time before treatment, the smaller was the antidepressant effect. Other disease-related variables were not found to be significant moderators in clinical outcome.LIMITATIONS: Meta-regression may lack sufficient sensibility to detect specific subtle features, so a failure to find significant effect is not definitive evidence of a lack of effect.CONCLUSIONS: Our results, though significant, were generally observed with small estimate values, their clinical relevance is subtle since each feature is expected to influence marginally the whole outcome, and probably a more pronounced effect could result only by analyzing very large samples.

AB - BACKGROUND: Meta-analyses and reviews are powerful tools to inform clinicians on overall effects of their therapeutic choices, but do not provide practically useful clinical profiles for each drug optimal efficacy. Therefore clinicians in everyday practice have to rely mainly on personal or anecdotic experience. The aim of present study was to define the most suitable sociodemographic and disease-related profile for the use of paroxetine as an antidepressant treatment.METHODS: MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for randomized controlled trials (RCT) in English focused on "paroxetine" and "depressive disorder" or "major depression". We also considered reviews and meta-analyses focusing on paroxetine. Fifty-five total unique RCTs were included and sociodemographic and clinical data as moderator of efficacy measures (standardized mean difference based on Hamilton Depressive Rating Scale and Montgomery-Asberg Depression Rating Scale) were investigated via meta-regression analysis.RESULTS: Paroxetine was significantly characterized by better response in females and in Caucasians, whilst for patients who have been ill for a longer time before treatment, the smaller was the antidepressant effect. Other disease-related variables were not found to be significant moderators in clinical outcome.LIMITATIONS: Meta-regression may lack sufficient sensibility to detect specific subtle features, so a failure to find significant effect is not definitive evidence of a lack of effect.CONCLUSIONS: Our results, though significant, were generally observed with small estimate values, their clinical relevance is subtle since each feature is expected to influence marginally the whole outcome, and probably a more pronounced effect could result only by analyzing very large samples.

KW - Adult

KW - Antidepressive Agents, Second-Generation

KW - Depressive Disorder, Major

KW - Double-Blind Method

KW - Evidence-Based Medicine

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Paroxetine

KW - Personality Inventory

KW - Randomized Controlled Trials as Topic

KW - Regression Analysis

KW - Sex Factors

KW - Treatment Outcome

U2 - 10.1016/j.jad.2010.08.018

DO - 10.1016/j.jad.2010.08.018

M3 - Journal article

C2 - 20863574

VL - 132

SP - 14

EP - 25

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

IS - 1-2

ER -