Initial severity and antidepressant efficacy for anxiety disorders, obsessive‐compulsive disorder, and posttraumatic stress disorder: An individual patient data meta‐analysis

Vries, Ymkje Anna de; Roest, Annelieke M.; Burgerhof, Johannes G. M.; Jonge, Peter de

doi:10.1002/da.22737

Cited by 20 publications

(17 citation statements)

References 35 publications

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“…Another observation that can be made from the 3 studies that measured FQ:Agoraphobia is the effectiveness of antidepressants along this dimension in spite of the "normality" of the scores. This finding is suggested by results of a recent meta-analysis concluding that antidepressants are effective across all severity levels of anxiety disorders [74], and reinforces earlier findings that antidepressants can reduce attentional vigilance to threat in healthy volunteers [75]. These findings are consistent with the dimensional conceptualisation of psychobehavioural constructs spanning normality to pathology.…”

Section: Psychometric Score Interpretationsupporting

confidence: 85%

Exploring the utility of RDoC in differentiating effectiveness amongst antidepressants: A systematic review using proposed psychometrics as the unit of analysis for the Negative Valence Systems domain

Hui

2020

PLoS ONE

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Background RDoC conceptualises psychopathology as neurobiologically-rooted behavioural psychological “constructs” that span dimensionally from normality to pathology, but its clinical utility remains controversial. Aim To explore RDoC’s potential clinical utility by examining antidepressant effectiveness through Negative Valence Systems (NVS) domain constructs. Method A systematic review was conducted on Web of Science, MEDLINE, EMBASE and PsycINFO for antidepressant trials that included psychometric instruments assessed by Watson, Stanton & Clark (2017) to represent NVS constructs of Acute Threat, Potential Threat and Loss. Results 221 citations were identified; 13 were included in qualitative synthesis, none for quantitative analysis. All suffered from significant bias risks. 9 antidepressants were investigated, most within 1 construct, and most were found to be effective. Paroxetine, citalopram and fluvoxamine were found to be effective for Acute Threat, fluoxetine, desvenlafaxine and sertraline for Potential Threat, and sertraline, fluvoxamine, fluoxetine and desvenlafaxine effective for Loss. Nefazodone was found to be ineffective for acute fear. Conclusion Preliminary evidence supports RDoC NVS constructs’ clinical utility in assessing antidepressant effectiveness, but lack of discriminant validity between Potential Threat and Loss supports their recombination into a single Distress construct. Finding of effectiveness within “normal” construct levels support the utility of a dimensional approach. Testable hypotheses were generated that can further test RDoC’s clinical utility.

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Section: Psychometric Score Interpretationsupporting

confidence: 85%

Exploring the utility of RDoC in differentiating effectiveness amongst antidepressants: A systematic review using proposed psychometrics as the unit of analysis for the Negative Valence Systems domain

Hui

2020

PLoS ONE

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“…Most importantly, the clinical use of drugs has expanded dramatically over the years. For example, antidepressants are often used for obsessive-compulsive disorder, anxiety disorder, and post-traumatic stress disorder (Skapinakis et al 2016 ; Locher et al 2017 ; Vries et al 2018 ; Amerio et al 2019 ; Slee et al 2019 ; Stone 2019 ). Antiepileptics are used for many other diseases than epilepsy including prevention of migraine and trigeminal neuralgia, polyneuropathies, restless leg syndrome, fibromyalgia, and bipolar disorder (Zilliox and Russell 2011 ; Kaufman 2011 ; Qin et al 2018 ; Hirakata et al 2018 ; Salminen and Winkelmann 2018 ; Parikh and Silberstein 2019 ), just to mention some indications.…”

Section: Problems Associated With Inconsistent Drug Nomenclaturementioning

confidence: 99%

“…The term antidepressant may stigmatize the patient. Kenakin 2008 ; Skapinakis et al 2016 ; Locher et al 2017 ; Seifert 2018 ; Vries et al 2018 ; Amerio et al 2019 Antiepileptic (drug) Neuronal inhibitor with pleiotropic effects NIPE See antidepressants. The term antiepileptic may stigmatize the patient.…”

Section: Proposed Solution To the Problem—step 1: Get Rid Of Traditiomentioning

confidence: 99%

A simple mechanistic terminology of psychoactive drugs: a proposal

Seifert

Schirmer

2020

Naunyn-Schmiedeberg's Arch Pharmacol

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Antidepressants, antiepileptics, mood stabilizers, and antipsychotics are extremely broadly used psychoactive drugs. These drug terms are universally used in the literature. However, the indications of these drugs have broadened substantially and overlap. The mismatch between drug classification and clinical uses causes a lot of confusion in communication and renders literature searches increasingly difficult. Therefore, we propose to drop the above terms altogether and replace them by simple mechanistic terms. Antidepressants are re-named as norepinephrine/serotonin (NE/5-HT) enhancers, antiepileptics comprising drugs with different mechanisms become neuronal inhibitors with pleiotropic effects (NIPEs), and antipsychotics become antagonists at multiple G protein–coupled receptors (mGPCR antagonists). Alkali metal ions, comprising lithium, are integrated into NIPEs. The terms “typical/first-generation/conventional” and “atypical/second-generation/non-conventional” antipsychotics should be dropped, because the original criterion for distinction, i.e., the presence and absence of extrapyramidal motor effects, respectively, is not valid anymore. The suggested changes in drug nomenclature have already been implemented into a recent textbook (Seifert R, Basic Knowledge of Pharmacology ). The revised nomenclature ensures consistency with other fields of pharmacology and assignment of drug classes to indications without causing confusion. The authors acknowledge that the change in drug nomenclature is a cultural process that will take time and openly discuss the problems associated with the proposal. Ultimately, international learned societies will have to agree on a new nomenclature. Electronic supplementary material The online version of this article (10.1007/s00210-020-01918-x) contains supplementary material, which is available to authorized users.

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“…Partly, this could be explained because in adolescents, antidepressants were found to be differentially effective for different disorders (i.e., strongest for non-OCD anxiety disorders, intermediate for OCD, and more modest in major depressive disorder (MDD) [ 69 ]. The efficacy of antidepressants in social anxiety disorder (SAD) is not related to initial severity of symptoms [ 70 ]. For both depressive and anxiety disorders, combination therapy of an antidepressant with CBT may be statistically more effective [ 71 ].…”

Section: Diagnostic and Therapeutic Issues Regarding Tribmentioning

confidence: 99%

Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence

Herpers

Neumann

2020

Child Psychiatry Hum Dev

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Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance transdiagnostic interventions, such as addressing non-compliance, restoration of trust between parents and their child, and limitation of avoidance behaviour. These may be seen as higher order interventions within the HiTOP framework.

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Initial severity and antidepressant efficacy for anxiety disorders, obsessive‐compulsive disorder, and posttraumatic stress disorder: An individual patient data meta‐analysis

Abstract: Antidepressants are equally effective across severity levels for SAD, OCD, and PTSD. For GAD and PD, however, benefits are small at low severity, and the benefit-risk ratio may be unfavorable for these patients.

Cited by 20 publications

References 35 publications

Exploring the utility of RDoC in differentiating effectiveness amongst antidepressants: A systematic review using proposed psychometrics as the unit of analysis for the Negative Valence Systems domain

Exploring the utility of RDoC in differentiating effectiveness amongst antidepressants: A systematic review using proposed psychometrics as the unit of analysis for the Negative Valence Systems domain

A simple mechanistic terminology of psychoactive drugs: a proposal

Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence

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