Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses

Leucht, Stefan; Hierl, Sandra; Kissling, Werner; Dold, Markus; Davis, John M.

doi:10.1192/bjp.bp.111.096594

Cited by 359 publications

(252 citation statements)

References 91 publications

Supporting

Mentioning

226

Contrasting

Unclassified

Order By: Relevance

“…In randomised controlled trials (RCTs) the mean effect sizes of antidepressants in major depression were ,0.30 for acute treatment and ,0.60 for relapse prevention, which are comparable to what was found in other areas of medicine [6]. Unless shown otherwise, antidepressant treatments can be expected to be effective in depression with somatic comorbidities.…”

Section: Introductionmentioning

confidence: 61%

Depression and suicidality in COPD: understandable reaction or independent disorders?

Hegerl

Mergl

2014

Eur Respir J

View full text Add to dashboard Cite

Both depression and chronic obstructive pulmonary disease (COPD) are prevalent, severe and often comorbid disorders. There is a risk of undertreatment for depression in patients with COPD as depressive symptoms, including suicidal tendencies, can erroneously be conceptualised as an understandable reaction to COPD and not as signs of an independent depressive disorder. In this context, the comorbidity rates of COPD and depression, the risk of suicidal behaviour in patients with COPD, and the evidence base for pharmaco-and psychotherapy in these patients are reviewed.Because symptoms of depression and COPD overlap it remains unclear how far the prevalence of major depression in COPD exceeds that in the general population. The suicide risk appears to be increased in COPD. Methodological studies providing evidence for the antidepressant efficacy of antidepressants or psychotherapy in patients with COPD are lacking. Recommendations for clinicians on how to separate depression from an understandable reaction to COPD are provided.Given the profound effects of depression on quality of life, life expectancy, COPD prognosis and suicide risk it is important to carefully diagnose and treat depression in patients with COPD according to national guidelines. @ERSpublications Comorbid depression has profound effects on COPD prognosis and should not be seen as understandable reaction to COPD

show abstract

Section: Introductionmentioning

confidence: 61%

Depression and suicidality in COPD: understandable reaction or independent disorders?

Hegerl

Mergl

2014

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Pharmacotherapy is underused in its treatment despite evidence of moderate effect [156], similar to that in other conditions [159].…”

Section: Resultsmentioning

confidence: 99%

Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence

et al. 2016

View full text Add to dashboard Cite

Alcohol use disorders (AUD) cause significant morbidity and mortality worldwide, but pharmacological treatments for them are underused, despite evidence of efficacy.Acamprosate, naltrexone, nalmefene and disulfiram are all approved in one or more region for the treatment of alcohol use disorders. Baclofen currently has a temporary indication in France. Safety considerations for using psychopharmacological treatments in this patient group include the impact of concurrent alcohol consumption at high levels, multiple physical comorbidities which may interfere with pharmacological effects, distribution and metabolism, and concomitant medication for the treatment of comorbid physical and psychiatric conditions. The five drugs, including an extended-release injectable suspension of naltrexone, have different safety profiles which need to be balanced with the objective of treatment (initiation or continuation of abstinence, or reduction of drinking), individual patient preferences and comorbid conditions. Appropriate treatment will be based on the unique riskbenefit profile in each case. KEY POINTS Acamprosate has an excellent safety profile and is recommended as first line treatment for patients wishing abstinence. Naltrexone and nalmefene are contraindicated with opioid-containing medication, but have reasonable tolerability  The disulfiram-alcohol reaction is integral to its use, but careful patient selection and monitoring can mitigate safety risks  Baclofen is a CNS depressant so there are potential concerns regarding overdose: it may have a role in patients with severe liver disease Pharmacological treatments for alcohol dependence 3

show abstract

“…We are still developing the tools to understand its normal function, particularly on the very, very short time-scale by which neurons transmit information. In spite of such difficulties, the effectiveness of our drugs, although moderate, are comparable to those in other fields of medicine in spite of our being a 'younger' science (Leucht et al, 2012). Exciting new techniques and approaches are facilitating greatly our ability to understand the functioning of circuits in the brain and even that of individual cells.…”

mentioning

confidence: 96%

Neuropsychopharmacology: Reflections on 40 Volumes

Frazer

2015

Neuropsychopharmacol

View full text Add to dashboard Cite

This issue completes volume 40 of Neuropsychopharmacology (NPP), with the first issue published in December, 1987. This should be distinguished from our 40th anniversary; for the first several years, issues were thin, months were skipped, and multiple volumes were published per year. To commemorate this accomplishment, the editor-in-chief (Dr Carlezon) asked me as in-coming ACNP President to write a brief overview of my views on the developments in our field over this time period, using highly cited articles published in NPP as a guide.Early on, two articles highlight themes that continue today. One is the development of animal models for psychiatric illnesses. Markou and Koob (1991) developed an animal model of the depression or anhedonia that accompanies cocaine withdrawal, with the drug being self-administered. The use of intracranial-self stimulation (ICSS) thresholds revealed them to be elevated during cocaine withdrawal, with this being interpreted as an 'anhedonic' state due to a desensitization of the reward pathways mediating ICSS reward. The establishment of this model enabled studies to try to understand the neurochemical mechanisms underlying a specific aspect of cocaine withdrawal, with this search continuing to the present.This article was ahead of its time by focusing on a component of the withdrawal process rather than withdrawal per se. Presently, much attention is focused on specific behavioral components of our psychiatric syndromes rather than the complete illness, and this is so both clinically and pre-clinically. This makes sense because our diagnostic schema have no bases in biology and

show abstract

Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses

Cited by 359 publications

References 91 publications

Depression and suicidality in COPD: understandable reaction or independent disorders?

Depression and suicidality in COPD: understandable reaction or independent disorders?

Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence

Neuropsychopharmacology: Reflections on 40 Volumes

Contact Info

Product

Resources

About