Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-12-03T19:18:28.888Z Has data issue: false hasContentIssue false
  • English
  • Français

Methodological approaches to the long-term study of antidepressants

Published online by Cambridge University Press:  16 April 2020

F Rouillon ,
L Steru  and
S Wood
F Rouillon
Affiliation:
Department of Psychiatry, Hôpital Louis-Mourier, University Paris VII, 178 rue des Renouillers, 92701Colombes cedex, France
L Steru
Affiliation:
ITEM (Institute for the Technical Evaluation of Medicines), 93 avenue de Fontainebleau, 94276 Le Kremlin-Bicêtre cedex, France
S Wood
Affiliation:
ITEM (Institute for the Technical Evaluation of Medicines), 93 avenue de Fontainebleau, 94276 Le Kremlin-Bicêtre cedex, France
Get access

Summary

It has long been known that most patients with bipolar disorder have a course marked by multiple recurrence of major depressive and manic episodes. More recently, many epidemiological studies have shown that at least 50% of unipolar depressive patients have one or more subsequent episodes of depression in their lifetimes. Likewise, relapse following successful short-term treatment of depression is so common that it is now recommended to prolong treatment in the form of maintenance pharmacotherapy. Interest in preventing the recurrence of depression has been stimulated by the results from long-term trials involving antidepressant drugs and lithium. However, these pharmacological studies suffer somewhat from methodological deficits, making difficult any clear and complete interpretation of their results. While some methodological recommendations have now been established to compensate for previous deficits (eg, definition of relapse and recurrence, duration of acute and maintenance treatments, statistical analysis of efficacy), unfortunately, many key points still remain to be resolved (eg, selection of patients, dosage in maintenance and prophylactic phases, maximum length of a course of treatment, etc).

Keywords

long-termclinical trialantidepressantmethodology
Type
Research Article
Information
European Psychiatry , Volume 11 , Issue 3: Issues of Concern in the Standardization and Harmonization of Psychotropic Drug Trials in Europe , 1996 , pp. 109 - 115
Copyright
Copyright © Elsevier, Paris 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Belsher, G, Costello, CGRelapse after recovery from unipolar depression: a critical review. Psychol Bull 1988; 104: 84–96CrossRefGoogle ScholarPubMed
Bialos, D, Giller, F, Jatlow, P, et al.Recurrence of depression after discontinuation of long-term amitriptyline treatment. Am J Psychiatry 1982; 139: 325–329Google ScholarPubMed
Coppen, A, Ghose, K, Montgomery, S, et al.Continuation therapy with amitriptyline in depression. Br J Psychiatry 1978; 133: 28–33CrossRefGoogle ScholarPubMed
Doogan, D, Caillard, VSertraline in the prevention of depression. Br J Psychiatry 1992; 160: 217–222CrossRefGoogle ScholarPubMed
Dunbar, GC, Mewetts, S A double-blind comparative study of paroxetine and placebo in preventing recurrent major depressive episodes. Presented at the British Assoc of Psychopharmacology Annual meeting. York 1991Google Scholar
Frank, E, Kupfer, DJ, Perel, JM, et al.Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1990; 47: 1093–1099CrossRefGoogle ScholarPubMed
Glen, AIM, Johnson, AL, Shepherd, MContinuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomized, double-blind controlled trial. Psychol Med 1984; 14: 37–50CrossRefGoogle Scholar
Grof, PDesigning long term clinical trials in affective disorders. J Affect Disord 1994; 30: 243–255CrossRefGoogle ScholarPubMed
Harrison, W, Rabkin, J, Stewart, JW, et al.Phenelzine for chronic depression: a study of continuation treatment. J Clin Psychiatry 1986; 47: 346–349Google ScholarPubMed
Jonsson, B, Bebbington, PHealth economics of depression In: Jonsson, B, Rosenbaum, JPerspectives in Psychiatry Vol 4 1993 John Wiley 35–48Google Scholar
Kane, JM, Quitkin, FM, Rifkin, A, et al.Lithium carbonate and imipramine in the prophylaxis of unipolar and bipolar I illness. Arch Gen Psychiatry 1982; 39: 1065–1069CrossRefGoogle Scholar
Kay, DWK, Fahy, T, Garside, RFA seven-month double-blind trial of amitriptyline and diazepam in ECT-treated depressed patients. Br J Psychiatry 1970; 117: 667–671CrossRefGoogle ScholarPubMed
Klerman, GL, Di Mascio, A, Weissman, MM, et al.Treatment of depression by drugs and psychotherapy. Am J Psychiatry 1974; 131: 186–191CrossRefGoogle Scholar
Kraepelin, EDas Manisch-Depressive irresein In: Psychiatrie. Ein Lehrbuch für Studierende and Aerzte vol III Chichester, England: Barth, 1913; 2Google Scholar
Kupfer, DJ, Frank, EThe minimum length of treatment for recovery In: Montgomery, SA, Rouillon, FLong-term Treatment of Depression Leipzig, Germany: John Wiley & Sons Ltd, 1992; 33–52Google Scholar
Kupfer, DJ, Frank, E, Perel, JM, et al.Five year outcome for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1992; 49: 769–773CrossRefGoogle ScholarPubMed
Lendresse, P, Cren, MC, Lemarie, JCTraitement prolongé par nomifensine 75 mg dans les états dépressifs névrotiques et réactionnels. Psychiatrie Française 1984; 16 (suppl) : 156–158Google Scholar
Loonen, AJN, Zwanikken, GJContinuation and maintenance therapy with antidepressive agents: an overview of research. Phar Weekbl (Sci) 1990; 12: 128–141CrossRefGoogle ScholarPubMed
Mindham, RHS, Howland, C, Shepherd, MAn evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychol Med 1973; 3: 5–17CrossRefGoogle ScholarPubMed
Montgomery, SA, Dufour, H, Brion, S, et al.The prophylactic efficacy of fluoxetin in unipolar depression Br J Psychiatry 1988 153 3 suppl 69–76CrossRefGoogle Scholar
Montgomery, SA, Green, M, Baldwin, D, Montgomery, DProphylactic treatment of depression: A public health issue. Neuropsycholiology 1989; 22: 214–219CrossRefGoogle ScholarPubMed
Montgomery, SA, Montgomery, DBProphylactic treatment in recurrent unipolar depression In: Montgomery, SA, Rouilion, FLong-Term Treatment of Depression London: John Wiley & Sons Ltd, 1992; 53–79Google Scholar
Montgomery, SA, Rasmussen, TGCCitalopram 20 mg, Citalopram 40 mg and placebo in the prevention of relapses of major depression Int Clin Psychopharmacol 1991 6 suppl 5 71–73CrossRefGoogle Scholar
NIH/NIMH Consensus development conference statement Mood disorders: Pharmacologic Prevention of Recurrences. Consensus Development Panel Am J Psychiatry 142/4 1985 469–476Google Scholar
Okuma, T, Inanaga, K, Otsuki, SA preliminary double blind study on the efficacy of carbamazepine in prophylaxis of manic depressive illness. Psychopharmacology 1981; 73: 95–96CrossRefGoogle ScholarPubMed
Peto, R, Pike, MC, Armitage, P, et al.Design and analysis of randomized clinical trials requiring prolonged observation of each patient, II: analysis and examples. Br J Cancer 1977; 35: 1–39CrossRefGoogle ScholarPubMed
Prien, R, Kupfer, DJ, Mansky, PA, et al.Drug therapy in the prevention of recurrence in unipolar and bipolar affective disorders. Arch Gen Psychiatry 1984; 41: 1096–1104CrossRefGoogle ScholarPubMed
Rouillon, F, Serrurier, D, Miller, HD, Gérard, MJProphylactic efficacy of maprotiline on unipolar depression relapse J Clin Psychiatry 1991 52/10 423–431Google Scholar
Rouillon, F, Lejoyeux, M, Filteau, MJUnwanted effects of long term treatment In: Montgomery, SA, Rouillon, FLong-Term Treatment of Depression London: John Wiley & Sons, 1992; 81–112Google Scholar
Seager, CP, Bird, RLImipramine with electrical treatment in depression: a controlled trial. J Ment Sci 1962; 108: 704–707CrossRefGoogle ScholarPubMed
Stein, M, Rickels, K, Weise, CCMaintenance therapy with amitriptyline: a controlled trial. Am J Psychiatry 1980; 137: 370–371Google ScholarPubMed
Thase, MERelapse and recurrence in unipolar major depression. Short-term and long-term approaches. J Clin Psychiatry 1990; 51 6 (suppl): 51–57Google ScholarPubMed
Van Praag, H, De Haan, SDepression vulnerability and 5-HT prophylaxis. Psychiatry Res 1980; 3: 75–83CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.