[Lack of evidence in the treatment of important subgroups of depression].
Despite over 1,000 randomised controlled trials (RCTs) evaluating the efficacy of antidepressants, their effectiveness in important subgroups of depression is almost unknown. Around 40% of patients with depression do not respond to treatment with selective serotonin-reuptake inhibitors, the most frequently used type of antidepressant in The Netherlands. Only 3 RCTs have studied whether another type of antidepressant is effective in these patients. Two other examples are psychotic depression and bipolar depression. While these conditions account for 15% and 20% of all depressed patients, respectively, their treatment has been studied in only 10 and 12 RCTs, respectively. The main reason for this lack of research is lack of funding. Therefore, it is argued that a special Dutch research programme for comparative drug studies is warranted. Funds for such a programme should become available from The Netherlands Organisation for Health Research and Development (ZonMw), the pharmaceutical industry and health-insurance companies.
Nolen
W A
WA
Universitair Medisch Centrum Groningen, afd. Psychiatrie, Postbus 30.001, 9700 RB Groningen. w.a.nolen@med.umcg.nl
D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000145:classification / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D009426:Netherlands; D016032:Randomized Controlled Trials as Topic; D012106:Research / Q000191:economics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors