title: Pharmacological and psychotherapeutic interventions for management of poststroke depression: A Bayesian network meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Poststroke depression (PSD) constitutes an important complication of stroke, leading to great disability as well as increased mortality. Since which treatment for PSD should be preferred are still matters of controversy, we are aiming to compare and rank these pharmacological and nonpharmacological interventions.
  
  
  METHODS
  We will employ a network meta-analysis to incorporate both direct and indirect evidence from relevant trials. We will search PubMed, the Cochrane Library Central Register of Controlled Trials, Embase, and the reference lists of relevant articles for randomized controlled trials (RCT) of different PSD treatment strategies. The characteristics of each RCT will be summarized, including the study characteristics, the participant characteristics, the outcome measurements, and adverse events. The risk of bias will be assessed by means of the Cochrane Collaboration's risk of bias tool. The primary outcome was change in Hamilton Depression Scale (HAMD) score. Secondary outcomes involve patient response rate (defined as at least a 50% score reduction on HAMD), and remission rate (defined as no longer meeting baseline criteria for depression). Moreover, we will assess the acceptability of treatments according to treatment discontinuation. We will perform pairwise meta-analyses by random effects model and network meta-analysis by Bayesian random effects model.
  
  
  CONCLUSIONS
  Formal ethical approval is not required as primary data will not be collected. Our results will help to reduce the uncertainty about the effectiveness and safety of PSD management, which will encourage further research for other therapeutic options. The review will be disseminated in peer-reviewed publications and conference presentations.
  CRD42016049049.
authors.affiliation: Second Department of Psychiatry, Kangning Hospital, Anshan, Liaoning Stroke Clinical Research Unit, Department of Neurology Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Sun
authors.forename: Linghui
authors.initials: L
authors.lastname: Deng
authors.forename: Shi
authors.initials: S
authors.lastname: Qiu
authors.forename: Xiang
authors.initials: X
authors.lastname: Tu
authors.forename: Deren
authors.initials: D
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001499:Bayes Theorem; D000529:Complementary Therapies; D003863:Depression / Q000209:etiology / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012944:Social Support; D020521:Stroke / Q000150:complications; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D000071076:Network Meta-Analysis as Topic
chemical_list: D000928:Antidepressive Agents