Table 16Summary of included studies. Comparison 15. Increasing the dose of SSRI versus augmenting with lithium

StudyPopulationInterventionComparisonDetails of inadequate response/treatment resistanceComments

Fava 1994a

RCT

US

N=29

Mean age (years): NR

Gender (% female): NR

Ethnicity (% BME): NR

Baseline severity: HAMD 18.09 (more severe)

Fluoxetine 40-60mg/dayLithium 300-600mg/day + fluoxetine 20mg/dayInadequate response (defined as failure to achieve a 50% or greater reduction in HAMD score and a HAMD score of ≥10) to 8 weeks of open-label treatment with fluoxetine (20mg/day)

Treatment length (weeks): 4

Outcomes:

  • Depression symptomatology endpoint
  • Depression symptomatology change score
  • Remission
  • Discontinuation due to any reason
  • Discontinuation due to side effects

Fava 2002

RCT

US

N=67

Mean age (years): NR

Gender (% female): NR

Ethnicity (% BME): NR

Baseline severity: HAMD 16.1 (more severe)

Fluoxetine 40-60mg/dayLithium 300-600mg/day + fluoxetine 20mg/dayInadequate response (defined as failure to achieve a 50% or greater reduction in HAMD score and a HAMD score of ≥10) to 8 weeks of open-label treatment with fluoxetine (20mg/day)

Treatment length (weeks): 4

Outcomes:

  • Depression symptomatology endpoint
  • Depression symptomatology change score
  • Remission
  • Response
  • Discontinuation due to any reason

BME: black and minority ethnic; HAMD: Hamilton depression scale; NR: not reported; RCT: randomised controlled trial; SSRI: selective serotonin reuptake inhibitor

From: Further-line treatment

Cover of Further-line treatment
Further-line treatment: Depression in adults: Evidence review D.
NICE Guideline, No. 222.
Copyright © NICE 2022.

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