| Study | Population | Intervention | Comparison | Details of inadequate response/treatment resistance | Comments |
|---|---|---|---|---|---|
|
RCT US |
N=96 Mean age (years): 45.2 Gender (% female): 69 Ethnicity (% BME): NR Baseline severity: MADRS 27 (more severe) | Lamotrigine 100-400mg/day + paroxetine/paroxetine CR | Placebo + paroxetine/paroxetine CR | TRD: History of failure of ≥1 adequate trial of a US FDA-approved antidepressant within the current episode of MDD, and failure to respond (HAMD≥15) to open-label prospective treatment with paroxetine or paroxetine CR (in flexible doses up to 50/62.5mg/day) after 8 weeks |
Treatment length (weeks): 10 Outcomes:
|
|
RCT China |
N=84 Mean age (years): NR Gender (% female): NR Ethnicity (% BME): NR Baseline severity: NR (more severe) | Sodium valproate 600mg/day + paroxetine 20mg/day | Paroxetine 20mg/day | TRD: Inadequate response to ≥2 adequate treatments from different classes of antidepressants in the current depressive episode (adequate dosages of antidepressants with at least 3-month duration) determined through medical records and/or prospective treatment |
Treatment length (weeks): 8 Outcomes:
|
|
RCT China |
N=98 Mean age (years): 67.0 Gender (% female): 56 Ethnicity (% BME): NR Baseline severity: HAMD 23.7 (more severe) | Lamotrigine 50-100mg/day + sertraline 100-150mg/day | Sertraline 100-150mg/day | TRD (failure to respond to at least 2 antidepressant treatment trials with adequate dose and duration) |
Treatment length (weeks): 4 Outcomes:
|
|
RCT China |
N=115 Mean age (years): 33.8 Gender (% female): 44 Ethnicity (% BME): NR Baseline severity: HAMD 36.5 (more severe) | Lamotrigine 25-150mg/day + paroxetine 20-40mg/day | Paroxetine 20-40mg/day | TRD (failure to respond to at least 2 antidepressant treatment trials with adequate dose and duration) |
Treatment length (weeks): 8 Outcomes:
|
|
RCT Iran |
N=53 Mean age (years): 36.2 Gender (% female): 57 Ethnicity (% BME): NR Baseline severity: HAMD 21.79 (more severe) | Topiramate 100-200mg/day + SSRI | Placebo + SSRI | Inadequate response (HAMD≥18) to at least 8 weeks of treatment with an adequate and stable dose of one of the SSRIs (fluoxetine, citalopram or sertraline) |
Treatment length (weeks): 8 Outcomes:
|
|
RCT Brazil |
N=34 Mean age (years): 27.5 Gender (% female): 74 Ethnicity (% BME): NR Baseline severity: MADRS 30.4 (more severe) | Lamotrigine 50-200mg/day + any antidepressant | Placebo + any antidepressant | TRD: Inadequate response to treatment with at least 2 antidepressants of different classes at the maximum-tolerated dose for at least 6 weeks |
Treatment length (weeks): 8 Outcomes:
|
|
RCT China |
N=60 Mean age (years): 45.3 Gender (% female): 45 Ethnicity (% BME): NR Baseline severity: HAMD 22.75 (more severe) | Lamotrigine 100-200mg/day + venlafaxine 75-225mg/day | Venlafaxine 75-225mg/day | TRD: failed to achieve a response in at least 2 antidepressant treatment trials of adequate dose and duration |
Treatment length (weeks): 12 Outcomes:
|
|
RCT China |
N=66 Mean age (years): 38.2 Gender (% female): 52 Ethnicity (% BME): NR Baseline severity: HAMD 28.01 (more severe) | Lamotrigine 150mg/day + escitalopram 10-20mg/day | Escitalopram 10-20mg/day | TRD: failed to achieve a response in at least 2 antidepressant treatment trials of adequate dose and duration |
Treatment length (weeks): 12 Outcomes:
|
|
RCT China |
N=88 Mean age (years): 47.3 Gender (% female): 72 Ethnicity (% BME): NR Baseline severity: HAMD 31.23 (more severe) | Lamotrigine 50-200mg/day + duloxetine 60mg/day | Duloxetine 60mg/day | TRD: failed to respond to at least 2 antidepressant treatment trials of adequate dose and duration |
Treatment length (weeks): 8 Outcomes:
|
BME: black and minority ethnic; CR: controlled release; FDA: food and drug administration; HAMD: Hamilton depression scale; MADRS: Montgomery-Asberg depression rating scale; MDD: major depressive disorder; NR: not reported; RCT: randomised controlled trial; SSRI: selective serotonin reuptake inhibitor; TRD: treatment-resistant depression
From: Further-line treatment
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