Table 5Summary of included studies. Comparison 4. Augmenting with IPT versus continuing with antidepressant

StudyPopulationInterventionComparisonDetails of inadequate response/treatment resistanceComments

Murray 2010

RCT

Canada

N=64

Mean age (years): 45.2

Gender (% female): 72

Ethnicity (% BME): NR

Baseline severity: NR (unclear severity)

IPT group (Re-ChORD) + any antidepressant

Intensity: 16x 90-min sessions

Any antidepressantTRD: Mean 2.95 (SD=1.1) failed medication trials

Treatment length (weeks): 16

Outcomes:

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

Reynolds 2010

RCT

US

N=124

Mean age (years): 72.3

Gender (% female): 68

Ethnicity (% BME): 8

Baseline severity: HAMD 12.5 (less severe)

IPT individual + escitalopram (dose increase; 10-20mg/day)

Intensity: IPT 16x 60-75 min sessions

Escitalopram (dose increase; 10-20mg/day)Inadequate (partial) response (HAMD score=11-14) to 6 weeks prospective open-label treatment with escitalopram

Treatment length (weeks): 16

Outcomes:

  • Remission
  • Discontinuation due to any reason

Schramm 2007

RCT

Germany

N=130

Mean age (years): 41.9

Gender (% female): 65

Ethnicity (% BME): NR

Baseline severity: HAMD 23.53 (more severe)

IPT individual & group (modified for an inpatient setting) + SSRI/TCA (sertraline 50-250mg/day or amitriptyline 75-360mg/day)

Intensity: 15x 50-min individual sessions

SSRI/TCA (sertraline 50-250mg/day or amitriptyline 75-360mg/day)Inadequate response: met inclusion criteria despite 83% having received outpatient treatment before admission

Treatment length (weeks): 5

Outcomes:

  • Depression symptomatology at:
    • Endpoint
    • 3-month follow-up
    • 12-month follow-up
  • Depression symptomatology change score
  • Remission
  • Response
  • Discontinuation due to any reason
  • Global functioning at:
    • Endpoint
    • 3-month follow-up
    • 12-month follow-up

Souza 2016

RCT

Brazil

N=40

Mean age (years): 49.2

Gender (% female): 85

Ethnicity (% BME): NR

Baseline severity: HAMD 19 (more severe)

IPT individual + any antidepressant

Intensity: 16x 40-min weekly sessions

Any antidepressantInadequate response to 1 trial of antidepressant medication in adequate dose (defined as the equivalent of at least 75mg of amitriptyline) and duration (at least 4 weeks)

Treatment length (weeks): 19

Outcomes:

  • Depression symptomatology at:
    • Endpoint
    • 1-month follow-up
  • Depression symptomatology change score
  • Remission
  • Response
  • Discontinuation due to any reason

BME: black and minority ethnic; HAMD: Hamilton depression scale; IPT: interpersonal therapy; NR: not reported; RCT: randomised controlled trial; SD: standard deviation; SSRI: selective serotonin reuptake inhibitors; TCA: tricyclic antidepressants; TRD: treatment-resistant depression

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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