Table 55Summary of included studies. Comparison 54. Augmenting with lithium versus switch to antipsychotic

StudyPopulationInterventionComparisonDetails of inadequate response/treatment resistanceComments

Bauer 2013

RCT

Australia, Austria, Belgium, Bulgaria, Germany, Hungary, Italy, Portugal, Romania, Slovakia, Spain & UK

N=457

Mean age (years): NR

Gender (% female): NR

Ethnicity (% BME): NR

Baseline severity: MADRS 33.3 (more severe)

Lithium 450-900mg/day (target plasma level: 0.6–1.2mmol/L) + SSRI/SNRIQuetiapine monotherapy 200-300mg/dayStage I (failure to achieve remission after ≥1 adequate trial of 1 major class of antidepressant) or stage II (failure of adequate trials of 2 different classes of antidepressant) TRD, 50% in each category

Treatment length (weeks): 6

Outcomes:

  • Remission
  • Response
  • Discontinuation due to any reason
  • Discontinuation due to side effects

BME: black and minority ethnic; MADRS: Montgomery-Asberg depression rating scale; NR: not reported; RCT: randomised controlled trial; SNRI: serotonin-norepinephrine reuptake inhibitor; SSRI: selective serotonin reuptake inhibitor; 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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