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Pharmacopsychiatry 2023; 56(01): 5-17
DOI: 10.1055/a-1934-9856
Review

Antipsychotic Monotherapy for Major Depressive Disorder: A Systematic Review and Meta-Analysis

Akira Nishi   *
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
,
Kyosuke Sawada   *
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
,
Hiroyuki Uchida
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
,
Masaru Mimura
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
,
Hiroyoshi Takeuchi
1   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Abstract

Although several randomized controlled trials (RCTs) have compared the effectiveness, efficacy, and safety of antipsychotic monotherapy (APM) versus placebo in patients with major depressive disorder (MDD), no meta-analysis has examined this topic. We conducted a systematic literature search using MEDLINE and Embase to identify relevant RCTs and performed a meta-analysis to compare the following outcomes between APM and placebo: response and remission rates, study discontinuation due to all causes, lack of efficacy, and adverse events, changes in total scores on depression severity scales, and individual adverse event rates. A total of 13 studies were identified, with 14 comparisons involving 3,197 participants that met the eligibility criteria. There were significant differences between APM and placebo in response and remission rates and changes in the primary depression severity scale in favor of APM, and study discontinuation due to adverse events and several individual adverse events in favor of placebo. No significant difference was observed in discontinuation due to all causes. APM could have antidepressant effects in the acute phase of MDD, although clinicians should be aware of an increased risk of some adverse events.

Key words

major depressive disorder - antipsychotics - monotherapy - meta-analysis - systematic review

* Both authors contributed equally


Supplementary Material



Publication History

Received: 21 June 2022
Received: 18 August 2022

Accepted: 13 August 2022

Article published online:
18 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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