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Review: lithium augmentation increases treatment response in refractory depression

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QUESTION: Is lithium augmentation clinically effective in patients with refractory depression?

Data sources

Studies were identified by searching Medline (1980 to June 1997) and the Cochrane Library and by scanning the references of published reviews and standard textbooks.

Study selection

Studies were selected if they were double blind, placebo controlled trials that involved patients who had not responded to conventional antidepressants; accepted, operationalised diagnostic criteria for depression were used; and outcome measures included acceptable criteria for assessing response.

Data extraction

2 reviewers independently assessed the quality of each study (Quality Assessment Scale by Detsky) and resolved differences by consensus. Data were extracted on study population, antidepressant treatment, lithium dose, duration …

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