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Review: there is limited evidence about the effectiveness of interventions for treatment-refractory depression
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QUESTION: How effective are different pharmacological and psychological interventions for treatment-refractory depression?

Design

Systematic review with narrative synthesis.

Data sources

Studies were identified using the Cochrane Controlled Trials Register, Embase, Medline, PsychLit, PsychInfo and LILACS (to January 2001).

Study selection

Eligible studies were randomised controlled trials of pharmacological or psychological interventions for people aged 18 to 75 years with treatment-refractory unipolar depression (no response to a 4-week course of antidepressant treatment at the recommended dose). The authors identified 17 trials with 645 participants: 4 compared an antidepressant with placebo or other treatment; 4 compared 2 active drug treatments; 7 compared an antidepressant plus augmentor with antidepressant plus placebo, …

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