Antidepressant medication does not add any effect to usual consultations by general practitioners in patients with minor and mild-major depression.
ID
Bron
Verkorte titel
Aandoening
Depression.
Ondersteuning
EMGO-Institute
Dept. General Practice
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
1. Severity of Depressive by MADRS (Montgomery Åsberg Depression Rating Scale); <br>
2. Remission of depression by MADRS score<10.
Achtergrond van het onderzoek
Objective:
To examine whether antidepressant medication adds any effect to usual consultations by the General Practitioner (GP) in adult patients with minor and mild-major depression.
Design:
A pragmatic patient-randomised equivalence trial with 12 months follow up.
Setting:
59 GPs in The Netherlands recruited eligible patients.
Participants:
181 contacting patients entered the study with minor or mild-major depression. Mean age was 46 years (SD 16.0) and 73% were female. Complete follow up on the primary outcomes was available for 131 patients (72%).
Interventions:
Patients were randomly assigned to on average 3 usual consultations during 3 months with (n=85) or without paroxetine (n=96). Both treatments were carried out by the patient’s own GP.
Main outcome measure:
Depression severity by the Montgomery Åsberg Depression Rating Scale and remission from depression at 6, 13, 26 and 52 weeks follow up. Secondary outcome measures were the Short Form 36, Beck Depression Inventory and Client Satisfaction Questionnaire.
Results:
The intention-to-treat analysis showed that paroxetine with counselling was equivalent (i.e. non-superior) to counselling alone at 6, 13 and 52 weeks, but not at 26 weeks. The power was too low to draw firm conclusions on the per-protocol analysis. Patients who received usual consultations were at least as satisfied with their treatment as patients receiving additional antidepressives. Non-inferiority of costs could be demonstrated for 76% of the cases.
Conclusion:
Apparently, paroxetine does not add to the treatment effect of usual consultations by GPs in patients with minor and mild-major depression.
Doel van het onderzoek
Antidepressant medication does not add any effect to usual consultations by general practitioners in patients with minor and mild-major depression.
Onderzoeksopzet
N/A
Onderzoeksproduct en/of interventie
Patients were randomly assigned to four sessions of counselling during 3 months with (n=85) or without paroxetine (n=96). Both treatments were carried out by the patient’s own GP.
Algemeen / deelnemers
Van der Boechorststraat 7
Hein Hout, van
Van der Boechorststraat 7
Amsterdam 1081 BT
The Netherlands
+31 (0)20 4448199
Wetenschappers
Van der Boechorststraat 7
Hein Hout, van
Van der Boechorststraat 7
Amsterdam 1081 BT
The Netherlands
+31 (0)20 4448199
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
1. Aged 18 years or over;
2. Having 3-6 out of 9 depressive symptoms for at least 2 weeks for most days of the week, including at least one of the core symptoms ‘sadness’ or ‘loss of pleasure’;
3. Impairment by depressive symptoms in social, occupational or other important areas of functioning. (minor depression=3-4 symptoms, mild-major depression=5-6 symptoms).
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
1. Current intake of antidepressants or receiving psychological therapy;
2. Psychotic features;
3. Alcohol or drug addiction;
Z
4. Loss of a loved one or significant other in the past six months;
5. Pregnancy or breastfeeding;
6. Inability to complete questionnaires because of language difficulties, illiteracy or cognitive decline;
7. Not having a telephone.
Opzet
Deelname
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Andere (mogelijk minder actuele) registraties in dit register
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In overige registers
| Register | ID |
|---|---|
| NTR-new | NL143 |
| NTR-old | NTR178 |
| Ander register | : OOG00-020 |
| ISRCTN | ISRCTN03007807 |