Executive summary of the report by the WPA section on pharmacopsychiatry on general and comparative efficacy and effectiveness of antidepressants in the acute treatment of depressive disorders

• Published in: European archives of psychiatry and clinical neuroscience 2012-02, Vol.262 (1), p.13-22
• Main Authors: Baghai, Thomas C., Blier, Pierre, Baldwin, David S., Bauer, Michael, Goodwin, Guy M., Fountoulakis, Kostas N., Kasper, Siegfried, Leonard, Brian E., Malt, Ulrik F., Stein, Dan J., Versiani, Marcio, Möller, Hans-Jürgen
• Format: Article
• Language: English
• Subjects: Algorithms; Antidepressants; Antidepressive Agents - therapeutic use; Data processing; Databases, Bibliographic - statistics & numerical data; Depression; Depressive Disorder - drug therapy; Depressive Disorder - rehabilitation; Humans; Medicine; Medicine & Public Health; Meta-Analysis as Topic; Nervous system; Neurosciences; Original Paper; Pharmacodynamics; Psychiatry; Psychotherapy; Randomized Controlled Trials as Topic; Reviews; Social interactions; Statistical analysis; Treatment Outcome
• ISSN: 0940-1334; 1433-8491
• DOI: 10.1007/s00406-011-0274-7

Current gold standard in the treatment of depression includes pharmacotherapeutic and psychotherapeutic strategies together with social support. Due to the actually discussed controversies concerning the differential efficacy of antidepressants, a contribution to a comprehensive clarification seems to be necessary to avert further deterioration and uncertainty from patients, relatives, and their treating psychiatrists and general practitioners. Both efficacy and clinical effectiveness of antidepressants in the treatment of depressive disorders can be confirmed. Clinically meaningful antidepressant treatment effects were confirmed in different types of studies. Methodological issues of randomized controlled studies, meta-analyses, and effectiveness studies will be discussed. Furthermore, actual data about the differential efficacy and effectiveness of antidepressants with distinct pharmacodynamic properties and about outcome differences in studies using antidepressants and/or psychotherapy are discussed. This is followed by a clinically oriented depiction—the differential clinical effectiveness of different pharmacodynamic modes of action of antidepressants in different subtypes of depressive disorders. It can be summarized that the spectrum of different antidepressant treatments has broadened during the last decades. The efficacy and clinical effectiveness of antidepressants is statistically significant and clinically relevant and proven repeatedly. For further optimizing antidepressant treatment plans, clearly structured treatment algorithms and the implementation of psychotherapy seem to be useful. A modern individualized antidepressant treatment in most cases is a well-tolerated and efficacious tool to minimize the negative impact of the otherwise devastating and life-threatening outcome of depressive disorders.