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Antidepressants plus benzodiazepines for major depression

Overview of attention for article published in Cochrane database of systematic reviews, July 2001
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Title
Antidepressants plus benzodiazepines for major depression
Published in
Cochrane database of systematic reviews, July 2001
DOI 10.1002/14651858.cd001026
Pubmed ID
Authors

Toshi A Furukawa, David Streiner, L. Trevor Young, Yoshihiro Kinoshita

Abstract

Anxiety frequently coexists with depression. Adding benzodiazepines to antidepressants is commonly used to treat people with depression, although there has been no convincing evidence to show that such a combination is more effective than antidepressants alone and that there are suggestions that benzodiazepines may lose their efficacy with long-term administration and that their chronic use carries risks of dependence. To determine whether, among adult patients with major depression, adding benzodiazepines to antidepressants brings about any benefit in terms of symptomatic recovery or side-effects in the short term (less than 8 weeks) and long term (more than 2 months), in comparison with treatment by antidepressants alone. We searched MEDLINE (1972 to September 1997), EMBASE (1980 to September 1997), International Pharmaceutical Abstracts (1972 to September 1997), Biological Abstracts (1984 to September 1997), LILACS (1980 to September 1997), PsycLIT (1974 to September 1997), the Cochrane Library (issue 3, 1997) and the trial register of the Cochrane Depression, Anxiety and Neurosis Group (last searched March 1999), combined with hand searching, reference searching, SciSearch and personal contacts. All randomised controlled trials that compared combined antidepressant-benzodiazepine treatment with antidepressant alone for adult patients with major depression. Exclusion criteria are: antidepressant dosage lower than 100 mg of imipramine or its equivalent daily and duration of trial shorter than four weeks. Two reviewers independently assessed the eligibility and quality of the studies. Two reviewers independently extracted the data. Standardized weighted mean differences and relative risks were estimated with random effects model. The dropouts were assigned the least favourable outcome. Two sensitivity analyses examined the effect of this assumption as well as the effect of including medium quality studies. Three a priori subgroup analyses were performed with regard to the patients with or without comorbid anxiety and with regard to the type. Aggregating nine studies with a total of 679 patients, the combination therapy group was less likely to drop out than the antidepressant alone group (relative risk 0.63, 95% confidence interval 0.49 to 0.81). The intention-to-treat analysis (with people dropping out assigned the least favourable outcome) showed that the combination group was more likely to show improvement in their depression (defined as 50% or greater reduction in the depression scale from baseline) (relative risk 1.63, 95% confidence interval 1.18 to 2.27 at one week and relative risk 1.38, 95% confidence interval 1.15 to 1.66 at four weeks). The difference was no longer significant at six to eight weeks. None of the included RCTs lasted longer than eight weeks. The patients allocated to the combination therapy were less likely to drop out from the treatment due to side effects than those receiving antidepressants alone (relative risk 0.53, 95% confidence interval 0.32 to 0.86). However, these two groups of patients were equally likely to report at least one side effect (relative risk 0.99, 95% confidence interval 0.92 to 1.07). The potential benefits of adding a benzodiazepine to an antidepressant must be balanced judiciously against possible harms including development of dependence and accident proneness, on the one hand, and against continued suffering following no response and drop-out, on the other.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 76 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Unknown 75 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 9%
Student > Master 4 5%
Student > Postgraduate 4 5%
Student > Bachelor 4 5%
Professor > Associate Professor 3 4%
Other 8 11%
Unknown 46 61%
Readers by discipline Count As %
Medicine and Dentistry 14 18%
Psychology 6 8%
Unspecified 4 5%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Biochemistry, Genetics and Molecular Biology 1 1%
Other 3 4%
Unknown 46 61%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 October 2016.
All research outputs
#10,906,603
of 13,715,132 outputs
Outputs from Cochrane database of systematic reviews
#9,755
of 10,724 outputs
Outputs of similar age
#189,465
of 281,097 outputs
Outputs of similar age from Cochrane database of systematic reviews
#232
of 250 outputs
Altmetric has tracked 13,715,132 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 10,724 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.2. This one is in the 3rd percentile – i.e., 3% of its peers scored the same or lower than it.
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