Evidence map›Paper›PMID 27486148›Full record

SynthesisCanadian journal of psychiatry. Revue canadienne de psychiatrie2016

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments.

Sidney H Kennedy, Raymond W Lam, Roger S McIntyre, S Valérie Tourjman, Venkat Bhat, Pierre Blier, Mehrul Hasnain, Fabrice Jollant, Anthony J Levitt, Glenda M MacQueen and 9 more

Erratum issued 2 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 508 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
508citing papers in PubMed, 20 pooled it
64.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04234776 phase4unknown statusnot on this mapstarted 2018, after this paper: background citation

Intramuscular Ketamine Versus Escitalopram and Aripiprazole in Acute and Maintenance Treatment of Patients With Treatment-resistant Depression

TypeinterventionalSponsorUniversity of Sao PauloRan2018 to 2021Enrolled88ConditionsDepressive DisorderArmsKetamine, Cognition, Suicide risk, Depression thoughts, Quality of life and disability
NCT05814640 phase1 / phase2recruitingnot on this mapstarted 2023, after this paper: background citation

Sequenced Treatment Alternatives to Relieve Adolescent Depression (STAR-AD): a Pragmatic Clinical Trial

TypeinterventionalSponsorFirst Affiliated Hospital of Chongqing Medical UniversityRan2023 to 2027Enrolled520ConditionsDepression, SequestraArmsFluoxetine, Sertraline, Vortioxetine, Duloxetine, Aripiprazole
3 · Its place in the literature

Who cites it

508 citing papers in PubMed, 20 syntheses or guidelines pooled it, 1,103 citations in OpenAlex.

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  20. Efficacy of Transcranial Photobiomodulation on Depressive Symptoms: A Meta-Analysis.Photobiomodulation, photomedicine, and laser surgery · 2023
    Pooled it

448 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 11 institutions in 2 countries.

Sidney H KennedyDepartment of Psychiatry, University of Toronto, Toronto, Ontario *Co-first authors. sidney.kennedy@uhn.ca.
Raymond W LamDepartment of Psychiatry, University of British Columbia, Vancouver, British Columbia *Co-first authors.
Roger S McIntyreDepartment of Psychiatry, University of Toronto, Toronto, Ontario.
S Valérie TourjmanDepartment of Psychiatry, L'Université de Montréal, Montréal, Quebec.
Venkat BhatDepartment of Psychiatry, McGill University, Montréal, Quebec.
Pierre BlierDepartment of Psychiatry, University of Ottawa, Ottawa, Ontario.
Mehrul HasnainDepartment of Psychiatry, Memorial University, St. John's, Newfoundland.
Fabrice JollantDepartment of Psychiatry, McGill University, Montréal, Quebec.
Anthony J LevittDepartment of Psychiatry, University of Toronto, Toronto, Ontario.
Glenda M MacQueenDepartment of Psychiatry, University of Calgary, Calgary, Alberta.
Shane J McInerneyDepartment of Psychiatry, University of Toronto, Toronto, Ontario.
Diane McIntoshDepartment of Psychiatry, University of British Columbia, Vancouver, British Columbia.
Roumen V MilevDepartment of Psychiatry, Queen's University, Kingston, Ontario.
Daniel J MüllerDepartment of Psychiatry, University of Toronto, Toronto, Ontario.
Sagar V ParikhDepartment of Psychiatry, University of Toronto, Toronto, Ontario Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Norma L PearsonCanadian Pharmacists Association, Ottawa, Ontario.
Arun V RavindranDepartment of Psychiatry, University of Toronto, Toronto, Ontario.
Rudolf UherDepartment of Psychiatry, Dalhousie University, Halifax, Nova Scotia.
CANMAT Depression Work Group
University of Toronto · CAMcGill University · CAUniversity of British Columbia · CACanadian Pharmacists Association · CADalhousie University · CAHealth First · USMemorial University of Newfoundland · CAQueen's University · CAUniversité de Montréal · CAUniversity of Calgary · CAUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals.

methodsUsing the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. "Pharmacological Treatments" is the third of six sections of the 2016 guidelines. With little new information on older medications, treatment recommendations focus on second-generation antidepressants.

resultsEvidence-informed responses are given for 21 questions under 4 broad categories: 1) principles of pharmacological management, including individualized assessment of patient and medication factors for antidepressant selection, regular and frequent monitoring, and assessing clinical and functional outcomes with measurement-based care; 2) comparative aspects of antidepressant medications based on efficacy, tolerability, and safety, including summaries of newly approved drugs since 2009; 3) practical approaches to pharmacological management, including drug-drug interactions and maintenance recommendations; and 4) managing inadequate response and treatment resistance, with a focus on switching antidepressants, applying adjunctive treatments, and new and emerging agents.

conclusionsEvidence-based pharmacological treatments are available for first-line treatment of MDD and for management of inadequate response. However, given the limitations of the evidence base, pharmacological management of MDD still depends on tailoring treatments to the patient.

Indexed as

Antidepressive AgentsCanadaEvidence-Based MedicineHumansMajor Depressive DisorderPractice Guidelines as TopicSocieties, MedicalAntidepressive Agentsantidepressantsantipsychoticsclinical practice guidelinesclinical trialsevidence-based medicinemajor depressive disordermeta-analysispharmacotherapyrandomized controlled trial

Identifiers

PMID27486148
PMCPMC4994790
OpenAlexW2478017657

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.