Abstract
Background: Major depressive disorder is a prevalent and disabling illnessv, approximately 70% of patients do not remit after first-line antidepressant treatment, and about 20% develop to treatment-resistant depression(TRD). Treatment of TRD have been one of clinical problems. Adjunctive valprovate was a most sued ways for treatment of TRD. The magnesium valproate was common drug for both episode and bipolar disorder in China and also was used for TRD. To systematically evaluate the difference in efficacy of magnesium valproate and antidepressants for therapy of treatment-resistant depression(TRD) in China. Methods: Searches were applied to the following electronic databases in china: Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG and Chinese Social Sciences Citation Index (VIP) databases. A total of 13 RCTs were included. A meta-analysis was performed of all the literatures germane to estimate the treatment-resistant depression patients treated with magnesium valproate combination with antidepressants and only antidepressants randomized controlled trials (RCTs) from 2010 to 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and the meta-analysis was conducted with Revman4.2 software. Results: A total of 13 RCTs were included for meta-analysis. The results of meta-analysis demonstrated by effective rate and depressive symptoms change between two groups of combination treatment with magnesium valproate and only antidepressant. The effective rate was higher in magnesium valproate combination with antidepressants group than that in antidepressants group(81/306, 35/298, Z=4.60, P=0.00001). The depressive scale was lower found in magnesium valproate combination with antidepressants group than that in antidepressants group after treatment (Z=16.20, P <0.00001). These results indicated that magnesium valproate combination with antidepressants maybe one better therapeutic way for TRD. Conclusion: The results indicate that magnesium valproate combination with antidepressants was better than antidepressants group in effective rate and improving depressive symptoms during treatment of patients with TRD. So these results may recommend to the patients with TRD though without the differences between groups.
Highlights
Major depressive disorder is a prevalent and disabling illnessv, approximately 70% of patients do not remit after first-line antidepressant treatment, and about 20% develop to treatment-resistant depression(TRD)
The success of switching to a different antidepressant following a first-line agent is supported by evidence, but there is limited evidence for effective combination strategies
The use of augmentation of newer-generation antidepressants with atypical antipsychotics is supported by a growing evidence base
Summary
Major depressive disorder is a prevalent and disabling illnessv, approximately 70% of patients do not remit after first-line antidepressant treatment, and about 20% develop to treatment-resistant depression(TRD). The results of meta-analysis demonstrated by effective rate and depressive symptoms change between two groups of combination treatment with magnesium valproate and only antidepressant. The depressive scale was lower found in magnesium valproate combination with antidepressants group than that in antidepressants group after treatment (Z=16.20, P
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