Summary of findings 7. Augmentation of current antidepressant (various) with quetiapine (150 mg/d to 300 mg/d) compared to augmentation of current antidepressant (various) with placebo for treatment‐resistant depression in adults.
| Augmentation of current antidepressant (various) with quetiapine (150 mg/d to 300 mg/d) compared to augmentation of current antidepressant (various) with placebo for treatment‐resistant depression in adults | |||||
| Patient or population: treatment‐resistant depression in adults Setting: outpatient Intervention: augmentation of current antidepressant (various) with quetiapine (150 mg/d to 300 mg/d) Comparison: augmentation of current antidepressant (various) with placebo | |||||
| Outcomes | № of participants (studies) Follow‐up | Certainty of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects* (95% CI) | |
| Risk with augmentation of current antidepressant (various) with placebo | Risk difference with augmentation of current antidepressant (various) with quetiapine (150 mg/d to 300 mg/d) | ||||
| Depressive symptoms (MADRS or HAM‐D) ‐ Any dose | 977 (3 RCTs) | ⊕⊕⊕⊕ HIGH | ‐ | The mean depressive symptom score (MADRS or HAM‐D) ‐ any dose was not calculable | SMD 0.32 lower (0.46 lower to 0.18 lower) |
| Dropouts ‐ Any dose | 997 (3 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | RR 1.33 (0.90 to 1.95) | Study population | |
| 159 per 1,000 | 52 more per 1,000 (16 fewer to 151 more) | ||||
| Response (≥ 50% reduction in MADRS or HAM‐D score) ‐ Any dose | 977 (3 RCTs) | ⊕⊕⊕⊝ MODERATE 2 | RR 1.25 (1.09 to 1.44) | Study population | |
| 442 per 1,000 | 110 more per 1,000 (40 more to 194 more) | ||||
| Remission (MADRS score ≤ 8/HAM‐D score ≤ 7) ‐ Any dose | 977 (3 RCTs) | ⊕⊕⊕⊝ MODERATE 2 | RR 1.53 (1.23 to 1.90) | Study population | |
| 233 per 1,000 | 123 more per 1,000 (54 more to 210 more) | ||||
| Quality of life (% max score of Q‐LES‐Q‐SF) ‐ Any dose Scale from: 0 to 100 (better) follow‐up: 6 weeks | 884 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | ‐ | The mean quality of life (% max score of Q‐LES‐Q‐SF) ‐ any dose was 55% | MD 0.57 higher (1.52 lower to 2.65 higher) |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
1 Downgraded one level for imprecision (broad confidence interval which crossed the null)
2 Downgraded one level for imprecision (broad confidence interval)