Summary of findings 3. Memantine compared to placebo for adults with depression in bipolar disorder.
| Mematine compared to placebo for adults with depression in bipolar disorder | ||||||
| Patient or population: adults (aged 18 years+) with depression in bipolar disorder Setting: any setting (outpatient, inpatient, or both) Intervention: memantine Comparison: placebo | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with placebo | Risk with mematine | |||||
| Efficacy: number of participants who respond to treatment ‐ at 1 week | Study population | OR 1.08 (0.06 to 19.05) | 29 (1 RCT) | ⊕⊝⊝⊝ VERY LOW1,2 | ||
| 67 per 1000 | 72 per 1000 (4 to 576) | |||||
| Efficacy: number of participants who respond to treatment ‐ at 2 weeks | Study population | OR 4.88 (0.78 to 30.29) | 29 (1 RCT) | ⊕⊝⊝⊝ VERY LOW1,2 | ||
| 133 per 1000 | 429 per 1000 (107 to 823) | |||||
| Efficacy: number of participants who respond to treatment ‐ at 4 weeks | Study population | OR 5.33 (1.02 to 27.76) | 29 (1 RCT) | ⊕⊝⊝⊝ VERY LOW1,2 | ||
| 200 per 1000 | 571 per 1000 (203 to 874) | |||||
| Efficacy: number of participants who respond to treatment ‐ at 3 months | Study population | OR 1.66 (0.69 to 4.03) | 261 (2 RCTs) | ⊕⊕⊝⊝ LOW1,3 | ||
| 326 per 1000 | 445 per 1000 (250 to 661) | |||||
| Efficacy: number of participants who achieve remission ‐ at 1 week | Study population | OR 1.08 (0.06 to 19.05) | 29 (1 RCT) | ⊕⊝⊝⊝ VERY LOW1,2 | ||
| 67 per 1000 | 72 per 1000 (4 to 576) | |||||
| Depression rating scale score ‐ at 3 months | ‐ | MD 0.6 lower (2.63 lower to 1.43 higher) | ‐ | 157 (1 RCT) | ⊕⊕⊝⊝ LOW1 | |
| Acceptability: total dropouts | Study population | OR 0.77 (0.45 to 1.31) | 261 (2 RCTs) | ⊕⊕⊝⊝ LOW1,3 | ||
| 33 per 1000 | 278 per 1000 (184 to 396) | |||||
| Moderate | ||||||
| 275 per 1000 | 226 per 1000 (146 to 332) | |||||
| Acceptability: dropouts due to adverse effects | Study population | OR 0.34 (0.01 to 8.34) | 232 (1 RCT) | ⊕⊕⊝⊝ LOW1,3 | ||
| 9 per 1000 | 3 per 1000 (0 to 67) | |||||
| *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; HDRS: Hamilton depression rating scale; 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 by one point because no studies described the outcome assessment as masked. 2 Downgraded by two points because of the very small sample size and the wide confidence interval. 3 Downgraded by one point because of wide confidence intervals.