Trial reportEuropean archives of psychiatry and clinical neuroscience2017
Guideline adherence of antidepressant treatment in outpatients with major depressive disorder: a naturalistic study.
Trial report in European archives of psychiatry and clinical neuroscience, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00974155 (Randomised Clinical Trial Comparing Early Medication Change), which is not on this map. Cited by 16 papers, 2 of them syntheses that pooled 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.
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.
Randomised Clinical Trial Comparing Early Medication Change (EMC) Strategy With Treatment as Usual (TAU) in Patients With Major Depressive Disorder - the EMC Trial
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Adherence to evidence-based treatment guidelines for depression: a systematic review.BMC psychiatry · 2025Pooled it
- Research hotspots and frontiers of acceptance and commitment therapy for mental disorders: a bibliometric analysis.Frontiers in psychiatry · 2025Pooled it
- Predictors of the effectiveness of an early medication change strategy in patients with major depressive disorder.BMC psychiatry · 2019Trial
- Turbulent-like Dynamics Predict Treatment Outcome in Major Depressive Disorder.Research square · 2025Article
- Evaluating the Construct Validity and Sensitivity to Change of the Klenico Depression Domain in Psychotherapeutic Inpatient Care: Instrument Validation Study.JMIR formative research · 2025Article
- Prospective study of antidepressant treatment of psychiatric patients with depressive disorders: treatment adequacy and outcomes.BMC psychiatry · 2023Article
- Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health.International journal of clinical pharmacy · 2023Article
- Current Status of Therapeutic Drug Monitoring in Mental Health Treatment: A Review.Pharmaceutics · 2022Review
- Article
- Concordance of the treatment patterns for major depressive disorders between the Canadian Network for Mood and Anxiety Treatments (CANMAT) algorithm and real-world practice in China.Frontiers in pharmacology · 2022Article
- Challenges in the Transition from In-Patient to Out-Patient Treatment in Depression.Deutsches Arzteblatt international · 2020Article
- Changes in Prescription of Psychotropic Drugs After Introduction of Polypharmacy Reduction Policy in Japan Based on a Large-Scale Claims Database.Clinical drug investigation · 2019Observational
- Improvement of psychiatrists' clinical knowledge of the treatment guidelines for schizophrenia and major depressive disorders using the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)' project: A nationwide dissemination, education, and evaluation study.Psychiatry and clinical neurosciences · 2019Article
- Prognosis and improved outcomes in major depression: a review.Translational psychiatry · 2019Review
- Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - A cross sectional analysis of the COPDGene cohort.Journal of psychosomatic research · 2019Article
- On the search of new treatment strategies in patients with affective disorders.European archives of psychiatry and clinical neuroscience · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Little is known about guideline adherence of naturalistic antidepressant drug therapy in outpatients with major depressive disorder (MDD). The aim of the study was to analyze guideline adherence, especially regarding treatment length, treatment evaluation and medication change strategies. We investigated 889 patients with MDD who had been admitted for inpatient treatment and were enrolled in the early medication change trial (ClinicalTrials.gov NCT00974155). We investigated all patients at screening visit regarding previous outpatient drug treatment in the index episode, which was assessed by structured interviews. Demographic variables were obtained from patients and patients' records. 51.0% of the patients had received previous drug treatment in the index episode, 56.6% were females, and their mean age was 40.0 years. In the 153 patients who were pharmacologically treated at least 8 weeks, medication was not changed in 129 (84.3%) patients. Patients who had a medication change in their index episode (n = 24, 15.7%) waited 71.1 weeks (±110.4) for their treatment optimization. Only 5 of those 153 patients (3.3%) had a dose increase, whereas 132 patients (86.3%) had no dose adaption at all. Antidepressant blood levels were measured in 46 patients (30.1%). We conclude that a large proportion of patients with MDD is not treated in adherence to treatment guidelines recommending treatment evaluation (e.g. therapeutic drug monitoring) and treatment change after 4 to 8 weeks in non-responders. Earlier treatment optimization may prevent long-term suffering of patients and may avoid inpatient treatment.
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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 OpenQuestion graph.