ReviewBMJ open2017
Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews.
Review in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 7 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
75 citing papers in PubMed, 7 syntheses or guidelines pooled it, 193 citations in OpenAlex.
- Individual Participant Data Meta-Analysis Identifies Risk Factors for Acute and Persistent Posttraumatic Stress Disorder and Depression Symptoms Following Trauma.Depression and anxiety · 2026Pooled it
- Efficacy and safety of home-based transcranial direct current stimulation (tDCS) on patients with depressive disorders: a systematic review and meta-analysis of randomized clinical trials.Scientific reports · 2025Pooled it
- A conceptual model of factors potentially influencing prescribing decisions for chronic conditions: an overview of systematic reviews.BMC medicine · 2025Pooled it
- A bayesian network meta-analysis to explore modifying factors in randomized controlled trials: what works for whom to reduce depression in nursing home residents?BMC geriatrics · 2024Pooled it
- Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation.The Cochrane database of systematic reviews · 2024Pooled it
- Second-generation antidepressants for treatment of seasonal affective disorder.The Cochrane database of systematic reviews · 2021Pooled it
- Nonpharmacological Treatment for Supporting Social Participation of Adults with Depression.Occupational therapy international · 2021Pooled it
- Probiotics and magnesium orotate for the treatment of major depressive disorder: a randomised double blind controlled trial.Scientific reports · 2024Trial
- Individualized fMRI connectivity defines signatures of antidepressant and placebo responses in major depression.Molecular psychiatry · 2023Trial
- Cilostazol as an adjunctive treatment in major depressive disorder: a pilot randomized, double-blind, and placebo-controlled clinical trial.Psychopharmacology · 2022Trial
- Rapid and sustained decreases in suicidality following a single dose of ayahuasca among individuals with recurrent major depressive disorder: results from an open-label trial.Psychopharmacology · 2021Trial
- Humanistic outcomes in treatment resistant depression: a secondary analysis of the STAR*D study.BMC psychiatry · 2018Trial
- Inflammatory Markers Associated with Antidepressant-Related Side Effects in Patients with Major Depressive Disorder: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Are People Worse Off in a Mental Health Treatment Paradigm Where Medication Is Deemphasised? A Naturalistic Noninferiority Trial of an Initiative to Improve Patient Choice.The International journal of social psychiatry · 2026Article
- Transcriptional profiling reveals brain region-specific changes in gene expression induced by chronic unpredictable mild stress between stress-susceptible and stress-resilient mice.Psychopharmacology · 2026Article
- Review
- Nature-Based Health Interventions for People with Mild to Moderate Anxiety, Depression, and/or Stress: Identifying Target Groups, Professionals, Mechanisms, and Outcomes Through a Delphi Study.International journal of environmental research and public health · 2026Article
- Real-world clinical practice, effectiveness and safety of esketamine nasal spray in major depressive disorder patients: a French prospective cohort (ELLIPSE study).Therapeutic advances in psychopharmacology · 2026Review
- Psychedelics: Future Therapeutics in Major Depression?Advances in experimental medicine and biology · 2026Review
- Functional electrical stimulation for major depressive disorder: Protocol for a pilot randomized controlled trial.PloS one · 2026Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aims to summarise the evidence on more than 140 pharmacological and non-pharmacological treatment options for major depressive disorder (MDD) and to evaluate the confidence that patients and clinicians can have in the underlying science about their effects.
designThis is a review of systematic reviews. DATA SOURCES: This study used MEDLINE, Embase, Cochrane Library, PsycINFO and Epistemonikos from 2011 up to February 2017 for systematic reviews of randomised controlled trials in adult patients with acute-phase MDD.
methodsWe dually reviewed abstracts and full-text articles, rated the risk of bias of eligible systematic reviews and graded the strength of evidence.
resultsNineteen systematic reviews provided data on 28 comparisons of interest. For general efficacy, only second-generation antidepressants were supported with high strength evidence, presenting small beneficial treatment effects (standardised mean difference: -0.35; 95% CI -0.31 to -0.38), and a statistically significantly higher rate of discontinuation because of adverse events than patients on placebo (relative risk (RR) 1.88; 95% CI 1.0 to 3.28).Only cognitive behavioural therapy is supported by reliable evidence (moderate strength of evidence) to produce responses to treatment similar to those of second-generation antidepressants (45.5% vs 44.2%; RR 1.10; 95% CI 0.93 to 1.30). All remaining comparisons of non-pharmacological treatments with second-generation antidepressants either led to inconclusive results or had substantial methodological shortcomings (low or insufficient strength of evidence).
conclusionsIn contrast to pharmacological treatments, the majority of non-pharmacological interventions for treating patients with MDD are not evidence based. For patients with strong preferences against pharmacological treatments, clinicians should focus on therapies that have been compared directly with antidepressants. TRIAL REGISTRATION NUMBER: International Prospective Register of Systematic Reviews (PROSPERO) registration number: 42016035580.
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What OpenQuestion holds
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.