SynthesisThe international journal of neuropsychopharmacology2020
Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines.
Synthesis in The international journal of neuropsychopharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis 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
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review and meta-analysis of augmentation and combination treatments for early-stage treatment-resistant depression.Journal of psychopharmacology (Oxford, England) · 2023Pooled it
- The behavioural effects of the serotonin 1A receptor agonist buspirone on cognition and emotional processing in healthy volunteers.Psychopharmacology · 2025Trial
- Repetitive Transcranial Magnetic Stimulation as Maintenance Treatment of Depression: The MAINT-R Randomized Clinical Trial.JAMA network open · 2025Trial
- Trial
- Ketamine for Depression in Serious Illness: Evidence, Safety, and Practical Approaches.Journal of pain and symptom management · 2026Review
- Treatment-emergent psychiatric adverse events in patient-reported outcomes during ketamine use for major depressive disorder: a retrospective analysis.Pharmacological reports : PR · 2026Observational
- Shared decision-making in depression: From a generalized ethical imperative to a personalized approach? A narrative review.European psychiatry : the journal of the Association of European Psychiatrists · 2026Review
- Analysis of Psychotropic Polypharmacy and Associated Factors in Antidepressant-Treated Patients With Depressive Disorder: A Population-Based Cohort Study Using Real World Data.Depression and anxiety · 2026Article
- Korean Medication Algorithm for Depressive Disorder 2025, Fifth Revision: An Executive Summary.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2025Article
- Commentary on the Canadian Network for Mood and Anxiety Treatments 2023 Clinical Guidelines for Management of Major Depressive Disorder in Adults - Capturing the State of the Art.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2024Article
- Association of Antipsychotic Polypharmacy and Two-Year All-Cause Mortality: A Population-Based Cohort Study of 33,221 Italian Continuous Users.Journal of clinical medicine · 2024Article
- The impact of the COVID-19 pandemic on rates of adolescents receiving psychopharmacological medication in Austria.Child and adolescent psychiatry and mental health · 2024Article
- Lithium prescription trends in psychiatric inpatient care 2014 to 2021: data from a Bavarian drug surveillance project.International journal of bipolar disorders · 2023Article
- Prospective study of antidepressant treatment of psychiatric patients with depressive disorders: treatment adequacy and outcomes.BMC psychiatry · 2023Article
- Thoughtful prescribing for patients with difficult-to-treat depression.Canadian family physician Medecin de famille canadien · 2023Article
- Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2023Article
- Identifying depression and its determinants upon initiating treatment: ChatGPT versus primary care physicians.Family medicine and community health · 2023Article
- Efficacy of Ketamine with and without Lamotrigine in Treatment-Resistant Depression: A Preliminary Report.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Appropriate Macronutrients or Mineral Elements Are Beneficial to Improve Depression and Reduce the Risk of Depression.International journal of molecular sciences · 2023Review
- Agomelatine enhances the therapeutic effect of venlafaxine on depression and improves the levels of S100B and GFAP.American journal of translational research · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundPharmacological augmentation is a recommended strategy for patients with treatment-resistant depression. A range of guidelines provide advice on treatment selection, prescription, monitoring and discontinuation, but variation in the content and quality of guidelines may limit the provision of objective, evidence-based care. This is of importance given the side effect burden and poorer long-term outcomes associated with polypharmacy and treatment-resistant depression. This review provides a definitive overview of pharmacological augmentation recommendations by assessing the quality of guidelines for depression and comparing the recommendations made.
methodsA systematic literature search identified current treatment guidelines for depression published in English. Guidelines were quality assessed using the Appraisal of Guidelines for Research and Evaluation II tool. Data relating to the prescription of pharmacological augmenters were extracted from those developed with sufficient rigor, and the included recommendations compared.
resultsTotal of 1696 records were identified, 19 guidelines were assessed for quality, and 10 were included. Guidelines differed in their quality, the stage at which augmentation was recommended, the agents included, and the evidence base cited. Lithium and atypical antipsychotics were recommended by all 10, though the specific advice was not consistent. Of the 15 augmenters identified, no others were universally recommended.
conclusionsThis review provides a comprehensive overview of current pharmacological augmentation recommendations for major depression and will support clinicians in selecting appropriate treatment guidance. Although some variation can be accounted for by date of guideline publication, and limited evidence from clinical trials, there is a clear need for greater consistency across guidelines to ensure patients receive consistent evidence-based care.
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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.