Evidence map›Paper›PMID 39783764›Full record

SynthesisNeuropsychopharmacology reports2025

Residual Fatigue in Unipolar and Bipolar Depression: A Systematic Review.

Michał Pastuszak, Wiesław Jerzy Cubała, Katarzyna Jakuszkowiak-Wojten, Aleksander Kwaśny, Damian Świeczkowski, Maria Gałuszko-Węgielnik

Abstract readSystematic Review
In one paragraph

Synthesis in Neuropsychopharmacology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michał PastuszakDepartment of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Wiesław Jerzy CubałaDepartment of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Katarzyna Jakuszkowiak-WojtenDepartment of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Aleksander KwaśnyDepartment of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.ORCID https://orcid.org/0009-0007-4061-775X
Damian ŚwieczkowskiDepartment of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, Gdańsk, Poland.
Maria Gałuszko-WęgielnikDepartment of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Funding

Medical University of Gdańsk 01-10025/0008245/01/221/221/0/2025
6 · The paper itself

Abstract

backgroundResidual fatigue is a common and debilitating symptom in patients with unipolar and bipolar depression, even after achieving partial or full remission. It significantly impacts patients' quality of life and increases the risk of relapse. This systematic review aims to evaluate the prevalence and effectiveness of therapeutic options for residual fatigue in individuals with unipolar major depressive disorder (MDD) and bipolar disorder (BD).

methodsA comprehensive search was conducted in the PubMed, SCOPUS, and Web of Science databases up to September 2024. The protocol for this systematic review was registered in PROSPERO. The search strategy included terms related to depression and residual fatigue. Studies were included if they provided data on adult patients diagnosed with MDD or BD, and if they measured the prevalence or treatment of residual fatigue. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale for non-randomized studies.

resultsTwenty studies were included in the review. The vast majority reported on MDD, and single papers investigated BD. Residual fatigue was reported by up to 83% of patients, and moderate to severe residual fatigue affected a smaller percentage. Pharmacological treatments, such as modafinil and to a lesser extent atomoxetine, demonstrated short-term reductions in residual fatigue.

conclusionResidual fatigue remains a significant challenge in the treatment of depression, persisting in a large portion of patients despite remission. Pharmacological interventions like modafinil appear promising, but more research is needed, especially in BD. Standardized assessment tools and longer-term studies are essential to better understand and treat residual fatigue.

trial registrationPROSPERO identifier: CRD42024543087.

Indexed as

Bipolar DisorderFatigueMajor Depressive DisorderHumansQuality of Lifebipolar depressionbipolar disorderdepressionmajor depressive disordermodafinilresidual fatigue

Identifiers

PMID39783764
PMCPMC11713126

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Registered trials

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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.