Relative effectiveness of antidepressant treatments in treatment-resistant depression: a systematic review and network meta-analysis of randomized controlled trials.
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology May 1, 2025 Johan Saelens, Anna Gramser, Victoria Watzal et al. 47 citations
A systematic review and network meta-analysis of 69 randomized controlled trials with 10,285 adults who had not responded to at least two antidepressant trials compared 25 treatments for treatment-resistant depression. Six treatments showed higher response rates than placebo or sham: electroconvulsive therapy (ECT) had the strongest effect, followed by minocycline, theta-burst stimulation, repetitive transcranial magnetic stimulation, ketamine, and aripiprazole. Odds ratios ranged from 1.9 for aripiprazole to 12.86 for ECT. Moderate heterogeneity was observed. These findings may help guide evidence-based treatment choices for treatment-resistant depression.