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Second-Generation Antidepressants for Treating Adult Depression—An Update

Slide: 27 of 28

Gaps in Knowledge (2 of 2)

The research from the comparative effectiveness review identified these gaps in knowledge:

  • The general efficacy of second-generation antidepressants for treating dysthymia and subsyndromal depression.
  • Differences in benefits and harms in subgroups such as the very elderly or patients with common comorbidities.
  • The most appropriate duration of antidepressant treatment for maintaining remission.
  • The effect of drug dose on the risk of relapse or recurrence.
  • The effect of switching to a new drug after successful completion of acute-phase or continuation-phase treatment.
  • The most effective second-generation antidepressant in patients who either did not respond or could not tolerate a first-line treatment.
  • How combinations of antidepressants compare with monotherapy in treatment-resistant depression.
  • How outcomes of second-generation antidepressants differ in populations with accompanying symptoms such as anxiety, insomnia, pain, or fatigue.
  • The comparative risks of second-generation antidepressants with respect to rare but serious adverse effects such as suicidality, hyponatremia, hepatotoxicity, seizures, cardiovascular adverse events, and serotonin syndrome.