Home > Clinical question: In people with depression during opioid agonist treatment for opioid dependence, what are the effects of antidepressants?

Kavirajan, Harish [The Cochrane Library] . (2016) Clinical question: In people with depression during opioid agonist treatment for opioid dependence, what are the effects of antidepressants? London: Wiley. Cochrane Clinical Answers

URL: https://www.cochranelibrary.com/cca/doi/10.1002/cc...

Based on randomized controlled trial evidence, it is unclear whether the very modest benefits of antidepressants outweigh their adverse effects in depressed patients with opioid dependence.

Low‐quality evidence suggests that antidepressants were no more effective than placebo in reducing depression severity at the end of treatment.

At the same time, moderate‐quality evidence shows a greater rate of dropouts due to medical reasons among patients receiving antidepressants, suggesting higher risk of adverse events. Rates of specific adverse events did not differ, however, between antidepressant and placebo groups, but since sample sizes in trials reporting on them ranged from 76 to 131, the studies were likely underpowered to detect small but significant differences.

Antidepressants may reduce frequency of drug use, but this finding derives from a single trial with 137 patients, albeit one that was deemed to be at low risk of bias.


Item Type:Evidence resource
Publication Type:Guideline
Drug Type:Opioid
Intervention Type:AOD disorder, AOD disorder drug therapy, AOD disorder treatment method, AOD disorder harm reduction, Psychosocial treatment method, Rehabilitation/Recovery
Source:The Cochrane Library
Date:29 January 2016
Publisher:Wiley
Place of Publication:London
EndNote:View
Subjects:B Substances > Opioids (opiates)
E Concepts in biomedical areas > Substance by legal status > Prescription drug (medicine / medication)
G Health and disease > Substance related disorder > Substance related mental disorder
HJ Treatment method > Substance disorder treatment method > Substance disorder drug therapy
HJ Treatment method > Treatment outcome
J Health care, prevention and rehabilitation > Patient care management
J Health care, prevention and rehabilitation > Treatment and maintenance > Treatment factors
J Health care, prevention and rehabilitation > Care by type of problem > Mental health care
N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines

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