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Results: 2

Treatment for Depression After Unsatisfactory Response to SSRIs [Internet]

Treatment for Depression After Unsatisfactory Response to SSRIs [Internet]

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US)

Version: April 2012


Figure 2 shows the number of citations retrieved in the search from bibliographic and grey literature sources. From an initial 46,884 citations from the seven databases, 2,380 were duplicates. Following the initial screen of title and abstract by two reviewers, 36,031 studies were excluded, indicating that the citation was any of the following: (1) a commentary, editorial or narrative review, (2) not published in English; or, (3) not focused on the treatment of depression. At the next level of title and abstract screening, an additional 8,473 citations were excluded as they were: (1) not a primary study, systematic review, or guideline, (2) not a population with major depressive disorder (MDD), dysthymia, or subsyndromal depression; or, (3) evaluated only electroconvulsive therapy, transmagnetic stimulation, or vagal nerve stimulation as treatments for depression. A total of 3,147 citations were then screened at full text. Figure 2 details the reasons for exclusion at full text. An additional 1,682 citations were derived from grey literature sources and reviewed for relevancy. Systematic reviews published from 2005 forward were screened for potentially relevant citations that may not have been captured by the search. Forty-four primary studies (74 publications),,– were eligible for adults and adolescents. Twenty-seven guidelines in 33 publications,,–,–,– were eligible.


The topic of this report and preliminary Key Questions (KQs) were developed through a participatory process involving the public, the Scientific Resource Center for the Effective Health Care program of the Agency for Healthcare Research and Quality (AHRQ), and various stakeholder groups. We communicated with eight key informants who represented psychiatrists, primary care practitioners, consumer representatives, and researchers in the area when formulating the research questions. Additional study, patient, intervention, and eligibility criteria, as well as outcomes, were refined and agreed upon through discussions between the McMaster University Evidence-based Practice Center, the Technical Expert Panel (TEP) members, the AHRQ Task Order Officer (TOO), a patient representative, and comments received from the public. Upon completion of the topic refinement, the key questions were posted for public comment, which were then summarized and discussed with the TEP. Relevant modifications (additions or clarifications) were incorporated.

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