Antidepresivos para personas con epilepsia y depresión
Appendices
Appendix 1. CRS Web search strategy
1. (antidepressant* or antidepressive* or "af 1161" or "ba 34276" or "bc 105" or "brl 29060" or "brl 29060" or "cl 67772" or "cp 15467 61" or "du 23000" or "fg 7051" or "ici 58834" or "l deprenyl" or "leo 640" or "lilly 110140" or "lu 10 171" or "ma 1291" or "nsc 16895" or "org gb 94" or "r 55667" or "ro 11 1163" or "trans 2 phenylcyclopropylamine" or "ym 35 995" or "ym 992" or "zk 62711" or abilify or adapin or adaptol or adderall or agomelatin* or aiglonyl or allegron or altrulin* or amfebutamon* or amineptin* or amineurin or amisulprid* or amitrip* or amitrol or amizol or amoxapin* or amphetamin* or anafranil or anapsique or aponal or ardeydorm or ardeytropin or aremis or arima or aripiprazol* or arminol or aropax or asenapin* or asendin or astyl or atomoxetin* or aurorix or aventyl or axiomin or azepin* or benactyzin* or benzeneacetic acid or besitran or bolvidon or bosnyl or brofaramin* or bupropion or buspar or buspiron* or butriptylin* or carbamazepin* or celexa or chlomipramin* or chlorgylin* or cipralex or cipramil or citalopram* or clomipramin* or clorgilin* or clorgylin* or concerta or cymbalta or cytalopram* or dalcipran or damilen or deanol or defanyl or deftan or demanyl or demolox or depakote or deponerton or deprax or deprenorm or deprilept or deptran or desidox or desiflu or desipramin* or desisulpid or desitriptylin* or desmethylamitriptylin* or desmethylimipramin* or desmethylloxapin* or desvenlafaxin* or desyrel or dexedrin* or dexmethylphenidat* or dextroamphetamin* or dibencycladin* or digton or dilithium carbonate or dimethylaminoethanol or dimethylethanolamin* or dmi or dogmatil or dolmatil or domical or doneurin or dosulepin or dothiepin or doxepia or doxepin* or duloxetin* or dumirox or edronax or effexor or eglonyl or ekilid or elavil or eldepryl or eldoral or emovit or emsam or endep or escitalopram or eskalith or espadox or espiride or etonin or etoperidone or evaden* or favarin or fenelzin or feprapax or feraken or fevarin or floxyfral or fluoxetin* or fluvoxadura or fluvoxamin* or focalin or gamanil or gladem or guastil or herphonal or hydiphen or imidobenzyl* or imipramin* or imizin or insidon or iprazid or iprindol* or iproniazid or isocarboxazid or ixel or janimin* or jatrosom or lamictal or lamotrigin* or laroxyl or leboprid* or lentizol or lerivon or lexapro or lisdexamfetamin* or lithan* or lithium or lithobid or lofepramin* or lomont or lopramin* or lubazodon* or lucidil or ludiomil or lustral or luvox or lyphan or manerix or maprolu or maprotilin* or mareen or marplan or melitracen or meresa or meridia or methylphenidat* or mianserin or micalith or midalcipran or milnacepra* or mirpan or mirtazapin* or moclamin* or moclix or moclobemid* or moclobeta or moclodura or moclonorm or modal or molipaxin or nardelzin* or nardil or naturruhe or nefadar or nefazodon* or neogama or nialamid* or norfenazin or noritren or norpramin* or nortrilen or nortriptylin* or norval or novoprotect or olanzapin* or opipramol or optimax or oxitriptan* or pamelor or parnate or paroxetin* or paxil or paxtibi or pertofran* or pertrofran or petylyl or phenelzin* or phenethylhydrazin* or phenylethylhydrazin* or pirazidol or pirlindol* or pizotifen or pizotylin* or polomigran or pontirid* or pramolan or priadel or pristiq or prondol or prothiaden or protriptylin* or prozac or prudoxin or pryleugan or psicocen or psymion or quetiapin* or quilinorm* or quipazin* or quitaxon or quomen or r55667 or reboxetin* or reductil or remeron or rhotrimin* or rimoc or ritalin or ritanserin or rolipram or sandomigran or saphris or sarafem or saroten or sarotex or savella or sealdin or sediel or selegilin* or sendis or seroquel or seroxat or sertralin* or serzone or sibutramin* or sinequan or solian or stangyl or strattera or sulp or sulpirid* or sulpitil or sulpivert or sulpor or surmontil or sycrest or symbyax or synedil or syneudon or tandospiron* or tegretol or tepavil or thombran or tianeptin* or tofranil or toledomin or tolvon or tonibral or tradozon* or tramadol or tramal or transamine or tranylcypromin* or trazodon* or trimepr* or trimidura or trimineurin or trimipr* or tripramin* or triptafen or trittico or trofan or tryptacin or tryptan or tryptanol or tryptin* or tryptizol or tryptophan* or tyrima or ultram or valdoxan or valpro* or venlafaxin* or viibryd or vilazodon* or viloxazin* or vivactil or vivalan or vyvanse or wellbutrin or xepin or yentreve or zelapar or zimelidin* or zispin or zoloft or zonalon or zyban or zyntabac):AB,KW,MC,MH,TI AND INSEGMENT
2. MeSH DESCRIPTOR Antidepressive Agents Explode All AND INSEGMENT
3. #1 OR #2 AND INSEGMENT
4. MeSH DESCRIPTOR Depression Explode All AND INSEGMENT
5. MeSH DESCRIPTOR Depressive Disorder Explode All AND INSEGMENT
6. MeSH DESCRIPTOR Dysthymic Disorder Explode All AND INSEGMENT
7. (depression* or depressive*):AB,KW,MC,MH,TI AND INSEGMENT
8. "respiratory depression":AB,KW,MC,MH,TI AND INSEGMENT
9. (#4 OR #5 OR #6 OR #7) NOT #8 AND INSEGMENT
10. #3 AND #9 AND INSEGMENT
11. MESH DESCRIPTOR Epilepsy EXPLODE ALL AND INSEGMENT
12. MESH DESCRIPTOR Seizures EXPLODE ALL AND INSEGMENT
13. (epilep* OR seizure* OR convuls*):AB,KW,MC,MH,TI AND INSEGMENT
14. #11 OR #12 OR #13 AND INSEGMENT
15. #10 AND #14 AND INSEGMENT
16. MESH DESCRIPTOR Electroconvulsive Therapy EXPLODE ALL AND INSEGMENT
17. #15 NOT #16 AND INSEGMENT
18. (antidepressant* or antidepressive* or "af 1161" or "ba 34276" or "bc 105" or "brl 29060" or "brl 29060" or "cl 67772" or "cp 15467 61" or "du 23000" or "fg 7051" or "ici 58834" or "l deprenyl" or "leo 640" or "lilly 110140" or "lu 10 171" or "ma 1291" or "nsc 16895" or "org gb 94" or "r 55667" or "ro 11 1163" or "trans 2 phenylcyclopropylamine" or "ym 35 995" or "ym 992" or "zk 62711" or abilify or adapin or adaptol or adderall or agomelatin* or aiglonyl or allegron or altrulin* or amfebutamon* or amineptin* or amineurin or amisulprid* or amitrip* or amitrol or amizol or amoxapin* or amphetamin* or anafranil or anapsique or aponal or ardeydorm or ardeytropin or aremis or arima or aripiprazol* or arminol or aropax or asenapin* or asendin or astyl or atomoxetin* or aurorix or aventyl or axiomin or azepin* or benactyzin* or benzeneacetic acid or besitran or bolvidon or bosnyl or brofaramin* or bupropion or buspar or buspiron* or butriptylin* or carbamazepin* or celexa or chlomipramin* or chlorgylin* or cipralex or cipramil or citalopram* or clomipramin* or clorgilin* or clorgylin* or concerta or cymbalta or cytalopram* or dalcipran or damilen or deanol or defanyl or deftan or demanyl or demolox or depakote or deponerton or deprax or deprenorm or deprilept or deptran or desidox or desiflu or desipramin* or desisulpid or desitriptylin* or desmethylamitriptylin* or desmethylimipramin* or desmethylloxapin* or desvenlafaxin* or desyrel or dexedrin* or dexmethylphenidat* or dextroamphetamin* or dibencycladin* or digton or dilithium carbonate or dimethylaminoethanol or dimethylethanolamin* or dmi or dogmatil or dolmatil or domical or doneurin or dosulepin or dothiepin or doxepia or doxepin* or duloxetin* or dumirox or edronax or effexor or eglonyl or ekilid or elavil or eldepryl or eldoral or emovit or emsam or endep or escitalopram or eskalith or espadox or espiride or etonin or etoperidone or evaden* or favarin or fenelzin or feprapax or feraken or fevarin or floxyfral or fluoxetin* or fluvoxadura or fluvoxamin* or focalin or gamanil or gladem or guastil or herphonal or hydiphen or imidobenzyl* or imipramin* or imizin or insidon or iprazid or iprindol* or iproniazid or isocarboxazid or ixel or janimin* or jatrosom or lamictal or lamotrigin* or laroxyl or leboprid* or lentizol or lerivon or lexapro or lisdexamfetamin* or lithan* or lithium or lithobid or lofepramin* or lomont or lopramin* or lubazodon* or lucidil or ludiomil or lustral or luvox or lyphan or manerix or maprolu or maprotilin* or mareen or marplan or melitracen or meresa or meridia or methylphenidat* or mianserin or micalith or midalcipran or milnacepra* or mirpan or mirtazapin* or moclamin* or moclix or moclobemid* or moclobeta or moclodura or moclonorm or modal or molipaxin or nardelzin* or nardil or naturruhe or nefadar or nefazodon* or neogama or nialamid* or norfenazin or noritren or norpramin* or nortrilen or nortriptylin* or norval or novoprotect or olanzapin* or opipramol or optimax or oxitriptan* or pamelor or parnate or paroxetin* or paxil or paxtibi or pertofran* or pertrofran or petylyl or phenelzin* or phenethylhydrazin* or phenylethylhydrazin* or pirazidol or pirlindol* or pizotifen or pizotylin* or polomigran or pontirid* or pramolan or priadel or pristiq or prondol or prothiaden or protriptylin* or prozac or prudoxin or pryleugan or psicocen or psymion or quetiapin* or quilinorm* or quipazin* or quitaxon or quomen or r55667 or reboxetin* or reductil or remeron or rhotrimin* or rimoc or ritalin or ritanserin or rolipram or sandomigran or saphris or sarafem or saroten or sarotex or savella or sealdin or sediel or selegilin* or sendis or seroquel or seroxat or sertralin* or serzone or sibutramin* or sinequan or solian or stangyl or strattera or sulp or sulpirid* or sulpitil or sulpivert or sulpor or surmontil or sycrest or symbyax or synedil or syneudon or tandospiron* or tegretol or tepavil or thombran or tianeptin* or tofranil or toledomin or tolvon or tonibral or tradozon* or tramadol or tramal or transamine or tranylcypromin* or trazodon* or trimepr* or trimidura or trimineurin or trimipr* or tripramin* or triptafen or trittico or trofan or tryptacin or tryptan or tryptanol or tryptin* or tryptizol or tryptophan* or tyrima or ultram or valdoxan or valpro* or venlafaxin* or viibryd or vilazodon* or viloxazin* or vivactil or vivalan or vyvanse or wellbutrin or xepin or yentreve or zelapar or zimelidin* or zispin or zoloft or zonalon or zyban or zyntabac):AB,KW,MC,MH,TI AND CENTRAL:TARGET
19. MeSH DESCRIPTOR Antidepressive Agents Explode All AND CENTRAL:TARGET
20. #18 OR #19 AND CENTRAL:TARGET
21. MeSH DESCRIPTOR Depression Explode All AND CENTRAL:TARGET
22. MeSH DESCRIPTOR Depressive Disorder Explode All AND CENTRAL:TARGET
23. MeSH DESCRIPTOR Dysthymic Disorder Explode All AND CENTRAL:TARGET
24. (depression* or depressive*):AB,KW,MC,MH,TI AND CENTRAL:TARGET
25. "respiratory depression":AB,KW,MC,MH,TI AND CENTRAL:TARGET
26. (#21 OR #22 OR #23 OR #24) NOT #25 AND CENTRAL:TARGET
27. #20 AND #26 AND CENTRAL:TARGET
28. MESH DESCRIPTOR Epilepsy EXPLODE ALL AND CENTRAL:TARGET
29. MESH DESCRIPTOR Seizures EXPLODE ALL AND CENTRAL:TARGET
30. (epilep* OR seizure* OR convuls*):AB,KW,MC,MH,TI AND CENTRAL:TARGET
31. #28 OR #29 OR #30 AND CENTRAL:TARGET
32. #27 AND #31 AND CENTRAL:TARGET
33. MESH DESCRIPTOR Electroconvulsive Therapy EXPLODE ALL AND CENTRAL:TARGET
34. #32 NOT #33 AND CENTRAL:TARGET
35. #17 OR #34
Appendix 2. MEDLINE Ovid search strategy
1. exp Depression/ or exp Depressive Disorder/ or exp Dysthymic Disorder/ or (depression$ or depressive$).tw.
2. "respiratory depression".tw.
3. 1 not 2
4. exp Antidepressive Agents/ or anti?depressant$.tw. or anti?depressiv$.tw.
5. ("af 1161" or "bc 105" or "brl 29060" or "cl 67772" or "cp 15467 61" or "du 23000" or "ici 58834" or "leo 640" or "lilly 110140" or "ma 1291" or "nsc 16895" or "org gb 94" or "r 55667" or "ro 11‐1163" or "trans 2 phenylcyclopropylamine" or "ym‐35,995" or "zk 62711" or abilify or adapin or adaptol or adderall or af?1161 or agomelatine or aiglonyl or allegron or altruline or amfebutamone or amineptine or amineurin or amisulpride or amitrip or amitriptylin$ or amitrol or amiz?l or amoxapine or amphetamine or anafranil or anapsique or apo?doxepin or apo?moclob?mide or apo?nortriptyline or apo?sertraline or apo?trimip or apoamitriptyline or aponal or ardeydorm or ardeytropin or aremis or arima or aripiprazole or arminol or aropax or asenapine or asendin or astyl or atomoxetine or auror?x or aventyl or axiomin or ba?34276 or bc?105 or benactyzine or benzeneacetic acid or besitran or beta?phenylethylhydrazine or bolvidon or bosnyl or brl?29060 or brofaramine or bupropion or buspar or buspirone or butriptyline or carbamazepine or celexa or chlomipramine or chlorgyline or cipralex or cipramil or citalopram or cl?67772 or clomipramine or clorgilin$ or clorgyline or concerta or cp?15467?61 or cymbalta or cytalopram or dalcipran or damilen or de?methylimipramine or deanol or defanyl or deftan or deman?l or demolox or depakote or deponerton or deprax or deprenorm or deprilept or deptran or desidox or desiflu or desipramine or desisulpid or desitriptyline or desmethylamitriptylin or desmethylloxapine or desvenlafaxine or desyrel or dexedrine or dexmethylphenidate or dextroamphetamine or dibencycladine or digton or dilithium carbonate or dimethylaminoethanol or dimethylethanolamine or dogmatil or dolmatil or domical or doneurin or dosulepin or dothiepin or doxepia or doxepin$ or du?23000 or duloxetine or dumirox or edronax or ef?exor or eglonyl or ekilid or elavil or eldepryl or eldoral or emovit or emsam or endep or escitalopram or eskalith or espadox or espiride or etonin or etoperidone or evadene or favarin or fenelzin or feprapax or feraken or fevarin or fg?7051 or floxyfral or fluoxetin$ or fluvoxadura or fluvoxamin$ or focalin or gam?nil or gen?nortriptyline or gen?sertraline or gladem or guastil or herphonal or hydiphen or ici?58834 or imidobenzyle or imipramine or imizin or insidon or iprazid or iprindole or iproniazid or isocarboxazid or ixel or janimine or jatrosom or lamictal or lamotrigine or laroxyl or l‐deprenyl or lebopride or lentizol or lerivon or levo?tryptophan or lexapro or lilly?110140 or lisdexamfetamine or lithane or lithium or lithobid or lofepramine or lomont or lopramine or l‐tryptophan or lu?10?171 or lubazodone or lucidil or ludiomil or lustral or luvox or lyphan or ma?1291 or manerix or maprolu or maprotilin$ or mareen or marplan or melitracen or meresa or meridia or methylphenidate or mianserin or micalith or midalcipran or milnacepram or milnacipra? or mirpan or mirtazapine or moclamine or moclix or moclob?mide or moclobemid$ or moclobeta or moclodura or moclonorm or modal or molipaxin or nardelzine or nardil or naturruhe or nefadar or nefazodone or neogama or nialamide or nor?nortriptyline or norfenazin or norpramin or nortrilen or nortriptyline or norval or novo?doxepin or novo?moclob?mide or novo?nortriptyline or novo?sertraline or novo?tripramine or novoprotect or nsc?16895 or nu?moclob?mide or nu?nortriptyline or nu?trimipramine or nu?tripramine or numo?moclob?mide or olanzapine or opipramol or optimax or oxitriptan or pamelor or parnate or paroxetine or paxil or paxtibi or pert?ofran$ or petylyl or phenelzine or phenethylhydrazine or phenylethylhydrazine or pirazidol or pirlindole or pizotifen or pizotyline or pms?moclob?mide or pms?nortriptyline or pms?tryptophan or polomigran or pontiride or pramolan or priadel or pristiq or prondol or prothiaden or protriptyline or prozac or prudoxin or pryleugan or psicocen or psymion or quetiapine or quilinorm?retard or quipazine or quitaxon or quomen or r55667 or r‐55667 or ratio?nortriptyline or ratio?sertraline or ratio?tryptophan or reboxetine or reductil or remeron or rhotrimine or rhoxal?sertraline or rimoc or ritalin or ritanserin or ro‐11‐1163 or rolipram or sandomigran or saphris or sarafem or saroten or sarotex or savella or sealdin or sediel or selegiline or sendis or seroquel or seroxat or sertraline or serzone or sibutramine or sin?quan or solian or stangyl or strattera or sulp or sulpiride or sulpitil or sulpivert or sulpor or surmontil or sycrest or symbyax or synedil or syneudon or tandospirone or tegretol or tepavil or thombran or tianeptine or tofranil or toledomin or tolvon or tonibral or tradozone or tramadol or tramal or trans‐2‐phenylcyclopropylamine or transamine or tranylcypromine or trazodon$ or trim?pr?min$ or trimidura or trimineurin or trimip or tripramine or triptafen or trittico or trofan or tryptacin or tryptan or tryptanol or tryptine or tryptizol or tryptophan or tyrima or ultram or valdoxan or valproic acid or venlafaxine or viibryd or vilazodone or viloxazine or vivactil or vivalan or vyvanse or wellbutrin or xepin or yentreve or ym‐992 or zelapar or zimelidine or zispin or zk?62711 or zoloft or zonalon or zyban or zyntabac).mp.
6. 4 or 5
7. exp Epilepsy/
8. exp Seizures/
9. (epilep$ or seizure$ or convuls$).tw.
10. 7 or 8 or 9
11. exp Pre‐Eclampsia/ or exp Eclampsia/
12. 10 not 11
13. 3 and 6 and 12
14. exp *Electroconvulsive Therapy/
15. 13 not 14
16. exp controlled clinical trial/ or (randomi?ed or placebo or randomly).ab.
17. clinical trials as topic.sh.
18. trial.ti.
19. 16 or 17 or 18
20. exp cohort studies/ or cohort$.tw,hw.
21. exp epidemiologic methods/ or exp follow‐up studies/ or exp prospective studies/
22. limit 21 to yr=1966‐1989
23. exp controlled before‐after studies/ or ("before and after" or "before‐and‐after").tw,hw.
24. 19 or 20 or 22 or 23
25. exp animals/ not humans.sh.
26. 24 not 25
27. 26 not case reports.pt.
28. 15 and 27
29. remove duplicates from 28
Appendix 3. SCOPUS search strategy
(((((((TITLE‐ABS‐KEY(antidepressant* OR antidepressiv*)) OR (TITLE‐ABS‐KEY("af 1161" OR "ba 34276" OR "bc 105" OR "brl 29060" OR "brl 29060" OR "cl 67772" OR "cp 15467 61" OR "du 23000" OR "fg 7051" OR "ici 58834" OR "l deprenyl" OR "leo 640" OR "lilly 110140" OR "lu 10 171" OR "ma 1291" OR "nsc 16895" OR "org gb 94" OR "r 55667" OR "ro 11 1163" OR "trans 2 phenylcyclopropylamine" OR "ym 35 995" OR "ym 992" OR "zk 62711" OR *amitriptyline OR *doxepin OR *moclobemide OR *nortriptyline OR *phenylethylhydrazine OR *sertraline OR *trimip OR *trimipramine OR *tripramine OR *tryptophan)) OR (TITLE‐ABS‐KEY(abilify OR adapin OR adaptol OR adderall OR agomelatine OR aiglonyl OR allegron OR altruline OR amfebutamone OR amineptine OR amineurin OR amisulpride OR amitrip OR amitriptylin* OR amitrol OR amiz?l OR amoxapine OR amphetamine OR anafranil OR anapsique OR aponal OR ardeydorm OR ardeytropin OR aremis OR arima OR aripiprazole OR arminol OR aropax OR asenapine OR asendin OR astyl OR atomoxetine OR auror?x OR aventyl OR axiomin)) OR (TITLE‐ABS‐KEY(benactyzine OR benzeneacetic acid OR besitran OR bolvidon OR bosnyl OR brofaramine OR bupropion OR buspar OR buspirone OR butriptyline OR carbamazepine OR celexa OR chlomipramine OR chlorgyline OR cipralex OR cipramil OR citalopram OR clomipramine OR clorgilin* OR clorgyline OR concerta OR cymbalta OR cytalopram)) OR (TITLE‐ABS‐KEY(dalcipran OR damilen OR de*methylimipramine OR deanol OR defanyl OR deftan OR deman?l OR demolox OR depakote OR deponerton OR deprax OR deprenorm OR deprilept OR deptran OR desidox OR desiflu OR desipramine OR desisulpid OR desitriptyline OR desmethylamitriptylin OR desmethylloxapine OR desvenlafaxine OR desyrel OR dexedrine OR dexmethylphenidate OR dextroamphetamine OR dibencycladine OR digton OR dilithium carbonate OR dimethylaminoethanol OR dimethylethanolamine OR dogmatil OR dolmatil OR domical OR doneurin OR dosulepin OR dothiepin OR doxepia OR doxepin* OR duloxetine OR dumirox))) OR ((TITLE‐ABS‐KEY(edronax OR ef*exor OR eglonyl OR ekilid OR elavil OR eldepryl OR eldoral OR emovit OR emsam OR endep OR escitalopram OR eskalith OR espadox OR espiride OR etonin OR etoperidone OR evadene OR favarin OR fenelzin OR feprapax OR feraken OR fevarin OR floxyfral OR fluoxetin* OR fluvoxadura OR fluvoxamin* OR focalin OR gam?nil OR gladem OR guastil OR herphonal OR hydiphen)) OR (TITLE‐ABS‐KEY(imidobenzyle OR imipramine OR imizin OR insidon OR iprazid OR iprindole OR iproniazid OR isocarboxazid OR ixel OR janimine OR jatrosom OR lamictal OR lamotrigine OR laroxyl OR lebopride OR lentizol OR lerivon OR lexapro OR lisdexamfetamine OR lithane OR lithium OR lithobid OR lofepramine OR lomont OR lopramine OR lubazodone OR lucidil OR ludiomil OR lustral OR luvox OR lyphan)) OR (TITLE‐ABS‐KEY(manerix OR maprolu OR maprotilin* OR mareen OR marplan OR melitracen OR meresa OR meridia OR methylphenidate OR mianserin OR micalith OR midalcipran OR milnacepra* OR mirpan OR mirtazapine OR moclamine OR moclix OR moclob?mide OR moclobemid* OR moclobeta OR moclodura OR moclonorm OR modal OR molipaxin OR nardelzine OR nardil OR naturruhe OR nefadar OR nefazodone OR neogama OR nialamide OR norfenazin OR norpramin OR nortrilen OR norval OR novoprotect OR olanzapine OR opipramol OR optimax OR oxitriptan)) OR (TITLE‐ABS‐KEY(pamelor OR parnate OR paroxetine OR paxil OR paxtibi OR pertofran* OR pertrofran OR petylyl OR phenelzine OR phenethylhydrazine OR pirazidol OR pirlindole OR pizotifen OR pizotyline OR polomigran OR pontiride OR pramolan OR priadel OR pristiq OR prondol OR prothiaden OR protriptyline OR prozac OR prudoxin OR pryleugan OR psicocen OR psymion OR quetiapine OR quilinorm* OR quipazine OR quitaxon OR quomen)))) OR (TITLE‐ABS‐KEY(r55667 OR reboxetine OR reductil OR remeron OR rhotrimine OR rimoc OR ritalin OR ritanserin OR rolipram OR sandomigran OR saphris OR sarafem OR saroten OR sarotex OR savella OR sealdin OR sediel OR selegiline OR sendis OR seroquel OR seroxat OR serzone OR sibutramine OR sin*quan OR solian OR stangyl OR strattera OR sulp OR sulpiride OR sulpitil OR sulpivert OR sulpor OR surmontil OR sycrest OR symbyax OR synedil OR syneudon)) OR (TITLE‐ABS‐KEY(tandospirone OR tegretol OR tepavil OR thombran OR tianeptine OR tofranil OR toledomin OR tolvon OR tonibral OR tradozone OR tramadol OR tramal OR transamine OR tranylcypromine OR trazodon* OR trimeprimin* OR trimidura OR trimineurin OR triptafen OR trittico OR trofan OR tryptacin OR tryptan OR tryptanol OR tryptine OR tryptizol OR tyrima OR ultram OR valdoxan OR valproic acid OR venlafaxine OR viibryd OR vilazodone OR viloxazine OR vivactil OR vivalan OR vyvanse OR wellbutrin OR xepin OR yentreve OR zelapar OR zimelidine OR zispin OR zoloft OR zonalon OR zyban OR zyntabac))) AND (TITLE‐ABS‐KEY(dysthymic OR depression* OR depressive*) AND NOT TITLE‐ABS‐KEY("respiratory depression"))) AND ((TITLE‐ABS‐KEY(epilep* OR "infantile spasm" OR "ring chromosome 20" OR "R20" OR "myoclonic encephalopathy" OR "pyridoxine dependency") OR (TITLE‐ABS‐KEY(syndrome) W/2 (aicardi OR angelman OR doose OR dravet OR janz OR jeavons OR "landau kleffner" OR "lennox gastaut" OR ohtahara OR panayiotopoulos OR rasmussen OR rett OR "sturge weber" OR tassinari OR "unverricht lundborg" OR west)) OR TITLE(seizure OR convuls*) OR (TITLE‐ABS‐KEY(lafora*) W/4 (disease OR epilep*) AND NOT (TITLE(dog OR canine) OR INDEXTERMS(dog OR canine)))) AND NOT (TITLE(*eclampsia) OR INDEXTERMS(*eclampsia)) AND NOT INDEX(medline))) AND NOT (TITLE(electroconvulsive OR ECT))) AND ((((TITLE((randomiz* OR randomis* OR controlled OR placebo OR blind* OR unblind* OR "parallel group" OR crossover OR "cross over" OR cluster OR "head to head") PRE/2 (analy* OR method OR procedure OR study OR studies OR trial))) OR (ABS((randomiz* OR randomis* OR controlled OR placebo OR blind* OR unblind* OR "parallel group" OR crossover OR "cross over" OR cluster OR "head to head") PRE/2 (analy* OR method OR procedure OR study OR studies OR trial)))) OR (TITLE(("before and after" OR cohort OR prospective) PRE/2 (trial OR method OR procedure OR study))) OR (ABS(("before and after" OR cohort OR prospective) PRE/2 (trial OR method OR procedure OR study)))) AND NOT (INDEXTERMS("case report") OR TITLE ("case report") OR DOCTYPE(re)))
Appendix 4. PsycINFO EBSCOhost search strategy
S11 S6 AND S10
S10 S7 OR S8 OR S9
S9 TI (("before and after" OR cohort OR prospective) W2 (analy* OR method OR procedure OR study OR studies OR trial))
S8 AB (("before and after" OR cohort OR prospective) W2 (analy* OR method OR procedure OR study OR studies OR trial))
S7 TI ( (randomiz* OR randomis* OR controlled OR placebo OR blind* OR unblind* OR "parallel group" OR crossover OR cross‐over OR cluster OR "head to head") N2 (analy* OR method OR procedure OR study OR studies OR trial) ) OR AB ( (randomiz* OR randomis* OR controlled OR placebo OR blind* OR unblind* OR "parallel group" OR crossover OR cross‐over OR cluster OR "head to head") N2 (analy* OR method OR procedure OR study OR studies OR trial) )
S6 S5 NOT DE "Electroconvulsive Shock Therapy"
S5 (S1 OR S2) AND S3 AND S4
S4 DE "Epilepsy" OR DE "Seizures" OR DE "Epileptic Seizures" OR DE "Grand Mal Seizures" OR DE "Petit Mal Seizures" OR DE "Status Epilepticus" OR epilep* OR seizure* OR convuls*
S3 (DE "Depression (Emotion)" OR DE "Major Depression" OR DE "Anaclitic Depression" OR DE "Dysthymic Disorder" OR DE "Endogenous Depression" OR DE "Postpartum Depression" OR DE "Reactive Depression" OR DE "Recurrent Depression" OR DE "Treatment Resistant Depression" OR depression* OR depressive*) NOT "respiratory depression"
S2 DE "Serotonin Reuptake Inhibitors" OR DE "Chlorimipramine" OR DE "Citalopram" OR DE "Fluoxetine" OR DE "Fluvoxamine" OR DE "Paroxetine" OR DE "Zimeldine" OR DE "Serotonin Agonists" OR DE "Triptans" OR DE "Serotonin Antagonists" OR DE "Dihydroxytryptamine" OR DE "Lysergic Acid Diethylamide" OR DE "Mianserin" OR DE "Molindone" OR DE "Parachlorophenylalanine" OR DE "Ritanserin" OR DE "Tetrabenazine" OR DE "Tryptophan" OR DE "Hydroxytryptophan (5‐)" OR DE "Serotonin Precursors" OR DE "Tryptophan" OR DE "Antidepressant Drugs" OR DE "Bupropion" OR DE "Citalopram" OR DE "Fluoxetine" OR DE "Fluvoxamine" OR DE "Iproniazid" OR DE "Isocarboxazid" OR DE "Lithium Carbonate" OR DE "Methylphenidate" OR DE "Mianserin" OR DE "Moclobemide" OR DE "Molindone" OR DE "Nefazodone" OR DE "Nialamide" OR DE "Nomifensine" OR DE "Paroxetine" OR DE "Phenelzine" OR DE "Pheniprazine" OR DE "Pipradrol" OR DE "Serotonin Norepinephrine Reuptake Inhibitors" OR DE "Sertraline" OR DE "Sulpiride" OR DE "Tranylcypromine" OR DE "Trazodone" OR DE "Tricyclic Antidepressant Drugs" OR DE "Venlafaxine" OR DE "Zimeldine" OR DE "Serotonin Norepinephrine Reuptake Inhibitors" OR DE "Venlafaxine" OR DE "Tricyclic Antidepressant Drugs" OR DE "Amitriptyline" OR DE "Chlorimipramine" OR DE "Desipramine" OR DE "Doxepin" OR DE "Imipramine" OR DE "Maprotiline" OR DE "Nortriptyline" OR DE "Lithium" OR DE "Lithium Carbonate" OR DE "Monoamine Oxidase Inhibitors" OR DE "Iproniazid" OR DE "Isocarboxazid" OR DE "Moclobemide" OR DE "Nialamide" OR DE "Pargyline" OR DE "Phenelzine" OR DE "Pheniprazine" OR DE "Tranylcypromine" OR antidepressant OR antidepressive
S1 "af 1161" OR "ba 34276" OR "bc 105" OR "brl 29060" OR "brl 29060" OR "cl 67772" OR "cp 15467 61" OR "du 23000" OR "fg 7051" OR "ici 58834" OR "l deprenyl" OR "leo 640" OR "lilly 110140" OR "lu 10 171" OR "ma 1291" OR "nsc 16895" OR "org gb 94" OR "r 55667" OR "ro 11 1163" OR "trans 2 phenylcyclopropylamine" OR "ym 35 995" OR "ym 992" OR "zk 62711" OR abilify or adapin or adaptol or adderall or agomelatine or aiglonyl or allegron or altruline or amfebutamone or amineptine or amineurin or amisulpride or amitrip or amitriptylin* or amitrol or amiz?l or amoxapine or amphetamine or anafranil or anapsique or apo#doxepin or apo#moclob?mide or apo#nortriptyline or apo#sertraline or apo#trimip or apoamitriptyline or aponal or ardeydorm or ardeytropin or aremis or arima or aripiprazole or arminol or aropax or asenapine or asendin or astyl or atomoxetine or auror?x or aventyl or axiomin or benactyzine or benzeneacetic acid or besitran or beta#phenylethylhydrazine or bolvidon or bosnyl or brofaramine or bupropion or buspar or buspirone or butriptyline or carbamazepine or celexa or chlomipramine or chlorgyline or cipralex or cipramil or citalopram or clomipramine or clorgilin* or clorgyline or concerta or cymbalta or cytalopram or dalcipran or damilen or de#methylimipramine or deanol or defanyl or deftan or deman?l or demolox or depakote or deponerton or deprax or deprenorm or deprilept or deptran or desidox or desiflu or desipramine or desisulpid or desitriptyline or desmethylamitriptylin or desmethylloxapine or desvenlafaxine or desyrel or dexedrine or dexmethylphenidate or dextroamphetamine or dibencycladine or digton or dilithium carbonate or dimethylaminoethanol or dimethylethanolamine or dogmatil or dolmatil or domical or doneurin or dosulepin or dothiepin or doxepia or doxepin* or duloxetine or dumirox or edronax or ef#exor or eglonyl or ekilid or elavil or eldepryl or eldoral or emovit or emsam or endep or escitalopram or eskalith or espadox or espiride or etonin or etoperidone or evadene or favarin or fenelzin or feprapax or feraken or fevarin or floxyfral or fluoxetin* or fluvoxadura or fluvoxamin* or focalin or gam?nil or gen#nortriptyline or gen#sertraline or gladem or guastil or herphonal or hydiphen or imidobenzyle or imipramine or imizin or insidon or iprazid or iprindole or iproniazid or isocarboxazid or ixel or janimine or jatrosom or lamictal or lamotrigine or laroxyl or lebopride or lentizol or lerivon or levo#tryptophan or lexapro or lisdexamfetamine or lithane or lithium or lithobid or lofepramine or lomont or lopramine or l#tryptophan or lubazodone or lucidil or ludiomil or lustral or luvox or lyphan or manerix or maprolu or maprotilin* or mareen or marplan or melitracen or meresa or meridia or methylphenidate or mianserin or micalith or midalcipran or milnacepram or milnacipra? or mirpan or mirtazapine or moclamine or moclix or moclob?mide or moclobemid* or moclobeta or moclodura or moclonorm or modal or molipaxin or nardelzine or nardil or naturruhe or nefadar or nefazodone or neogama or nialamide or nor#nortriptyline or norfenazin or norpramin or nortrilen or nortriptyline or norval or novo#doxepin or novo#moclob?mide or novo#nortriptyline or novo#sertraline or novo#tripramine or novoprotect or nu#moclob?mide or nu#nortriptyline or nu#trimipramine or nu#tripramine or numo#moclob?mide or olanzapine or opipramol or optimax or oxitriptan or pamelor or parnate or paroxetine or paxil or paxtibi or pert#ofran* or petylyl or phenelzine or phenethylhydrazine or phenylethylhydrazine or pirazidol or pirlindole or pizotifen or pizotyline or pms#moclob?mide or pms#nortriptyline or pms#tryptophan or polomigran or pontiride or pramolan or priadel or pristiq or prondol or prothiaden or protriptyline or prozac or prudoxin or pryleugan or psicocen or psymion or quetiapine or quilinorm#retard or quipazine or quitaxon or quomen or r55667 or ratio#nortriptyline or ratio#sertraline or ratio#tryptophan or reboxetine or reductil or remeron or rhotrimine or rhoxal#sertraline or rimoc or ritalin or ritanserin or rolipram or sandomigran or saphris or sarafem or saroten or sarotex or savella or sealdin or sediel or selegiline or sendis or seroquel or seroxat or sertraline or serzone or sibutramine or sin#quan or solian or stangyl or strattera or sulp or sulpiride or sulpitil or sulpivert or sulpor or surmontil or sycrest or symbyax or synedil or syneudon or tandospirone or tegretol or tepavil or thombran or tianeptine or tofranil or toledomin or tolvon or tonibral or tradozone or tramadol or tramal or transamine or tranylcypromine or trazodon* or trim?pr?min* or trimidura or trimineurin or trimip or tripramine or triptafen or trittico or trofan or tryptacin or tryptan or tryptanol or tryptine or tryptizol or tryptophan or tyrima or ultram or valdoxan or valproic acid or venlafaxine or viibryd or vilazodone or viloxazine or vivactil or vivalan or vyvanse or wellbutrin or xepin or yentreve or zelapar or zimelidine or zispin or zoloft or zonalon or zyban or zyntabac
Appendix 5. ClinicalTrials.gov search strategy
Interventional Studies | Epilepsy | Antidepressant
Appendix 6. ICTRP search strategy
Condition: epilepsy
Intervention: antidepressant
Recruitment status: All
Phases: All
Appendix 7. Signalling questions for the seven 'Risk of bias' domains of the ROBINS‐I tool
| Bias due to confounding | |
|---|---|
| 1.1 Is there potential for confounding of the effect of intervention in this study? If N/PN to 1.1: the study can be considered to be at low risk of bias due to confounding and no further signalling questions need be considered If Y/PY to 1.1: determine whether there is a need to assess time‐varying confounding | Y/PY/PN/N |
| 1.2. If Y/PY to 1.1: Was the analysis based on splitting participants’ follow‐up time according to intervention received? If N/PN to 1.2, answer questions relating to baseline confounding (1.4 to 1.6) If Y/PY to 1.2, go to question 1.3 | Y/PY/PN/N/NI/NA |
| 1.3 Were intervention discontinuations or switches likely to be related to factors that are prognostic for the outcome? If N/PN to 1.3, answer questions relating to baseline confounding (1.4 to 1.6) If Y/PY to 1.3, answer questions relating to both baseline and time‐varying confounding (1.7 and 1.8) | Y/PY/PN/N/NI/NA |
| 1.4. Did the authors use an appropriate analysis method that controlled for all the important confounding domains? | Y/PY/PN/N/NI/NA |
| 1.5. If Y/PY to 1.4, were confounding domains that were controlled for measured validly and reliably by the variables available in this study? | Y/PY/PN/N/NI/NA |
| 1.6. Did the authors control for any post‐intervention variables that could have been affected by the intervention? | Y/PY/PN/N/NI/NA |
| 1.7. Did the authors use an appropriate analysis method that controlled for all the important confounding domains and for time‐varying confounding? | Y/PY/PN/N/NI/NA |
| 1.8. If Y or PY to 1.7, were confounding domains that were controlled for measured validly and reliably by the variables available in this study? | Y/PY/PN/N/NI/NA |
| 'Risk of bias' judgement | Low/Moderate/Serious/Critical/NI |
| Bias in selection of participants into the study | |
| 2.1. Was selection of participants into the study (or into the analysis) based on participant characteristics observed after the start of intervention? If N/PN to 2.1, go to 2.4 | Y/PY/PN/N/NI |
| 2.2. If Y/PY to 2.1, were the post‐intervention variables that influenced selection likely to be associated with intervention? | Y/PY/PN/N/NI/NA |
| 2.3. If Y/PY to 2.2, were the post‐intervention variables that influenced selection likely to be influenced by the outcome or a cause of the outcome? | Y/PY/PN/N/NI/NA |
| 2.4. Do start of follow‐up and start of intervention coincide for most participants? | Y/PY/PN/N/NI |
| 2.5. If Y/PY to 2.2 and 2.3, or N/PN to 2.4, were adjustment techniques used that are likely to correct for the presence of selection biases? | Y/PY/PN/N/NI/NA |
| 'Risk of bias' judgement | Low/Moderate/Serious/Critical/NI |
| Bias in classification of interventions | |
| 3.1 Were intervention groups clearly defined? | Y/PY/PN/N/NI |
| 3.2 Was the information used to define intervention groups recorded at the start of the intervention? | Y/PY/PN/N/NI |
| 3.3 Could classification of intervention status have been affected by knowledge of the outcome or risk of the outcome? | Y/PY/PN/N/NI |
| 'Risk of bias' judgement | Low/Moderate/Serious/Critical/NI |
| Bias due to deviations from intended interventions If your aim for this study is to assess the effect of assignment to intervention, answer questions 4.1 and 4.2 If your aim for this study is to assess the effect of starting and adhering to intervention, answer questions 4.3 to 4.6 | |
| 4.1. Were there deviations from the intended intervention beyond what would be expected in usual practice? | Y/PY/PN/N/NI |
| 4.2. If Y/PY to 4.1, were these deviations from intended intervention unbalanced between groups and likely to have affected the outcome? | Y/PY/PN/N/NI/NA |
| 4.3. Were important co‐interventions balanced across intervention groups? | Y/PY/PN/N/NI |
| 4.4. Was the intervention implemented successfully for most participants? | Y/PY/PN/N/NI |
| 4.5. Did study participants adhere to the assigned intervention regimen? | Y/PY/PN/N/NI |
| 4.6. If N/PN to 4.3, 4.4, or 4.5, was an appropriate analysis used to estimate the effect of starting and adhering to the intervention? | Y/PY/PN/N/NI/NA |
| 'Risk of bias' judgement | Low/Moderate/Serious/Critical/NI |
| Bias due to missing data | |
| 5.1 Were outcome data available for all, or nearly all, participants? | Y/PY/PN/N/NI |
| 5.2 Were participants excluded due to missing data on intervention status? | Y/PY/PN/N/NI |
| 5.3 Were participants excluded due to missing data on other variables needed for the analysis? | Y/PY/PN/N/NI |
| 5.4 If PN/N to 5.1, or Y/PY to 5.2 or 5.3, are the proportion of participants and reasons for missing data similar across interventions? | Y/PY/PN/N/NI/NA |
| 5.5 If PN/N to 5.1, or Y/PY to 5.2 or 5.3, is there evidence that results were robust to the presence of missing data? | Y/PY/PN/N/NI/NA |
| 'Risk of bias' judgement | Low/Moderate/Serious/Critical/NI |
| Bias in measurement of outcomes | |
| 6.1 Could the outcome measure have been influenced by knowledge of the intervention received? | Y/PY/PN/N/NI |
| 6.2 Were outcome assessors unaware of the intervention received by study participants? | Y/PY/PN/N/NI |
| 6.3 Were the methods of outcome assessment comparable across intervention groups? | Y/PY/PN/N/NI |
| 6.4 Were any systematic errors in measurement of the outcome unrelated to intervention received? | Y/PY/PN/N/NI |
| 'Risk of bias' judgement | Low/Moderate/Serious/Critical/NI |
| Bias in selection of the reported result Is the reported effect estimate likely to be selected, on the basis of the results, from... | |
| 7.1. ... multiple outcome measurements within the outcome domain? | Y/PY/PN/N/NI |
| 7.2 ...multiple analyses of the intervention‐outcome relationship? | Y/PY/PN/N/NI |
| 7.3 ...different subgroups? | Y/PY/PN/N/NI |
| 'Risk of bias' judgement | Low/Moderate/Serious/Critical/NI |
| Abbreviations: Y: yes; PY: probably yes; PN: probably no; N: no; NI: no information; NA: not applicable | |
Study flow diagram
Comparison 1: RCT: paroxetine versus doxepin, Outcome 1: > 50% reduction in depressive symptoms
Comparison 1: RCT: paroxetine versus doxepin, Outcome 2: Mean depression scores
Comparison 1: RCT: paroxetine versus doxepin, Outcome 3: Withdrawals (any reason)
Comparison 1: RCT: paroxetine versus doxepin, Outcome 4: Adverse effects
Comparison 2: RCT: amitriptyline versus nomifensine, Outcome 1: > 50% reduction in depressive symptoms
Comparison 3: RCT: venlafaxine versus no treatment controls, Outcome 1: > 50% reduction in depressive symptoms
Comparison 3: RCT: venlafaxine versus no treatment controls, Outcome 2: Mean depression scores ‐ HAMD
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 1: Mean depression scores (BDI)
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 2: Remission in depressive symptoms
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 3: Seizure frequency
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 4: Seizure recurrence
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 5: Withdrawals (any reason)
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 6: Quality of life (QOLIE‐89)
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 7: Adverse events profile
Comparison 4: RCT: sertraline versus cognitive behavioural therapy (CBT), Outcome 8: Adverse events
Comparison 5: NRSI: citalopram (before and after), Outcome 1: Mean depression scores HAMD‐21
Comparison 5: NRSI: citalopram (before and after), Outcome 2: Mean monthly seizure frequency
Comparison 6: NRSI: SSRIs (sertraline or citalopram) versus CBT, Outcome 1: Mean depression scores (BDI)
Comparison 6: NRSI: SSRIs (sertraline or citalopram) versus CBT, Outcome 2: Remission in depressive symptoms
Comparison 6: NRSI: SSRIs (sertraline or citalopram) versus CBT, Outcome 3: Seizure frequency per month at 12 weeks
Comparison 6: NRSI: SSRIs (sertraline or citalopram) versus CBT, Outcome 4: Withdrawals (any reason)
Comparison 6: NRSI: SSRIs (sertraline or citalopram) versus CBT, Outcome 5: Quality of life (QOLIE‐31 overall score)
| Paroxetine compared to doxepin for people with epilepsy and depression | ||||||
|---|---|---|---|---|---|---|
| Patient or population: people with epilepsy and depression | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of participants | Certainty of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| doxepin | paroxetine | |||||
| > 50% reduction in depressive symptoms Follow‐up: 8 weeks | 706 per 1000 | 819 per 1000 | RR 1.16 | 67 | ⊕⊕⊕⊝ |
|
| Mean depression scores (HAMD scores; lower = better) Follow‐up: 8 weeks | NA | The mean HAMD depression score in the intervention groups was | NA | 67 | ⊕⊕⊕⊝ | |
| Seizure frequency Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ | |
| Withdrawals Follow‐up: 8 weeks | 88 per 1000 | 13 per 1000 | RR 0.15 | 67 | ⊕⊕⊕⊝ moderatea | doxepin: 3 withdrew paroxetine: 0 withdrew |
| Cognitive functioning Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Quality of life Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Adverse effects Follow‐up: 8 weeks | Reported adverse events: blurred vision, dizziness, dry mouth, sleep disorders, and urinary retention | Reported adverse events: blurred vision, dizziness, dry mouth, and sleep disorders | NA | 67 (1 RCT) | ⊕⊕⊕⊝ moderatea | There were no significant differences between treatment groups for any reported adverse events |
| *The basis for the assumed risk is the event rate in the doxepin group. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| aCertainty of the evidence downgraded for imprecision, because only one small study contributed to the outcomes. | ||||||
| Amitriptyline compared to nomifensine for people with epilepsy and depression | ||||||
|---|---|---|---|---|---|---|
| Patient or population: people with epilepsy and depression | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of participants | Certainty of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| nomifensine | amitriptyline | |||||
| > 50% reduction in depressive symptoms Follow‐up: 12 weeks | 786 per 1000 | 432 per 1000 | RR 0.55 | 28 | ⊕⊕⊝⊝ |
|
| Mean depression scores Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Seizure frequency Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Withdrawals Follow‐up: NA | ‐ | ‐ | ‐ | 0 | ‐ |
|
| Cognitive functioning Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Quality of life Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Adverse effects Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| *The basis for the assumed risk is the event rate in the nomifensine group. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| aCertainty of the evidence downgraded twice for imprecision, because only very small study contributed limited outcome data. | ||||||
| Venlafaxine compared to no treatment for people with epilepsy and depression | ||||||
|---|---|---|---|---|---|---|
| Patient or population: people with epilepsy and depression | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of participants | Certainty of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| no treatment | venlafaxine | |||||
| > 50% reduction in depressive symptoms Follow‐up: 8 weeks | 125 per 1000 | 406 per 1000 | RR 3.25 | 64 | ⊕⊕⊝⊝ lowa,b |
|
| Mean depression scores (HAMD scores; lower = better) Follow‐up: 8 weeks | NA | The mean HAMD depression score in the intervention group was | NA | 64 | ⊕⊕⊝⊝ lowa,b |
|
| Seizure frequency Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Withdrawals Follow‐up: NA | ‐ | ‐ | ‐ | 0 | ‐ |
|
| Cognitive functioning Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Quality of life Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Adverse effects Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| *The basis for the assumed risk is the event rate in the no treatment group. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| aCertainty of the evidence downgraded for imprecision, because only one small study contributed to the outcomes. | ||||||
| Sertraline compared to cognitive behavioural therapy for people with epilepsy and depression | ||||||
|---|---|---|---|---|---|---|
| Patient or population: people with epilepsy and depression | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of participants | Certainty of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| CBT | sertraline | |||||
| > 50% reduction in depressive symptoms Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Mean depression scores (BDI scores; lower = better) Follow‐up: 16 weeks | NA | The mean BDI depression score in the intervention group was 0.50 lower (4.47 lower to 3.47 higher) | NA | 117 | ⊕⊕⊕⊝ moderatea | At 8 weeks: MD ‐2.50 (95% CI ‐6.28 to 1.28; 104 participants) |
| Seizure frequency Follow‐up: 16 weeks | NA | The mean frequency of GTCS per month in the intervention group was 0 lower (‐0.10 lower to 0.10 higher) The mean frequency of focal seizures with impaired awareness per month in the intervention group was 3.00 lower (7.81 lower to 1.81 higher) | NA | 96 with GTCS plus 75 with focal seizures (1 RCT) | ⊕⊕⊝⊝ lowb | At 8 weeks: GTCS per month: MD ‐0.10 (95% CI ‐0.26 to 0.06; 86 participants) focal seizures with impaired awareness per month: MD ‐2.60 (95% CI ‐6.52 to 1.32; 75 participants) |
| Withdrawals Follow‐up: 16 weeks | 176 per 1000 | 222 per 1000 (113 to 434 per 1000) | RR 1.26 (0.64 to 2.46) | 140 | ⊕⊕⊕⊝ moderatea | CBT: 6 withdrew, 6 lost to follow‐up sertraline: 7 withdrew, 9 lost to follow‐up |
| Cognitive functioning Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ | |
| Quality of life (QOLIE‐89 scale; lower = better) Follow‐up: 16 weeks | NA | The mean QOLIE‐89 score in the intervention group was 3.10 higher (3.41 lower to 9.61 higher) | NA | 118 (1 RCT) | ⊕⊕⊕⊝ moderatea | at 8 weeks: MD 6.10 (95% CI ‐0.28 to 12.48; 104 participants) |
| Adverse effects Follow‐up: 16 weeks | NA | The mean adverse event profile score in the intervention group was 2.10 lower (6.21 lower to 2.01 higher) | NA | 118 (1 RCT) | ⊕⊕⊕⊝ lowa,c | Sertraline resulted in more cases of tiredness than CBT (RR 3.54, 99% CI 1.40 to 8.96; 140 participants) Sertraline did not result in more cases of any other adverse effects than CBT. |
| *The basis for the assumed risk is the event rate in the CBT group. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| aCertainty of the evidence downgraded once due to risk of bias: participants and personnel not blinded, and lack of blinding may have influenced outcome cCertainty of the evidence downgraded once due to imprecision: adverse event data not available for all participants who received an intervention | ||||||
| Citalopram (before and after treatment) for people with epilepsy and depression | ||||
|---|---|---|---|---|
| Patient or population: people with epilepsy and depression | ||||
| Outcomes | Illustrative comparative risks* (95% CI) | No of participants | Certainty of the evidence | Comments |
| Citalopram (before and after) | ||||
| > 50% reduction in depressive symptoms Follow‐up: 4 months | 11 out of 45 participants (24%) showed a 50% or more improvement in depression scores after treatment compared to baseline. | 45 (1 NRSI) | ⊕⊕⊝⊝ lowa | |
| Mean depression scores (HAMD scores; lower = better) Follow‐up: 8 weeks to 4 months | Improved depression scores were shown after citalopram compared to before (see comment) | 88 | ⊕⊕⊝⊝ | SMD in HAMD score was 1.17 (95% CI 0.96 to 1.38), indicating improved outcomes and a large treatment effect. |
| Seizure frequency Follow‐up: 8 weeks to 4 months | See comment | 88 | ⊕⊝⊝⊝ | Results were mixed between studies; due to very high heterogeneity (I² = 81%), we did not present the overall effect estimate. |
| Withdrawals Follow‐up: 8 weeks to 4 months | 6/45 participants (13%) withdrew from one study; 0/43 from the other study | 88 (2 NRSI) | ⊕⊕⊝⊝ lowa | |
| Cognitive functioning Follow‐up: NA | ‐ | 0 (0 studies) | ‐ |
|
| Quality of life Follow‐up: NA | ‐ | 0 (0 studies) | ‐ |
|
| Adverse effects Follow‐up: 8 weeks to 4 months | 22/45 participants (56%) experienced adverse events in one study; 5/43 (12%) in the other study | 88 (2 NRSI) | ⊕⊕⊝⊝ lowa | Specific adverse events reported: nausea, sexual dysfunction, headache, dizziness, drowsiness, and fatigue |
| CI: confidence interval; HAMD: Hamilton Rating Scale for Depression; NRSI: non‐randomised studies of interventions | ||||
| GRADE Working Group grades of evidence | ||||
| aCertainty of the evidence downgraded twice as studies were judged to be at serious risk of bias due to lack of blinding, which may have influenced participant‐recorded outcomes, and lack of adjustment for confounding variables. | ||||
| Selective serotonin reuptake inhibitorscompared to cognitive behavioural therapy for people with epilepsy and depression | ||||||
|---|---|---|---|---|---|---|
| Patient or population: people with epilepsy and depression | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of participants | Certainty of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| CBT | SSRIs | |||||
| > 50% reduction in depressive symptoms Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ | |
| Mean depression scores (BDI scores; lower = better) Follow‐up: 12 weeks | NA | The mean BDI depression score in the intervention group was 4.90 lower (14.90 lower to 4.80 higher) | NA | 15 | ⊕⊝⊝⊝ very lowa,b | at 6 weeks: MD ‐2.60 (95% CI ‐11.58 to 6.38; 15 participants) |
| Seizure frequency Follow‐up: 12 weeks | NA | The mean frequency of seizures per month in the intervention group was 1.60 lower (5.63 lower to 2.43 higher) | NA | 15 (1 NRSI) | ⊕⊝⊝⊝ very lowa,b | |
| Withdrawals Follow‐up: 12 weeks | 286 per 1000 | 126 per 1000 (14 to 1000 per 1000) | RR 0.44 (0.05 to 3.85) | 15 (1 NRSI) | ⊕⊝⊝⊝ very lowa,b | CBT: 2 lost to follow‐up SSRI: 1 lost to follow‐up in the |
| Cognitive functioning Follow‐up: NA | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| Quality of life ‐ QOLIE‐31 scale Follow‐up: 12 weeks | NA | The mean QOLIE‐31 score in the intervention group was 0.50 lower (19.67 lower to 18.67 higher) | NA | 15 (1 NRSI) | ⊕⊝⊝⊝1,2 very low |
|
| Adverse effects ‐ adverse event profile Follow‐up: 16 weeks | ‐ | ‐ | ‐ | 0 (0 studies) | ‐ |
|
| *The basis for the assumed risk is the event rate in the CBT group. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1. Certainty of the evidence downgraded twice as the study was judged to be at serious risk of bias with regards to lack of blinding which may have influenced participant recorded outcomes and lack of adjustment for confounding variables. 2. Certainty of the evidence downgraded once due to imprecision: very small study of 15 participants, confidence intervals around effect estimates wide | ||||||
| Risk of bias judgement | Criteria based on seven risk of bias domains |
|---|---|
| Low risk of bias: the study is comparable to a well‐performed randomised trial | The study is judged to be at low risk of bias for all domains |
| Moderate risk of bias: the study appears to provide sound evidence for a non‐randomised study but cannot be considered comparable to a well‐performed randomised trial | The study is judged to be at low or moderate risk of bias for all domains |
| Serious risk of bias: the study has some important problems | The study is judged to be at serious risk of bias in at least 1 domain, but not at critical risk of bias in any domain |
| Critical risk of bias: the study is too problematic to provide any useful evidence on the effects of intervention | The study is judged to be at critical risk of bias in at least 1 domain |
| No information on which to base a judgement about risk of bias | There is no clear indication that the study is at serious or critical risk of bias, and there is a lack of information in 1 or more key domains of bias (a judgement is required for this) |
| Domain and risk of bias judgement | Study | |||||
|---|---|---|---|---|---|---|
| Bias due to confounding | Serious | Moderate | Serious | Moderate | Serious | Serious |
| Bias in selection of participants into the study | Moderate | Low | Moderate | Low | Serious | Moderate |
| Bias in classification of interventions | Low | Low | Moderate | Low | Low | Low |
| Bias due to deviations from intended interventions | Low | Low | Moderate | Moderate | Moderate | Low |
| Bias due to missing data | Low | Low | Serious | Serious | Serious | Low |
| Bias in measurement of outcomes | Moderate | Serious | Moderate | Moderate | Moderate | Moderate |
| Bias in selection of the reported result | Low | Moderate | Low | Moderate | Low | Low |
| Overall judgement | Serious | Serious | Serious | Serious | Serious | Serious |
| Support for judgement | No adjustment for confounding; unclear if participants were recruited consecutively; and by design, blinding was not possible, which may have influenced subjectively‐assessed outcomes | Some analyses to investigate prognostic variables, but not a complete analysis of confounders; unclear which variables were of interest in advance, and if other characteristics were tested and analysed; and by design, blinding was not possible, which may have influenced subjectively‐assessed outcomes. The measure of depression was not an accurate or reliable measure | No adjustment for confounding; many discontinuations due to adverse events and non‐compliance, with outcome data analysed by last observation carried forward; unclear if participants were already receiving the intervention on entry into the study, and exactly how groups were assigned. Lack of blinding may have influenced some participant‐reported outcomes. | Some analyses to investigate prognostic variables, but not a complete analysis of confounders; unclear which variables were of interest in advance, and if other characteristics were tested and analysed; small groups and dropouts, with outcome data analysed by last observation carried forward, Lack of blinding may have influenced some participant‐reported outcomes. | No adjustment for confounding; outcome data included only for those who completed analysis (6 participants excluded); and by design, blinding was not possible, which may have influenced subjectively‐assessed outcomes | No adjustment for confounding; unclear if participants were recruited consecutively; and by design, blinding was not possible, which may have influenced subjectively‐assessed outcomes. |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 > 50% reduction in depressive symptoms Show forest plot | 1 | 67 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.16 [0.88, 1.52] |
| 1.2 Mean depression scores Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 1.2.1 HAMD scores | 1 | 67 | Mean Difference (IV, Fixed, 95% CI) | 0.65 [‐2.15, 3.45] |
| 1.3 Withdrawals (any reason) Show forest plot | 1 | 67 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.15 [0.01, 2.74] |
| 1.4 Adverse effects Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 99% CI) | Subtotals only | |
| 1.4.1 Blurred vision | 1 | 67 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.34 [0.09, 1.32] |
| 1.4.2 Dizziness | 1 | 67 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.21 [0.03, 1.37] |
| 1.4.3 Dry mouth | 1 | 67 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.26 [0.06, 1.20] |
| 1.4.4 Sleep disorders | 1 | 67 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.32 [0.08, 1.20] |
| 1.4.5 Urinary retention | 1 | 67 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.34 [0.01, 21.99] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 2.1 > 50% reduction in depressive symptoms Show forest plot | 1 | 28 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.55 [0.28, 1.06] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 3.1 > 50% reduction in depressive symptoms Show forest plot | 1 | 64 | Risk Ratio (M‐H, Fixed, 95% CI) | 3.25 [1.19, 8.90] |
| 3.2 Mean depression scores ‐ HAMD Show forest plot | 1 | 64 | Mean Difference (IV, Fixed, 95% CI) | ‐7.59 [‐11.52, ‐3.66] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 4.1 Mean depression scores (BDI) Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 4.1.1 BDI‐II scores at 8 weeks | 1 | 104 | Mean Difference (IV, Fixed, 95% CI) | ‐2.50 [‐6.28, 1.28] |
| 4.1.2 BDI‐II scores at 16 weeks | 1 | 117 | Mean Difference (IV, Fixed, 95% CI) | ‐0.50 [‐4.47, 3.47] |
| 4.2 Remission in depressive symptoms Show forest plot | 1 | 140 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.88 [0.65, 1.17] |
| 4.3 Seizure frequency Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 4.3.1 Generalised tonic‐clonic seizures per month at 8 weeks | 1 | 86 | Mean Difference (IV, Fixed, 95% CI) | ‐0.10 [‐0.26, 0.06] |
| 4.3.2 Generalised tonic‐clonic seizures per month at 16 weeks | 1 | 96 | Mean Difference (IV, Fixed, 95% CI) | 0.00 [‐0.10, 0.10] |
| 4.3.3 Focal seizures with impaired awareness per month at 8 weeks | 1 | 75 | Mean Difference (IV, Fixed, 95% CI) | ‐2.60 [‐6.52, 1.32] |
| 4.3.4 Focal seizures with impaired awareness per month at 16 weeks | 1 | 73 | Mean Difference (IV, Fixed, 95% CI) | ‐3.00 [‐7.81, 1.81] |
| 4.4 Seizure recurrence Show forest plot | 1 | 104 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.04 [0.27, 3.94] |
| 4.5 Withdrawals (any reason) Show forest plot | 1 | 140 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.26 [0.64, 2.46] |
| 4.6 Quality of life (QOLIE‐89) Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 4.6.1 QOLIE‐89 score at 8 weeks | 1 | 104 | Mean Difference (IV, Fixed, 95% CI) | 6.10 [‐0.28, 12.48] |
| 4.6.2 QOLIE‐89 score at 16 weeks | 1 | 118 | Mean Difference (IV, Fixed, 95% CI) | 3.10 [‐3.41, 9.61] |
| 4.7 Adverse events profile Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 4.7.1 Adverse event profile at 8 weeks | 1 | 106 | Mean Difference (IV, Fixed, 95% CI) | ‐2.70 [‐6.62, 1.22] |
| 4.7.2 Adverse event profile at 16 weeks | 1 | 118 | Mean Difference (IV, Fixed, 95% CI) | ‐2.10 [‐6.21, 2.01] |
| 4.8 Adverse events Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 99% CI) | Subtotals only | |
| 4.8.1 Anxiety | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 8.51 [0.19, 386.16] |
| 4.8.2 Chest pain | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.47 [0.05, 4.21] |
| 4.8.3 Cold | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.63 [0.13, 3.13] |
| 4.8.4 Diarrhoea | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 19.85 [0.49, 805.53] |
| 4.8.5 Dizziness | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 1.51 [0.37, 6.14] |
| 4.8.6 Dry mouth | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 3.78 [0.22, 65.10] |
| 4.8.7 Headache | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 1.48 [0.69, 3.19] |
| 4.8.8 Insomnia | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 2.16 [0.73, 6.38] |
| 4.8.9 Memory difficulty | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 0.71 [0.10, 4.82] |
| 4.8.10 Muscle strain or pain | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 1.21 [0.36, 4.12] |
| 4.8.11 Nausea | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 2.60 [0.62, 10.96] |
| 4.8.12 Rash | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 4.72 [0.29, 76.72] |
| 4.8.13 Sexual dysfunction | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 8.51 [0.19, 386.16] |
| 4.8.14 Shakiness | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 12.28 [0.88, 171.59] |
| 4.8.15 Tiredness | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 3.54 [1.40, 8.96] |
| 4.8.16 Unsteadiness | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 1.57 [0.25, 9.81] |
| 4.8.17 Worsening depression | 1 | 140 | Risk Ratio (M‐H, Fixed, 99% CI) | 1.13 [0.25, 5.07] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 5.1 Mean depression scores HAMD‐21 Show forest plot | 2 | 176 | Std. Mean Difference (IV, Fixed, 95% CI) | 1.17 [0.96, 1.38] |
| 5.2 Mean monthly seizure frequency Show forest plot | 2 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 6.1 Mean depression scores (BDI) Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 6.1.1 BDI at 6 weeks | 1 | 15 | Mean Difference (IV, Fixed, 95% CI) | ‐2.60 [‐11.58, 6.38] |
| 6.1.2 BDI at 12 weeks | 1 | 15 | Mean Difference (IV, Fixed, 95% CI) | ‐4.90 [‐14.60, 4.80] |
| 6.2 Remission in depressive symptoms Show forest plot | 1 | 15 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.53 [0.77, 3.06] |
| 6.3 Seizure frequency per month at 12 weeks Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | ‐1.60 [‐5.63, 2.43] | |
| 6.4 Withdrawals (any reason) Show forest plot | 1 | 15 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.44 [0.05, 3.85] |
| 6.5 Quality of life (QOLIE‐31 overall score) Show forest plot | 1 | 15 | Mean Difference (IV, Fixed, 95% CI) | ‐0.50 [‐19.67, 18.67] |
