Efficacy of antidepressants for relapse prevention in the treatment of major depression

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K10527
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Kyoto University
• Principal Investigator: Shinohara Kiyomi 京都大学, 医学研究科, 客員研究員 (90865908)
• Co-Investigator(Kenkyū-buntansha): 今井 必生 京都大学, 医学研究科, 客員研究員 (30758892) ; 田近 亜蘭 京都大学, 医学研究科, 准教授 (80368240) ; 古川 壽亮 京都大学, 医学研究科, 教授 (90275123)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: うつ病 / ネットワークメタアナリシス / メタアナリシス / 再発予防 / 維持治療 / 抗うつ薬 / 精神療法

Outline of Final Research Achievements

In the treatment of depression, even if symptoms of depression disappear (remission) during the acute phase of treatment, they often recur. Therefore, it is important to prevent recurrence. Pharmacotherapy with antidepressants and psychotherapy (e.g. cognitive-behavioral therapy) are the two standard treatments for depression, and they are generally used in the acute phase of treatment. However, it is unclear whether pharmacotherapy or psychotherapy is more effective in the long term.In the present study, we conducted a network meta-analysis using the results of all relevant randomised controlled trials. The results showed that psychotherapy as initial treatment, either alone or in combination with antidepressants, was more effective in achieving remission and preventing relapse than usual treatment with antidepressants alone (12-16% difference after 1 year of treatment).

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Free Research Field

精神科

Academic Significance and Societal Importance of the Research Achievements

現在の抗うつ薬中心のうつ病治療の治療の中で、治療初期の急性期に認知行動療法などの精神療法を行うことは、精神療法単独であっても抗うつ薬との併用であっても抗うつ薬単独治療より有効であると示したことは大きなインパクトがある。実際のうつ病治療の臨床現場では、精神療法へのアクセスの問題や質の管理の問題はあるが、再発予防のために急性期に精神療法が行えるようにガイドラインなどで推奨し広めていくことが必要と考えられた。