It may be precipitated by intercurrent illnesses (eg infections), addition of new anti-parkinsonian medication or dementia. From evidence to recommendation Psychosis is a common problem in later and can be difficult to manage. The methodological limitations for some of the included studies involved: lack of and methods, lack of multi-centre comparative results analysis, lack of power calculations, small sample sizes (N=31, 160, 30 and 60) short trial duration and no intention-to-treat analysis protocols. Three trials were found that compared two atypical antipsychotic drugs, and these were excluded as within drug class comparisons. From evidence to recommendation There is insufficient evidence from RCTs of the efficacy or safety of any antidepressant therapy in. However, were found more frequently in the fluoxetine-treated group than the rTMS group (p=0.03). (1+) One of the independent RCTs reported that the following outcomes were improved in both rTMS and fluoxetine-treated groups: the Hamilton Depression Rating Scale and, scores, and the (MMSE), with no significant differences between groups. (1) One of the independent RCTs reported no significant difference between sertraline (SSRI) and in terms of ‘response’ to treatment (defined as at least 50% reduction of the pre-treatment ), or motor scores. Confusion and visual hallucination were infrequently reported in people taking fluvoxamine and amitriptyline otherwise, no other major were reported. The methodological limitations included: short trial duration (8 weeks), small (N=42, 21 in each arm) and lack of power calculation.
The second independent compared repetitive transcranial magnetic stimulation (rTMS) versus an SSRI as an effective antidepressant therapy. The included three trials: one trial compared a selective serotonin re- inhibitor (SSRI) with another study compared a tricyclic antidepressant (TCA) with placebo and the third trial compared the effectiveness of an SSRI versus a TCA. No controlled trials were found on electroconvulsive therapy or behavioural therapy for the treatment of depression in people.
Methodology A and two randomised controlled trials, (published after the review’s search date) were found which addressed the effectiveness of antidepressant therapies versus or active comparator. Factors relevant to the aetiology of depression that need to be considered are. The development of depression creates an added burden for people with and their carers and has been shown to be an important determinant of. Psychological and physical symptoms of anxiety are also common. The disturbance of cognitive functions and thought processes may result in poor concentration and memory, excessive worry, feelings of worthlessness, hopelessness and guilt, negative views of self and life, and thoughts of suicide.
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