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Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS.

Publication ,  Journal Article
Mills, JC; Harman, JS; Cook, RL; Marlow, NM; Harle, CA; Duncan, RP; Bengtson, AM; Pence, BW
Published in: J Affect Disord
June 2017

BACKGROUND: Depression is the most common psychiatric comorbidity among people living with HIV/AIDS (PLWHA). Little is known about the comparative effectiveness between different types of antidepressants used to treat depression in this population. We compared the effectiveness of dual-action and single-action antidepressants in PLWHA for achieving remission from depression. METHODS: We used data from the Centers for AIDS Research Network of Integrated Clinic Systems to identify 1175 new user dual-action or single-action antidepressant treatment episodes occurring from 2005 to 2014 for PLWHA diagnosed with depression. The primary outcome was remission from depression defined as a Patient Health Questionnaire-9 (PHQ-9) score <5. Mean difference in PHQ-9 depressive symptom severity was a secondary outcome. The main approach was an intent-to-treat (ITT) evaluation complemented with a per protocol (PP) sensitivity analysis. Generalized linear models were fitted to estimate treatment effects. RESULTS: In ITT analysis, 32% of the episodes ended in remission for both dual-action and single-action antidepressants. The odds ratio (OR) of remission was 1.02 (95%CI=0.63,1.67). In PP analysis, 40% of dual-action episodes ended in remission compared to 32% in single-action episodes. Dual-action episodes had 1.33 times the odds of remission (95%CI=0.55,3.21), however the result was not statistically significant. Non-significant differences were also observed for depressive symptom severity. LIMITATIONS: Missing data was common but was addressed with inverse probability weights. CONCLUSIONS: Results suggest that single-action and dual-action antidepressants are equally effective in PLWHA. Remission was uncommon highlighting the need to identify health service delivery strategies that aid HIV providers in achieving full remission of their patients' depression.

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Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

June 2017

Volume

215

Start / End Page

179 / 186

Location

Netherlands

Related Subject Headings

  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Remission Induction
  • Psychiatry
  • Male
  • Humans
  • HIV Infections
  • Female
  • Depressive Disorder
  • Databases, Factual
  • Comparative Effectiveness Research
 

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ICMJE
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Mills, J. C., Harman, J. S., Cook, R. L., Marlow, N. M., Harle, C. A., Duncan, R. P., … Pence, B. W. (2017). Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS. J Affect Disord, 215, 179–186. https://doi.org/10.1016/j.jad.2017.03.042
Mills, Jon C., Jeffrey S. Harman, Robert L. Cook, Nicole M. Marlow, Christopher A. Harle, R Paul Duncan, Angela M. Bengtson, and Brian W. Pence. “Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS.J Affect Disord 215 (June 2017): 179–86. https://doi.org/10.1016/j.jad.2017.03.042.
Mills JC, Harman JS, Cook RL, Marlow NM, Harle CA, Duncan RP, et al. Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS. J Affect Disord. 2017 Jun;215:179–86.
Mills, Jon C., et al. “Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS.J Affect Disord, vol. 215, June 2017, pp. 179–86. Pubmed, doi:10.1016/j.jad.2017.03.042.
Mills JC, Harman JS, Cook RL, Marlow NM, Harle CA, Duncan RP, Bengtson AM, Pence BW. Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS. J Affect Disord. 2017 Jun;215:179–186.
Journal cover image

Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

June 2017

Volume

215

Start / End Page

179 / 186

Location

Netherlands

Related Subject Headings

  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Remission Induction
  • Psychiatry
  • Male
  • Humans
  • HIV Infections
  • Female
  • Depressive Disorder
  • Databases, Factual
  • Comparative Effectiveness Research