Comparing the Effectiveness, Safety and Tolerability of Interventions for Depressive Symptoms in People with Multiple Sclerosis: A Systematic Review

Stephanie Campese; Julia Lyons; Yvonne C Learmonth; Alexandra Metse; Allan G. Kermode; Claudia H Marck; Amalia Karahalios

doi:10.1016/j.msard.2024.105763

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Comparing the Effectiveness, Safety and Tolerability of Interventions for Depressive Symptoms in People with Multiple Sclerosis: A Systematic Review

Journal article

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Comparing the Effectiveness, Safety and Tolerability of Interventions for Depressive Symptoms in People with Multiple Sclerosis: A Systematic Review

Stephanie Campese, Julia Lyons, Yvonne C Learmonth, Alexandra Metse, Allan G. Kermode, Claudia H Marck and Amalia Karahalios

Multiple sclerosis and related disorders, Vol.89, 105763

2024

DOI: https://doi.org/10.1016/j.msard.2024.105763

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Abstract

depression

intervention

multiple sclerosis

randomised trial

systematic review

Background Depression is more common in people with multiple sclerosis (MS) compared to the general population. While many interventions are available for treating depressive symptoms in people with MS, it is unclear how different intervention modalities compare. This systematic review aimed to compare the reported effectiveness, safety, and tolerability of interventions for treating depressive symptoms in people with MS. Methods We systematically searched 7 databases for randomised controlled trials (RCTs) of pharmaceutical, psychological, physical, and electromagnetic stimulation interventions which aimed to reduce depressive symptoms among adults with MS. Screening, data extraction and risk of bias assessment were completed by at least two independent researchers. We planned to synthesise the data using network meta-analysis, however the high risk of bias of the included trials resulted in synthesis without meta-analysis. Results Of 1,949 citations, 31 trials (21 psychological, seven physical activity, two pharmaceutical, and one combination) were included, comprising 2,289 participants. Of the 31 eligible trials 24 were at high and six at moderate risk of bias, which precluded meta-analysis. Twenty-six trials reported on efficacy and only 16/31 reported safety and/or tolerability, using inconsistent methods. Conclusions The current strength of the evidence for treating depressive symptoms in MS is low, therefore, we are not able to summarise or make comparisons between the treatment modalities. There is an urgent need for high-quality and diverse trials investigating treatment options for depression in people with MS. This can only be achieved if the conduct and reporting of RCTs are improved.

Details

Title: Comparing the Effectiveness, Safety and Tolerability of Interventions for Depressive Symptoms in People with Multiple Sclerosis: A Systematic Review
Authors/Creators: Stephanie Campese - The University of Melbourne
Julia Lyons - The University of Melbourne
Yvonne C Learmonth - Murdoch University
Alexandra Metse - University of the Sunshine Coast
Allan G. Kermode - Perron Institute for Neurological and Translational Science
Claudia H Marck - The University of Melbourne
Amalia Karahalios - The University of Melbourne
Publication Details: Multiple sclerosis and related disorders, Vol.89, 105763
Publisher: Elsevier B.V
Identifiers: 991005687769207891
Murdoch Affiliation: Institute for Immunology and Infectious Diseases; School of Allied Health; Centre for Molecular Medicine and Innovative Therapeutics
Language: English
Resource Type: Journal article

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