Skip to main content
Top
Published in: BMC Psychiatry 1/2019

Open Access 01-12-2019 | Antidepressant Drugs | Research article

Clinical guidelines for the management of depression with specific comorbid psychiatric conditions French recommendations from experts (the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental)

Authors: D. Bennabi, A. Yrondi, T. Charpeaud, J.-B. Genty, S. Destouches, S. Lancrenon, N. Allaili, F. Bellivier, T. Bougerol, V. Camus, O. Doumy, J.-M. Dorey, F. Haesebaert, J. Holtzmann, C. Lançon, M. Lefebvre, F. Moliere, I. Nieto, C. Rabu, R. Richieri, L. Schmitt, F. Stephan, G. Vaiva, M. Walter, M. Leboyer, W. El-Hage, B. Aouizerate, E. Haffen, P.-M. Llorca, P. Courtet

Published in: BMC Psychiatry | Issue 1/2019

Login to get access

Abstract

Background

Recommendations for pharmacological treatments of major depression with specific comorbid psychiatric conditions are lacking.

Method

The French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental developed expert consensus guidelines for the management of depression based on the RAND/UCLA Appropriatneness Method. Recommendations for lines of treatment are provided by the scientific committee after data analysis and interpretation of the results of a survey of 36 psychiatrist experts in the field of major depression and its treatments.

Results

The expert guidelines combine scientific evidence and expert clinician’s opinion to produce recommendations for major depression with comorbid anxiety disorders, personality disorders or substance use disorders and in geriatric depression.

Conclusion

These guidelines provide direction addressing common clinical dilemmas that arise in the pharmacologic treatment of major depression with comorbid psychiatric conditions.
Literature
1.
go back to reference Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2197–223.CrossRef Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2197–223.CrossRef
2.
go back to reference Gilmer WS, Trivedi MH, Rush AJ, Wisniewski SR, Luther J, Howland RH, et al. Factors associated with chronic depressive episodes: a preliminary report from the STAR-D project. Acta Psychiatr Scand. 2005;112(6):425–33.CrossRef Gilmer WS, Trivedi MH, Rush AJ, Wisniewski SR, Luther J, Howland RH, et al. Factors associated with chronic depressive episodes: a preliminary report from the STAR-D project. Acta Psychiatr Scand. 2005;112(6):425–33.CrossRef
3.
go back to reference Murphy JA, Byrne GJ. Prevalence and correlates of the proposed DSM-5 diagnosis of chronic depressive disorder. J Affect Disord. 2012;139(2):172–80.CrossRef Murphy JA, Byrne GJ. Prevalence and correlates of the proposed DSM-5 diagnosis of chronic depressive disorder. J Affect Disord. 2012;139(2):172–80.CrossRef
4.
go back to reference Rush AJ, Zimmerman M, Wisniewski SR, Fava M, Hollon SD, Warden D, et al. Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features. J Affect Disord. 2005;87(1):43–55.CrossRef Rush AJ, Zimmerman M, Wisniewski SR, Fava M, Hollon SD, Warden D, et al. Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features. J Affect Disord. 2005;87(1):43–55.CrossRef
5.
go back to reference Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905–17.CrossRef Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905–17.CrossRef
6.
go back to reference Trivedi MH, Rush AJ, Wisniewski SR, Nierenberg AA, Warden D, Ritz L, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163(1):28–40.CrossRef Trivedi MH, Rush AJ, Wisniewski SR, Nierenberg AA, Warden D, Ritz L, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163(1):28–40.CrossRef
7.
go back to reference Samalin L, Abbar M, Courtet P, Guillaume S, Lancrenon S, Llorca P-M. French Society for Biological Psychiatry and Neuropsychopharmacology task force: formal consensus for the prescription of depot antipsychotics. Encéphale. 2013;39(Suppl 4):189–203.CrossRef Samalin L, Abbar M, Courtet P, Guillaume S, Lancrenon S, Llorca P-M. French Society for Biological Psychiatry and Neuropsychopharmacology task force: formal consensus for the prescription of depot antipsychotics. Encéphale. 2013;39(Suppl 4):189–203.CrossRef
8.
go back to reference Bauer M, Pfennig A, Severus E, Whybrow PC, Angst J, Möller H-J, et al. World Federation of Societies of biological psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013;14(5):334–85.CrossRef Bauer M, Pfennig A, Severus E, Whybrow PC, Angst J, Möller H-J, et al. World Federation of Societies of biological psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013;14(5):334–85.CrossRef
9.
go back to reference Gelenberg. Practice guideline for the treatment of patients with major depressive disorder. In: American psychiatric association; 2010. Gelenberg. Practice guideline for the treatment of patients with major depressive disorder. In: American psychiatric association; 2010.
10.
go back to reference Kennedy SH, Lam RW, McIntyre RS, Tourjman SV, Bhat V, Blier P, et al. Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the Management of Adults with major depressive disorder: section 3. Pharmacological treatments. Can J Psychiatr. 2016;61(9):540–60.CrossRef Kennedy SH, Lam RW, McIntyre RS, Tourjman SV, Bhat V, Blier P, et al. Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the Management of Adults with major depressive disorder: section 3. Pharmacological treatments. Can J Psychiatr. 2016;61(9):540–60.CrossRef
11.
go back to reference Cleare A, Pariante CM, Young AH, Anderson IM, Christmas D, Cowen PJ, et al. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J Psychopharmacol (Oxford). 2015;29(5):459–525.CrossRef Cleare A, Pariante CM, Young AH, Anderson IM, Christmas D, Cowen PJ, et al. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J Psychopharmacol (Oxford). 2015;29(5):459–525.CrossRef
12.
go back to reference National Collaborating Centre for Mental Health (UK). Depression: The Treatment and Management of Depression in Adults (Updated Edition), National Institute for Health and Clinical Excellence: Guidance. Leicester (UK): British Psychological Society; 2010. National Collaborating Centre for Mental Health (UK). Depression: The Treatment and Management of Depression in Adults (Updated Edition), National Institute for Health and Clinical Excellence: Guidance. Leicester (UK): British Psychological Society; 2010.
13.
go back to reference Pollack MH. Comorbid anxiety and depression. J Clin Psychiatry. 2005;66(Suppl 8):22–9.PubMed Pollack MH. Comorbid anxiety and depression. J Clin Psychiatry. 2005;66(Suppl 8):22–9.PubMed
14.
go back to reference Baldwin DS, Reines EH, Guiton C, Weiller E. Escitalopram therapy for major depression and anxiety disorders. Ann Pharmacother. 2007;41(10):1583–92.CrossRef Baldwin DS, Reines EH, Guiton C, Weiller E. Escitalopram therapy for major depression and anxiety disorders. Ann Pharmacother. 2007;41(10):1583–92.CrossRef
15.
go back to reference Rickels K, Schweizer E. The treatment of generalized anxiety disorder in patients with depressive symptomatology. J Clin Psychiatry. 1993;54(Suppl):20–3.PubMed Rickels K, Schweizer E. The treatment of generalized anxiety disorder in patients with depressive symptomatology. J Clin Psychiatry. 1993;54(Suppl):20–3.PubMed
16.
go back to reference Wittchen H-U. Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety. 2002;16(4):162–71.CrossRef Wittchen H-U. Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety. 2002;16(4):162–71.CrossRef
17.
go back to reference Mavissakalian M. Antidepressants in the treatment of agoraphobia and obsessive-compulsive disorder. Compr Psychiatry. 1983;24(3):278–84.CrossRef Mavissakalian M. Antidepressants in the treatment of agoraphobia and obsessive-compulsive disorder. Compr Psychiatry. 1983;24(3):278–84.CrossRef
18.
go back to reference Fawcett J, Barkin RL. A meta-analysis of eight randomized, double-blind, controlled clinical trials of mirtazapine for the treatment of patients with major depression and symptoms of anxiety. J Clin Psychiatry. 1998;59(3):123–7.CrossRef Fawcett J, Barkin RL. A meta-analysis of eight randomized, double-blind, controlled clinical trials of mirtazapine for the treatment of patients with major depression and symptoms of anxiety. J Clin Psychiatry. 1998;59(3):123–7.CrossRef
19.
go back to reference Goodnick PJ, Puig A, DeVane CL, Freund BV. Mirtazapine in major depression with comorbid generalized anxiety disorder. J Clin Psychiatry. 1999;60(7):446–8.CrossRef Goodnick PJ, Puig A, DeVane CL, Freund BV. Mirtazapine in major depression with comorbid generalized anxiety disorder. J Clin Psychiatry. 1999;60(7):446–8.CrossRef
20.
go back to reference Muehlbacher M, Nickel MK, Nickel C, Kettler C, Lahmann C, Pedrosa Gil F, et al. Mirtazapine treatment of social phobia in women: a randomized, double-blind, placebo-controlled study. J Clin Psychopharmacol. 2005;25(6):580–3.CrossRef Muehlbacher M, Nickel MK, Nickel C, Kettler C, Lahmann C, Pedrosa Gil F, et al. Mirtazapine treatment of social phobia in women: a randomized, double-blind, placebo-controlled study. J Clin Psychopharmacol. 2005;25(6):580–3.CrossRef
21.
go back to reference Davidson JRT. Treatment of posttraumatic stress disorder: the impact of paroxetine. Psychopharmacol Bull. 2003;37(Suppl 1):76–88.PubMed Davidson JRT. Treatment of posttraumatic stress disorder: the impact of paroxetine. Psychopharmacol Bull. 2003;37(Suppl 1):76–88.PubMed
22.
go back to reference Sugarman MA, Kirsch I, Huppert JD. Obsessive-compulsive disorder has a reduced placebo (and antidepressant) response compared to other anxiety disorders: a meta-analysis. J Affect Disord. 2017;218:217–26.CrossRef Sugarman MA, Kirsch I, Huppert JD. Obsessive-compulsive disorder has a reduced placebo (and antidepressant) response compared to other anxiety disorders: a meta-analysis. J Affect Disord. 2017;218:217–26.CrossRef
23.
go back to reference Pallanti S, Quercioli L, Paiva RS, Koran LM. Citalopram for treatment-resistant obsessive-compulsive disorder - Eur Psychiatry. 1999;14(2):101–6. Pallanti S, Quercioli L, Paiva RS, Koran LM. Citalopram for treatment-resistant obsessive-compulsive disorder - Eur Psychiatry. 1999;14(2):101–6.
24.
go back to reference Diniz JB, Shavitt RG, Fossaluza V, Koran L, Pereira CA, Miguel EC. A double-blind, randomized, controlled trial of fluoxetine plus quetiapine or clomipramine versus fluoxetine plus placebo for obsessive-compulsive disorder. J Clin Psychopharmacol. 2011;31(6):763–8.CrossRef Diniz JB, Shavitt RG, Fossaluza V, Koran L, Pereira CA, Miguel EC. A double-blind, randomized, controlled trial of fluoxetine plus quetiapine or clomipramine versus fluoxetine plus placebo for obsessive-compulsive disorder. J Clin Psychopharmacol. 2011;31(6):763–8.CrossRef
25.
go back to reference Adson DE, Kushner MG, Eiben KM, Schulz SC. Preliminary experience with adjunctive quetiapine in patients receiving selective serotonin reuptake inhibitors. Depress Anxiety. 2004;19(2):121–6.CrossRef Adson DE, Kushner MG, Eiben KM, Schulz SC. Preliminary experience with adjunctive quetiapine in patients receiving selective serotonin reuptake inhibitors. Depress Anxiety. 2004;19(2):121–6.CrossRef
26.
go back to reference Adson DE, Kushner MG, Fahnhorst TA. Treatment of residual anxiety symptoms with adjunctive aripiprazole in depressed patients taking selective serotonin reuptake inhibitors. J Affect Disord. 2005;86(1):99–104.CrossRef Adson DE, Kushner MG, Fahnhorst TA. Treatment of residual anxiety symptoms with adjunctive aripiprazole in depressed patients taking selective serotonin reuptake inhibitors. J Affect Disord. 2005;86(1):99–104.CrossRef
27.
go back to reference Yargic LI, Corapcioglu A, Kocabasoglu N, Erdogan A, Koroglu G, Yilmaz D. A prospective randomized single-blind, multicenter trial comparing the efficacy and safety of paroxetine with and without quetiapine therapy in depression associated with anxiety. Int J Psychiatry Clin Pract. 2004;8(4):205–11.CrossRef Yargic LI, Corapcioglu A, Kocabasoglu N, Erdogan A, Koroglu G, Yilmaz D. A prospective randomized single-blind, multicenter trial comparing the efficacy and safety of paroxetine with and without quetiapine therapy in depression associated with anxiety. Int J Psychiatry Clin Pract. 2004;8(4):205–11.CrossRef
28.
go back to reference McIntyre A, Gendron A, McIntyre A. Quetiapine adjunct to selective serotonin reuptake inhibitors or venlafaxine in patients with major depression, comorbid anxiety, and residual depressive symptoms: a randomized, placebo-controlled pilot study. Depress Anxiety. 2007;24(7):487–94.CrossRef McIntyre A, Gendron A, McIntyre A. Quetiapine adjunct to selective serotonin reuptake inhibitors or venlafaxine in patients with major depression, comorbid anxiety, and residual depressive symptoms: a randomized, placebo-controlled pilot study. Depress Anxiety. 2007;24(7):487–94.CrossRef
29.
go back to reference Coplan JD, Aaronson CJ, Panthangi V, Kim Y. Treating comorbid anxiety and depression: psychosocial and pharmacological approaches. World J Psychiatry. 2015;5(4):366–78.CrossRef Coplan JD, Aaronson CJ, Panthangi V, Kim Y. Treating comorbid anxiety and depression: psychosocial and pharmacological approaches. World J Psychiatry. 2015;5(4):366–78.CrossRef
30.
go back to reference Karyotaki E, Riper H, Cuijpers P. Internet-based self-help interventions for depression in routine care-reply. JAMA Psychiatry. 2017;74(8):853.CrossRef Karyotaki E, Riper H, Cuijpers P. Internet-based self-help interventions for depression in routine care-reply. JAMA Psychiatry. 2017;74(8):853.CrossRef
31.
go back to reference Nunes EV, Levin FR. Treatment of co-occurring depression and substance dependence: using meta-analysis to guide clinical recommendations. Psychiatr Ann. 2008;38(11):nihpa128505.CrossRef Nunes EV, Levin FR. Treatment of co-occurring depression and substance dependence: using meta-analysis to guide clinical recommendations. Psychiatr Ann. 2008;38(11):nihpa128505.CrossRef
32.
go back to reference Tolliver BK, Anton RF. Assessment and treatment of mood disorders in the context of substance abuse. Dialogues Clin Neurosci. 2015;17(2):181–90.PubMedPubMedCentral Tolliver BK, Anton RF. Assessment and treatment of mood disorders in the context of substance abuse. Dialogues Clin Neurosci. 2015;17(2):181–90.PubMedPubMedCentral
33.
go back to reference Cornelius JR, Chung TA, Douaihy AB, Kirisci L, Glance J, Kmiec J, et al. A review of the literature of mirtazapine in co-occurring depression and an alcohol use disorder. J Addict Behav Ther Rehabil. 2016;5(4). Cornelius JR, Chung TA, Douaihy AB, Kirisci L, Glance J, Kmiec J, et al. A review of the literature of mirtazapine in co-occurring depression and an alcohol use disorder. J Addict Behav Ther Rehabil. 2016;5(4).
34.
go back to reference Newton-Howes G, Tyrer P, Johnson T. Personality disorder and the outcome of depression: meta-analysis of published studies. Br J Psychiatry. 2006;188:13–20.CrossRef Newton-Howes G, Tyrer P, Johnson T. Personality disorder and the outcome of depression: meta-analysis of published studies. Br J Psychiatry. 2006;188:13–20.CrossRef
35.
go back to reference Mulsant BH, Blumberger DM, Ismail Z, Rabheru K, Rapoport MJ. A systematic approach to pharmacotherapy for geriatric major depression. Clin Geriatr Med. 2014;30(3):517–34.CrossRef Mulsant BH, Blumberger DM, Ismail Z, Rabheru K, Rapoport MJ. A systematic approach to pharmacotherapy for geriatric major depression. Clin Geriatr Med. 2014;30(3):517–34.CrossRef
36.
go back to reference Schatzberg AF, Kremer C, Rodrigues HE, Murphy GM, Mirtazapine vs. paroxetine study group. Double-blind, randomized comparison of mirtazapine and paroxetine in elderly depressed patients. Am J Geriatr Psychiatry. 2002;10(5):541–50.CrossRef Schatzberg AF, Kremer C, Rodrigues HE, Murphy GM, Mirtazapine vs. paroxetine study group. Double-blind, randomized comparison of mirtazapine and paroxetine in elderly depressed patients. Am J Geriatr Psychiatry. 2002;10(5):541–50.CrossRef
37.
go back to reference Patel K, Allen S, Haque MN, Angelescu I, Baumeister D, Tracy DK. Bupropion: a systematic review and meta-analysis of effectiveness as an antidepressant. Ther Adv Psychopharmacol. 2016;6(2):99–144.CrossRef Patel K, Allen S, Haque MN, Angelescu I, Baumeister D, Tracy DK. Bupropion: a systematic review and meta-analysis of effectiveness as an antidepressant. Ther Adv Psychopharmacol. 2016;6(2):99–144.CrossRef
38.
go back to reference Fernandes AC, Chandran D, Khondoker M, Dewey M, Shetty H, Dutta R, et al. Demographic and clinical factors associated with different antidepressant treatments: a retrospective cohort study design in a UK psychiatric healthcare setting. BMJ Open. 2018;8(9):e022170.CrossRef Fernandes AC, Chandran D, Khondoker M, Dewey M, Shetty H, Dutta R, et al. Demographic and clinical factors associated with different antidepressant treatments: a retrospective cohort study design in a UK psychiatric healthcare setting. BMJ Open. 2018;8(9):e022170.CrossRef
Metadata
Title
Clinical guidelines for the management of depression with specific comorbid psychiatric conditions French recommendations from experts (the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental)
Authors
D. Bennabi
A. Yrondi
T. Charpeaud
J.-B. Genty
S. Destouches
S. Lancrenon
N. Allaili
F. Bellivier
T. Bougerol
V. Camus
O. Doumy
J.-M. Dorey
F. Haesebaert
J. Holtzmann
C. Lançon
M. Lefebvre
F. Moliere
I. Nieto
C. Rabu
R. Richieri
L. Schmitt
F. Stephan
G. Vaiva
M. Walter
M. Leboyer
W. El-Hage
B. Aouizerate
E. Haffen
P.-M. Llorca
P. Courtet
Publication date
01-12-2019

Other articles of this Issue 1/2019

BMC Psychiatry 1/2019 Go to the issue