Protocol: Drug-induced Depression, An Updated Systematic Review to Inform Clinical Practice
Date
2024-09-18
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Abstract
Background: The etiology of depression is biopsychosocial, with therapeutic drugs often listed as potential risk factors. However, the role of drugs and medications in depression etiology remains unclear. The objective of this review is to summarize existing evidence etiologically linking therapeutic drugs to depression.
Methods: A systematic review will be conducted in a series of stages. As the goal of the review is to assess etiological evidence, issues of confounding (e.g. by illness or by illness severity) and temporality are of paramount importance. Therefore, the review will focus on randomized controlled trials (RCTs) and high-quality prospective cohort studies. With guidance from an academic librarian (CM), a literature search will be conducted in three stages. The first search will be a screening review of published review articles combined with a grey-literature search. The stage I search will be used to develop a list of drugs commonly implicated in depression etiology. A stage II search will cross-reference these drugs against methodological search terms to identify relevant RCTs. This stage will enable identification of a subset of drugs etiologically linked to depression. Finally, this subset of drugs will be included in the third stage of the literature search, which will cross-reference these specific drugs with search terms for prospective cohort studies, allowing of clinically salient observations on the course of drug-induced depression. Covidence will be used to organize and summarize eligibility assessment initially in screening for relevance, subsequently in selection of studies for full text review and finally in data extraction. The Cochrane RoB-2 and Robins-E tools will be used for quality assessment of included studies. Meta-analysis will be used, as appropriate, in analysis of the stage II studies whereas narrative description will be the main strategy for data synthesis of the stage III studies. The review will be reported using PRISMA standards.
Discussion: This systematic review will identify three subsets of drugs that may be linked to depression: (1) a set of drugs frequently implicated in causing depression, (2) a subset of this list consisting of drugs etiologically linked to depression according to reasonable standards of evidence, and (3) a summarization of evidence concerning diagnosis and clinical management of drug-induced depression. Such evidence will inform clinical practice by supporting risk-benefit decisions in treatment selection and by providing a better understanding of the side-effect profiles of medical drugs.
Description
This is a systematic review protocol. It will be linked to PROSPERO and OSF.
Keywords
Despression, Depressive disorders, etiology, substance-induced mood disorders, drug-induced depression, systematic review