Executive summary of the report by the WPA section on pharmacopsychiatry on general and comparative efficacy and effectiveness of antidepressants in the acute treatment of depressive disorders

  • Thomas C. BaghaiEmail author
  • Pierre Blier
  • David S. Baldwin
  • Michael Bauer
  • Guy M. Goodwin
  • Kostas N. Fountoulakis
  • Siegfried Kasper
  • Brian E. Leonard
  • Ulrik F. Malt
  • Dan J. Stein
  • Marcio Versiani
  • Hans-Jürgen Möller
Original Paper


Current gold standard in the treatment of depression includes pharmacotherapeutic and psychotherapeutic strategies together with social support. Due to the actually discussed controversies concerning the differential efficacy of antidepressants, a contribution to a comprehensive clarification seems to be necessary to avert further deterioration and uncertainty from patients, relatives, and their treating psychiatrists and general practitioners. Both efficacy and clinical effectiveness of antidepressants in the treatment of depressive disorders can be confirmed. Clinically meaningful antidepressant treatment effects were confirmed in different types of studies. Methodological issues of randomized controlled studies, meta-analyses, and effectiveness studies will be discussed. Furthermore, actual data about the differential efficacy and effectiveness of antidepressants with distinct pharmacodynamic properties and about outcome differences in studies using antidepressants and/or psychotherapy are discussed. This is followed by a clinically oriented depiction—the differential clinical effectiveness of different pharmacodynamic modes of action of antidepressants in different subtypes of depressive disorders. It can be summarized that the spectrum of different antidepressant treatments has broadened during the last decades. The efficacy and clinical effectiveness of antidepressants is statistically significant and clinically relevant and proven repeatedly. For further optimizing antidepressant treatment plans, clearly structured treatment algorithms and the implementation of psychotherapy seem to be useful. A modern individualized antidepressant treatment in most cases is a well-tolerated and efficacious tool to minimize the negative impact of the otherwise devastating and life-threatening outcome of depressive disorders.


Antidepressant treatments Depression Pharmacological treatments Psychotherapy 


Conflict of interest

T.C. Baghai accepted paid speaking engagements and acted as a consultant for Astra-Zeneca, Glaxo-Smith-Kline, Janssen-Cilag, Organon, Pfizer and Servier. M. Bauer has received Grant/Research Support from The Stanley Medical Research Institute, NARSAD and the European Commission (FP7). He is a consultant for AstraZeneca, Lilly, Servier, Lundbeck, Bristol-Myers Squibb and Otsuka and has received Speaker Honoraria from AstraZeneca, Lilly, GlaxoSmithKline, Lundbeck, GlaxoSmithKline, Bristol-Myers Squibb and Otsuka. D. Baldwin holds or has held grants from Cephalon, GlaxoSmithKline, Lilly, Lundbeck, Pharmacia and Wyeth; has received honoraria from AstraZeneca, Bristol Myers Squibb, GlaxoSmithKline, Lilly, Lundbeck, Pharmacia, Pierre Fabre, Pfizer, Servier and Wyeth; and has served on advisory boards for AstraZeneca, GlaxoSmithKline, Grunenthal, Lilly, Lundbeck, Organon, Pierre Fabre, Pfizer and Servier. P. Blier received honoraria for speaking engagements, advisory boards, and/or investigator-initiated grants from Angelini, Astra-Zeneca, Bristol Myers Squibb, Eli Lilly, Euthymics, Janssen, Labopharm, Lundbeck, Merck, Organon, Pfizer, Pierre Fabre, Schering-Plough, Servier, Takeda, Wyeth. G.M.Goodwin holds or has held grants from Bailly Thomas charity, Medical Research Council, NIHR, Servier; has received honoraria from AstraZeneca, BMS, Lundbeck, Sanofi-Aventis, Servier, holds shares in P1vital ltd; has served on advisory boards for AstraZeneca, BMS, Boehringer Ingelheim, Cephalon, Janssen-Cilag, Lilly, Lundbeck, P1Vital, Servier, Shering Plough, Wyeth and acted as an expert witness for Lilly and Servier. K.N. Fountoulakis has received grant/research support from Eli Lilly, Bristol-Myers Squibb, and Servier; has served as a consultant or on advisory boards for AstraZeneca, Bristol-Myers Squibb and Servier, Janssen, and has given lectures for AstraZeneca, Eli Lily, Janssen, Servier, and Bristol-Myers Suibb. S. Kasper has received grant/research support from Eli Lilly, Lundbeck, Bristol-Myers Squibb, GlaxoSmithKline, Organon, Sepracor and Servier; has served as a consultant or on advisory boards for AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Eli Lilly, Lundbeck, Pfizer, Organon, Schwabe, Sepracor, Servier, Janssen, and Novartis; and has served on speakers’ bureaus for AstraZeneca, Eli Lily, Lundbeck, Schwabe, Sepracor, Servier, Pierre Fabre, and Janssen. D. J. Stein has received research grants and/or consultancy honoraria from Abbott, Astrazeneca, Eli-Lilly, GlaxoSmithKline, Jazz Pharmaceuticals, Johnson & Johnson, Lundbeck, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo, Takeda, Tikvah, and Wyeth. H.-J. Möller has received grant/research support, is member of advisory boards, or has served as a speaker for AstraZeneca, Bristol-Myers Squibb, Eisai, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, Merck, Novartis, Organon, Pfizer, Sanofi-Aventis, Schering-Plough, Schwabe, Sepracor, Servier and Wyeth. B.E. Leonard, U. Malt and M. Versiani had no conflicts of interest to declare.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Thomas C. Baghai
    • 1
    • 2
    Email author
  • Pierre Blier
    • 3
  • David S. Baldwin
    • 4
  • Michael Bauer
    • 5
  • Guy M. Goodwin
    • 6
  • Kostas N. Fountoulakis
    • 7
  • Siegfried Kasper
    • 8
  • Brian E. Leonard
    • 9
  • Ulrik F. Malt
    • 10
  • Dan J. Stein
    • 11
  • Marcio Versiani
    • 12
  • Hans-Jürgen Möller
    • 1
  1. 1.Department of Psychiatry and PsychotherapyLudwig-Maximilian-University of MunichMunichGermany
  2. 2.Department of Psychiatry and PsychotherapyUniversity RegensburgRegensburgGermany
  3. 3.Department of PsychiatryUniversity of OttawaOttawaCanada
  4. 4.University Department of PsychiatryUniversity of SouthamptonSouthamptonUK
  5. 5.University Hospital Carl Gustav CarusDresdenGermany
  6. 6.University DepartmentWarneford HospitalOxfordUK
  7. 7.3rd Department of PsychiatryAristotle University of ThessalonikiThessalonikiGreece
  8. 8.Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
  9. 9.National University of IrelandGalwayIreland
  10. 10.Department of Neuropsychiatry and Psychosomatic Medicine, Oslo University HospitalUniversity of OsloOsloNorway
  11. 11.MRC Unit of Anxiety DisordersUniversity of StellenboschCape TownSouth Africa
  12. 12.Department of PsychiatryFederal University of Rio de JaneiroRio de JaneiroBrazil

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