The current status of antidepressants and cognitive function enhancers treatment research in Korea

Article type
Authors
Jang B1, Kim M1, Park K1, Park JE1, Han C2, Bae C3
1NECA, Korea
2Korea University College of Medicine and NECA, Korea
3The Catholic University of Korea College of Medicine, Korea
Abstract
Background: According to an epidemiological survey in 2011, the lifetime-prevalence of mental illness in Korea is up to 28%. To establish practical guidelines for psychiatric disorders treatment, it is needed to evaluate the evidence level of clinical research in Korea.

Objectives: To investigate the current status of clinical research on antidepressants and cognitive function enhancers for Korean patients and to assess quality of the studies.

Methods: We performed a systematic search for all entries in Ovid Medline, Ovid EMBASE, Ovid PsycINFO, Cochrane library as well as five regional databases including KoreaMed and eight domestic psychiatric journals related to antidepressants or cognitive function enhancers treatment for Korean patients since 2000. Data were extracted on objectives, design, setting, participants, interventions, main outcomes, main results, and conclusions from the included studies, and the collected information was evaluated though assessments of risk of bias (ROB) or methodological items for non-randomized studies (MINORS).

Results: Eighty studies were selected for antidepressants, which comprised of randomized controlled trials (10%), pretest-posttest studies and time series analysis (28%), and case reports (53%). Among them, 32% was on SSRIs, 17% on SNRIs, 6% on TCA, and 28% on others. For cognitive function enhancers, 28 studies consisted with randomized controlled trials (7%), pretest-posttest studies and time series analysis (50%), and case reports (18%). Cholinesterase inhibitors were 89% and NMDAR antagonists were 11%. Bias and quality analysis of the literature revealed that overall the risk of bias was high, or the quality was low in existing literatures.

Conclusions: Clinical research in antidepressants and cognitive function enhancers for Korean patients was insufficient, and it was unclear in terms of ‘allocation concealment’ and ‘blinding’. Further research with high-quality is needed on randomization and blinding in the randomized controlled trials.