Treatment of depression in multiple sclerosis: Review and meta-analysis

The aim of this article is to review the results of outcome studies of the treatment of depression in patients with multiple sclerosis (MS) using meta -analysis. All treatments for depression in MS were found to be significant ly more effective than no treatment. Patients in control groups that receiv ed no treatment, as opposed to minimal treatment, tended to become more dep ressed over time, suggesting that untreated depression worsens without trea tment. There appears to be no significant difference in efficacy between ps ychotherapy and antidepressant medication. Psychotherapies that focus an im proving coping skills are more effective at reducing depression than psycho therapies that focus on increasing insight. We conclude that patients with MS should be evaluated routinely for depression. Patients reporting symptom s of depression should be referred for treatment since active intervention is effective at reducing depression and untreated symptoms are likely to wo rsen.