Pharmacological interventions targeting anhedonia in patients with major depressive disorder: A systematic review

Bing Cao; Judy Zhu; Hannah Zuckerman; Joshua D Rosenblat; Elisa Brietzke; Zihang Pan; Mehala Subramanieapillai; Caroline Park; Yena Lee; Roger S McIntyre

doi:10.1016/j.pnpbp.2019.01.002

Pharmacological interventions targeting anhedonia in patients with major depressive disorder: A systematic review

Prog Neuropsychopharmacol Biol Psychiatry. 2019 Jun 8:92:109-117. doi: 10.1016/j.pnpbp.2019.01.002. Epub 2019 Jan 3.

Authors

Affiliations

¹ Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing 100191, China; Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada. Electronic address: caobing@bjmu.edu.cn.
² Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, Canada.
³ Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
⁴ Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada.
⁵ Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing 100191, China; Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada.

PMID: 30611836
DOI: 10.1016/j.pnpbp.2019.01.002

Abstract

Anhedonia is defined as a diminished ability to experience interest or pleasure, and is a critical psychopathological dimension of major depressive disorder (MDD). The purpose of the current systematic review is to evaluate the therapeutic efficacy of pharmacological treatments on measures of anhedonia in adults with MDD. Electronic databases Cochrane Library (CENTRAL), Ovid MEDLINE, PubMed, PsycINFO, and Google Scholar were searched from inception to June 1, 2018 for longitudinal studies utilizing pharmacotherapy for the treatment of anhedonia in patients with MDD. A total of 17 eligible studies were identified (i.e., evaluated the effects of pharmacotherapy on a measure of anhedonia). Among the identified studies, the efficacy of 14 different pharmacotherapies on measures of anhedonia were evaluated, including melatonergic agents (i.e. agomelatine), monoaminergic agents (i.e. moclobemide, clomipramine, bupropion, venlafaxine, fluoxetine, amitifadine and levomilnacipran, escitalopram, and sertraline), glutamatergic agents (i.e., ketamine and riluzole), stimulants (i.e., methylphenidate), and psychedelics (i.e., psilocybin). Based on the available evidence, most antidepressants demonstrated beneficial effects on measures of anhedonia as well as the other depressive symptoms. Only escitalopram/riluzole combination treatment was ineffective in treating symptoms of anhedonia in MDD. Continued research is warranted to further support the efficacy of mechanistically-distinct antidepressants in treating symptoms of anhedonia in MDD. Future research should also aim to parse out the heterogeneous effects of different pharmacotherapies on anhedonic symptoms.

Keywords: Agomelatine; Anhedonia; Antidepressant; Major depressive disorder; The Snaith-Hamilton Pleasure Scale.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Anhedonia / drug effects*
Antidepressive Agents / therapeutic use*
Depressive Disorder, Major / drug therapy*
Humans

Substances

Antidepressive Agents