Efficacy and safety of riluzole for depressive disorder: A systematic review and meta-analysis of randomized placebo-controlled trials

Glutamatergic modulators may have therapeutic potential in the treatment of depressive disorder (DD), riluzole, as a modulating drug of the glutamatergic system, its antidepressant efficacy and safety of riluzole for DD are inconsistent. This meta-analysis was performed to determine the efficacy and safety of riluzole used for DD. A systematic literature search was performed using PubMed, Embase, Cochrane Library, Web of Science, VIP and other databases from 1980 to 2019. The primary outcome was change in depression severity and meta analysis was performed using comprehensive meta-analysis software. Seven randomized controlled trials (RCTs) were included. There was some difference in depression severity change in riluzole-citalopram therapy. No significant differences were observed in response rate, remission rate, relapse rate and adverse events, while, the relapse time in riluzole group was longer than placebo group. In this meta-analysis riluzole showed no antidepressant efficacy compared to placebo in monotherapy or riluzole-ketamine combined therapy, while it might relieve depression severity to some extent in riluzole-citalopram therapy. Furthermore, riluzole showed favorable safety for DD. The longer relapse time of riluzole group might have clinical significance to some extent, although this had no statistical difference. More studies are needed to clarify the potential association between riluzole and DD.