PLOS One has retracted the 2024 systematic review and meta-analysis titled "Efficacy and safety of aripiprazole or bupropion augmentation and switching in patients with treatment‑resistant depression or major depressive disorder." The retraction notice was published by The PLOS One Editors on September 1, 2026 (doi: 10.1371/journal.pone.0357331). The retracted article originally pooled five randomized controlled trial publications to assess augmentation or switching strategies using aripiprazole or bupropion for patients with major depressive disorder, including those with treatment‑resistant illness.
Following publication, concerns were raised about the review methodology. Specifically, three of the five studies incorporated into the pooled analysis were found to report data from the same underlying trial cohort of 1,522 patients with major depressive disorder. This overlap violates the statistical assumption of independence across included studies that underlies standard meta‑analytic pooling. Treating multiple reports from a single trial as if they were independent studies can inflate the apparent number of studies and make pooled estimates appear more precise than is justified by independent evidence.
PLOS conducted an independent assessment of the cited publications and confirmed that the three reports in question derive from the VAST‑D randomized clinical trial cohort:
The notice also states that the cost‑effectiveness report appears not to meet the original review authors’ inclusion criteria. By counting these three reports as three separate trials, the meta‑analysis gave disproportionate weight to the shared cohort relative to the two remaining included studies.
The PLOS One Editors attempted to contact the article authors for comment on the methodological concerns, but the authors did not respond to editorial requests; ultimately, all authors either did not respond directly or could not be reached. The Editors consulted a Statistical Advisor with expertise in systematic reviews and meta‑analyses. Based on that advice, the Editors concluded that the concerns about non‑independence of included data were valid and substantial enough to call into question the validity of the published results and conclusions.
Because three of the five included publications report outcomes from the same set of 1,522 trial participants, the pooled effect estimates reported in the retracted meta‑analysis may be misleading. The duplication of the underlying patient cohort can artificially narrow confidence intervals and increase the apparent precision and weight of the shared data in the pooled estimate. Given that only five studies were included in total, the impact of treating multiple reports from one trial as independent is particularly important and can materially affect conclusions about the efficacy and safety of augmentation or switching with aripiprazole or bupropion in treatment‑resistant depression.
The retraction notice does not report additional numerical details, alternate analyses, or revised estimates. It states that the identified methodological flaws raise sufficient doubt about the validity of the published results and conclusions to warrant retraction.
The retraction notice cites the following items (as listed in the notice):
Ji M, Feng J, Liu G. RETRACTED: Efficacy and safety of aripiprazole or bupropion augmentation and switching in patients with treatment‑resistant depression or major depressive disorder: A systematic review and meta‑analysis of randomized controlled trials. PLoS One. 2024;19(4):e0299020. pmid:38669232.
Mohamed S, Johnson GR, Chen P, Hicks PB, Davis LL, Yoon J, et al. Effect of Antidepressant Switching vs Augmentation on Remission Among Patients with Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST‑D Randomized Clinical Trial. JAMA. 2017;318(2):132–45. pmid:28697253.
Yoon J, Zisook S, Park A, Johnson GR, Scrymgeour A, Mohamed S. Comparing Cost‑Effectiveness of Aripiprazole Augmentation with Other “Next‑Step” Depression Treatment Strategies: A Randomized Clinical Trial. J Clin Psychiatry. 2018;80(1):18m12294. pmid:30695291.
Zisook S, Johnson GR, Hicks P, Chen P, Beresford T, Michalets JP, et al. Continuation phase treatment outcomes for switching, combining, or augmenting strategies for treatment‑resistant major depressive disorder: A VAST‑D report. Depress Anxiety. 2021;38(2):185–95. pmid:33225492.
Publication metadata included in the retraction notice: the retraction was published September 1, 2026, and is open access under the Creative Commons Attribution License. The notice explicitly states the Editors’ decision to retract the article because the methodological concerns question the validity of the published results and conclusions. The notice does not provide revised analyses or corrected pooled estimates.
If you need the original retracted article text or the cited VAST‑D publications for further review, the retraction notice provides the original article DOI and references; however, the notice indicates the article is retracted and that the authors did not respond to editorial correspondence regarding these concerns.