Background Depression is a potentially treatable condition which can co-exist with multiple sclerosis (MS). To date, the existing literature has not been collated in a systematic fashion. We set out to collate all available evidence and on the prevalence of depression in MS through a systematic review with meta-analysis. We also aimed to provide an up-to-date review of the use of antidepressants in MS.

Methods An extensive electronic search of the literature yielded 36 relevant studies. Seven studies examined the pharmacological treatment of depression in MS.

Results There is an increased prevalence of depression in MS patients compared to healthy controls, OR 2.77 (95% CI 1.57–4.91). The prevalence of depression in these patients was not increased when compared to controls with other chronic diseases, OR 1.56 (95% CI 0.97–2.52). There was a good response to antidepressant treatment in MS (OR of responding to treatment vs non-response of 1.88 (95% CI 1.10–3.21).

Conclusions This review highlights the increased prevalence of depression in a patient group who appear to benefit from treatment. Further research is required in this area in order to fully understand the aetiology of depression in MS patients.