A Cochrane review [Abstract] 1 included 5 RCTs with a total of 213 stroke patients. We included seven trials with a total of 239 participants. Two trials were of cross‐over design, and outcome data were not available from the first phase (precross‐over) in an appropriate format for inclusion as a parallel randomised controlled trial (RCT). Thus, the results of the review are based on five trials with 213 participants. Treatment effects were observed on the following primary endpoints of emotionalism: There is very low quality of evidence from one small RCT that antidepressants increased the number of people who had 50% reduction in emotionalism (RR 16.50, 95% CI 1.07 to 253.40; 19 participants) and low quality evidence from one RCT of improved scores on Center for Neurologic Study ‐ Lability Scale (CNS‐LS) and Clinician Interview‐Based Impression of Change (CIBIC) with antidepressants (RR 1.44, 95% CI 0.95 to 2.19; 28 participants). There was moderate quality evidence from three RCTS that they increased the number of people who had a reduction in tearfulness (RR 2.18, 95% CI 1.29 to 3.71; 164 participants); and low quality evidence from one RCT of improved scores on the Pathological Laughter and Crying Scale (PLCS) (MD 8.40, 95% CI 11.56 to 5.24; 28 participants).
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, inadequate follow up), inconsistency (heterogeneity in patients and evaluation methods) and indirectness (differences in studied patients).
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