A Cochrane review [Abstract] 1 included 14 studies with a total of 2 283 subjects. The depression patients from the primary care setting were under the age of 65; 1364 patients were in the intervention and 919 in placebo groups. Ten studies examined tricyclic antidepressants (TCA), two selective serotonin reuptake inhibitors (SSRI) and two included both, all compared with placebo. Nearly all studies were of short duration, typically 6-8 weeks. TCAs (RR 1.24, 95% CI 1.11 to 1.38) and SSRIs (RR 1.28, 95% CI 1.15 to 1.43) were more effective than placebo for depression reduction. The numbers needed to treat (NNT) for TCAs ranged from 7 to 16 (median NNT 9) and for SSRIs from 7 to 8 (median NNT 7). The numbers needed to harm (NNH for withdrawal due to side effects) ranged from 4 to 30 for TCAs (excluding three studies with no harmful events leading to withdrawal) and 20 to 90 for SSRIs.
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