A Cochrane review [Abstract] 1 [withdrawn from publication] on drugs versus placebo included 29 trials. Similar results were obtained in terms of efficacy for different groups of drugs, such as tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI), monoamine oxidase (MAO) inhibitors and other drugs (sulpiride, amineptine, ritanserin). The pooled relative risk (RR) for absence of treatment response was 0.68 (95% CI 0.59 to 0.78) for TCAs, and the number needed to treat (NNT) was 4.3 (95% CI 3.2 to 6.5). SSRIs showed similar relative risk for this outcome: 0.68 (95% CI 0.56 to 0.82); NNT was 5 (95% CI 3.3 to 9). For MAO inhibitors, RR was 0.59 (95% CI 0.48 to 0.71) and NNT 2.9 (95% CI 2.2 to 4.3). Other drugs (amisulpiride, amineptine and ritanserin) showed similar results in terms of absence of treatment response. Patients on TCA were more likely to report adverse events, comparing with placebo.
A Cochrane review 2 (abstract , review [Abstract]) comparing different drugs included 14 studies with a total of 1659 patients. All studied drugs promoted similar clinical responses, although with different side effect profiles. The evidence for TCAs and SSRIs was the most robust, considering the number of trials and participants.
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