Comment: The quality of evidence is downgraded by indirectness (the definitions of “remission” were different in the studies).
A Cochrane review [Abstract] 1 included 10 studies with a total of 1,592 subjects. There was little or no difference in scores on depression symptom rating scales between the antidepressant and placebo treated groups after 6 to 13 weeks (standardised mean difference (SMD) -0.10, 95% CI -0.26 to 0.06; n=614; 8 studies). The remission rate at 6 to 13 weeks was probably higher in the antidepressant group than the placebo group (antidepressant: 40%, placebo: 21.7%; OR 2.57, 95% CI 1.44 to 4.59; n=240; 4 studies). There was evidence of no effect of antidepressants on performance of activities of daily living at weeks 6 to 13 and probably also little or no effect on cognition.
Participants on antidepressants were probably more likely to drop out of treatment than those on placebo over 6 to 13 weeks (OR 1.51, 95% CI 1.07 to 2.14; n=836; 9 studies). The meta-analysis of the number of participants suffering at least one adverse event showed a significant difference in favour of placebo (antidepressant: 49.2%, placebo: 38.4%; OR 1.55, 95% CI 1.21 to 1.98, n=1073; 3 studies)
Abstract and full text in Cochrane database http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003944.pub2/full, SOF table http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003944.pub2/full#CD003944-sec1-0001 (licence for full text and SOF table required) .
Primary/Secondary Keywords