Shinkai 2004.

Methods	Four‐week, randomised, double‐blind study.
Participants	Inpatients with DSM‐IV major depressive disorder without psychotic features with a minimum score of 15 on the Hamilton rating scale for depression (HDRS). Age range: 20‐78 years.
Interventions	Paroxetine: 21 participants. Milnacipram: 20 participants. Paroxetine mean dose: 34.28 mg. Milnacipran mean dose: 80.25 mg. No other drugs were administered throughout the study with the exception of a few patients who received benzodiazepines for insomnia.
Outcomes	HDRS‐17.
Notes	Funding: independent from industry.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "randomly divided into either milnacipran or the paroxetine group using StatView, a computerized statistical package"
Allocation concealment (selection bias)	Unclear risk	No information provided.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Quote: "double blind". No further details.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Quote: "double blind". No further details.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Study endpoint: 1/21 missing from paroxetine group, 0/20 missing from control group.
Selective reporting (reporting bias)	High risk	Adverse events were not reported so that could not be entered in to the meta‐analysis.
Other bias	Low risk	This study was independent from pharmaceutical industry.