Ash 1999.

Study characteristics
Methods	Design: parallel Duration: 10 weeks Assessment: baseline and post‐intervention Country: UK
Participants	Pain condition: RA Population: women with RA and depression Minimum pain intensity: NR Inclusion criteria: Patients with definite or classical RA as diagnosed per the ARA criteria Aged between 18 and 70 Scored a) > 7 on the depression or anxiety subscales of HADS, b) total score of > 11 on HADS scale, or c) considered to be depressed on clincial assessment Exclusion criteria Experiencing an acute flare in RA symptoms Taking oral steroids, antidepressants, or had received a steroid injection in the previous month Total participants randomised: 48 Age in years (mean, SD): NR Gender: 48/48 were female Pain duration in years (mean, SD): NR
Interventions	Dothiepin n = 25 TCA Flexible dosing dependent on tolerability and side‐effects Placebo n = 23 Identical appearance Inert
Outcomes	Pain intensity Mood Physical function Withdrawal
Missing data methods	ITT but does not state imputation methods
Funding source	Pharmaceutical ‐ Boots
Conflicts of interest	NR
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	States random allocation but no method given
Allocation concealment (selection bias)	Unclear risk	No information given
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐blind with identical appearing antidepressants and placebo
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Self‐reported outcomes from blinded participants
Incomplete outcome data (attrition bias) All outcomes	High risk	Over 40% of participants did not compelte the study due to lack of effect or intolerable side effects. Attrition: Total: 21/48 (43.75%) Placebo: 10/23 (43.5%) Dothiepin 75 to 150 mg: 11/25 (44.0%)
Selective reporting (reporting bias)	Unclear risk	No protocol or trial registration found
Other bias	Low risk	No other sources of bias were identified.