Summary of findings 15. Fluoxetine compared to milnacipran.
| Fluoxetine compared to milnacipran | ||||||
| Patient or population: patients with depression Settings: in‐ and outpatients Intervention: fluoxetine Comparison: milnacipran | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Milnacipran | Fluoxetine | |||||
|
Failure to respond (reduction ≥ 50% on HDRS) |
473 per 1000 | 518 per 1000 (412 to 623) | OR 1.20 (0.78 to 1.84) | 370 (2 studies) | ⊕⊕⊕⊝ moderate1 | |
|
Endpoint score (HDRS or MADRS) |
The mean endpoint score in the intervention groups was 0.36 standard deviations lower (0.63 to 0.08 lower) | 213 (2 studies) | ⊕⊕⊕⊝ moderate1 | This corresponds to a small effect according to conventions proposed by Cohen 1992 | ||
| Failure to complete ‐ total ‐ | 411 per 1000 | 406 per 1000 (322 to 497) | OR 0.98 (0.68 to 1.42) | 560 (3 studies) | ⊕⊕⊕⊝ moderate1 | |
| Failure to complete ‐ inefficacy ‐ | 137 per 1000 | 165 per 1000 (97 to 267) | OR 1.25 (0.68 to 2.30) | 560 (3 studies) | ⊕⊕⊕⊝ moderate1 | |
| Failure to complete ‐ side effects ‐ | 71 per 1000 | 103 per 1000 (59 to 175) | OR 1.50 (0.81 to 2.76) | 560 (3 studies) | ⊕⊕⊕⊝ moderate1 | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Limitations in studies designs: no details on randomisation procedures and allocation concealment. Blinding stated but not tested.