Summary of findings 19. Fluoxetine compared to paroxetine.
| Fluoxetine compared to paroxetine | ||||||
| Patient or population: patients with depression Settings: in‐ and outpatients Intervention: fluoxetine Comparison: paroxetine | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Paroxetine | Fluoxetine | |||||
|
Failure to respond (reduction ≥ 50% on HDRS) |
426 per 1000 | 477 per 1000 (408 to 550) | OR 1.23 (0.93 to 1.65) | 1574 (9 studies) | ⊕⊕⊕⊝ moderate1 | |
|
Endpoint score (HDRS or MADRS) |
The mean endpoint score in the intervention groups was 0.01 standard deviations lower (0.25 lower to 0.24 higher) | 2061 (11 studies) | ⊕⊕⊕⊝ moderate1 | This effect approaches zero | ||
| Failure to complete ‐ total ‐ | 317 per 1000 | 313 per 1000 (273 to 358) | OR 0.98 (0.81 to 1.20) | 1848 (10 studies) | ⊕⊕⊕⊝ moderate1 | |
| Failure to complete ‐ inefficacy ‐ | 52 per 1000 | 39 per 1000 (22 to 71) | OR 0.75 (0.41 to 1.39) | 1005 (4 studies) | ⊕⊕⊕⊝ moderate1 | |
| Failure to complete ‐ side effects ‐ | 133 per 1000 | 115 per 1000 (87 to 151) | OR 0.85 (0.62 to 1.16) | 1509 (9 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.