Beasley 1993a.

Methods	Six‐week double‐blind, randomised study
Participants	Inpatients fulfilling DSM‐III‐R criteria for major depressive episode, with a score of at least 20 on the Hamilton Rating Scale for Depression‐21 item (HDRS‐21). Age range: 18‐70 years Exclusion criteria: psychosis, organic mental disorder, substance abuse active within 1 year
Interventions	Fluoxetine: 56 participants Imipramine: 62 participants Fluoxetine dose range: 40‐80 mg/day Imipramine dose range: 150‐300 mg/day Chloral hydrate (max 1g) and flurazepam (max 30 mg) were allowed as hypnotic
Outcomes	HDRS‐21, Raskin, Covi, Clinical Global Impression Severity and Improvement Scales (CGI)
Notes	Response: decrease of at least 50% in the total score Remission: total score less than 7 One patient on fluoxetine committed suicide Funding: by industry
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "randomly assigned", no further information
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Double blind, no further information
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Double blind, no further information
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Double blind, no further information
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Quote: "efficacy data were analysed in accordance with ITT principle", but scores reported without denominator. Study completion rates and reasons for study discontinuations reported
Selective reporting (reporting bias)	Unclear risk	Only side‐effect over 5% reported. Vital signs reported
Other bias	High risk	Authors' affiliation was Psychopharmacology Division, Lilly Reasearch Laboratories, Eli Lilly and Company, Indianapolis. This company produces fluoxetine