Loo 1999.

Methods	Six‐week randomised, double‐blind, multicentre study
Participants	In‐ and outpatients fulfilling ICD‐10 criteria for depressive episode, recurrent depressive disorder, or bipolar affective disorder (depressive), with a score of at least 25 on the Montgomery and Asberg Scale for Depression (MADRS), requiring an antidepressant treatment. Age range: 18‐65 years Exclusion criteria: severe risk of suicide, acute or chronic psychosis, failure to respond to 2 antidepressants for the current depressive episode, previous history of drug abuse or dependence, severe somatic diseases in evolution, current treatment with barbiturate, buspirone, anti‐epileptic drugs, use of diazepam, lorazepam and alprazolam.
Interventions	Fluoxetine: 196 participants Tianeptine: 191 participants Fluoxetine dose: 20 mg/day Tianeptine dose: 37.5 mg/day
Outcomes	Primary outcome: MADRS global score Secondary outcomes: decrease of at least 50% in MADRS global score (responder patients) and Clinical Global Impression (CGI) scores
Notes	Funding: unclear
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomised, 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	Number and reasons for discontinuation reported, but withdrawal was not included in the analysis
Selective reporting (reporting bias)	Unclear risk	Only serious adverse events reported. End point mean scores reported with standard deviations
Other bias	Unclear risk	Funding: unclear