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. 2013 Jul 17;2013(7):CD004185. doi: 10.1002/14651858.CD004185.pub3

Nielsen 1993.

Methods Eight‐week double‐blind, randomised study
Participants Outpatients fulfilling DSM‐III and Bech‐Rafaelsen Melancholia Scale criteria for major depressive disorder, with a score of at least 18 on the Hamilton Rating Scale for Depression (HDRS‐21).
 Age range: 18‐70 years
 Exclusion criteria: suicide risk, history of schizophrenia or organic brain dysfunction, history of severe allergies or serious physical illness, recent period of alcohol or alcohol abuse, pregnancy.
Interventions Fluoxetine: 29 participants
 Imipramine: 30 participants
 Fluoxetine dose: 20 mg/day
 Imipramine dose range: 75‐150 mg/day
Outcomes HDRS‐21, Bech‐Rafaelsen Melancholia Scale (MES), Clinical Global Impression (CGI), Patient Global Impression (PGI)
Notes Funding: by industry
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 Reasons and numbers of dropouts reported. Scores reported without denominator
Selective reporting (reporting bias) Unclear risk Only most frequent side effects reported. End point scores and standard deviation not clearly reported
Other bias High risk One of the authors' affiliation was Eli Lilly, Denmark. This company produces fluoxetine