Sheehan 2009.

Methods	Six‐week randomised, double‐blind multicentre study
Participants	Inpatients fulfilling DSM‐IV criteria for the melancholic subtype of MDD of at least 1 month duration, with a score of at least 24 on the first 21 items of the Hamilton Rating Scale for Depression (HDRS‐21). (In patients at the moment of randomisation, then patients could complete the protocol as outpatients if, in the opinion of the investigator, the response to treatment was sufficient to allow discharge from hospital). Age range: adults, over 18 years old Exclusion criteria: severe or poorly controlled medical illnesses, known hypersensibility to either study drug, treatment with either study drug within 3 months, or myocardial infarction within 6 months before the start of the study, patients with clinically significant abnormalities on the physical examination, electrocardiogram, laboratory tests, or urine test, pregnancy, lactation, absence of contraception. Patients with active suicidal ideation, history of seizures, the presence or history of an organic mental disorder, mania or hypomania or psychotic disorder; electroconvulsive therapy within 3 months, any investigational or antipsychotic drug within 30 days, or astemizole, cisapride, sumatriptan, terfenadine, or any monoamine oxidase inhibitor within 14 days; patients could not have taken any other antidepressant, anxiolytic, sedative‐hypnotic, or other psychotropic drug within 2 days before the start of double blind treatment; any non psychopharmacological drug with psychotropic effects in the last 2 days, and history of alcohol or drug dependence or abuse within 1 year before double‐blind treatment.
Interventions	Fluoxetine: 99 participants Venlafaxine: 95 participants Fluoxetine dose range: 60‐80 mg/day Venlafaxine dose range: 225‐375 mg/day
Outcomes	Hamilton Rating Scale for Depression (HDRS‐21) total score, Clinical Global Impression (CGI) Improvement , Montgomery–Åsberg Depression Rating Scale (MADRS) total score Response: decrease of at least 50% in the total score on the HDRS and MADRS, or a score of 1‐2 on the CGI‐I
Notes	Funding: by industry
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "patients were enrolled by investigators and assigned to blinded treatment by a computerized randomisation process generated by the sponsor. Medication was randomised in blocks of six patients, lots containing equal numbers of each treatment."
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	Low risk	Number and reasons for withdrawal reported. Scores reported with denominators. Mean scores (HDRS, MADRS, CGI) and standard deviations reported clearly at baseline and at the endpoint
Selective reporting (reporting bias)	Unclear risk	Only most common (10%) side effects reported
Other bias	High risk	Quote: "this study was funded by Wyeth Pharmaceuticals and administered by Quitiles", and this company produces venlafaxine