Table 1.

Features of 15 Randomized Trials Comparing Either a Selective Serotonin Reuptake Inhibitor (SSRI) or Tricyclic Antidepressant (TCA) With Placebo

Study	Quality*	Diagnosis	TCA Dose†	Responsible for Treatment	Competing Interest	Study Period	Outcome
TCA vs placebo
Blashki et al26	High	Heterogeneous	High and low	GP and psychiatrist	No	4 wk	HAMD
Brink et al27	Low	Heterogeneous	High	GP	Yes	6 wk	HAMD
Doogan & Langdon19‡	High	MDD	High	GP	Yes	6 wk	MADRS 50%M
Feighner et al24	High	Heterogeneous	High	Psychiatrist	No	4 wk	HAMD 50%H
Hollyman et al23	High	Heterogeneous	High	Psychiatrist	No	6 wk	HAMD 50%H
Lecrubier et al25	Low	Heterogeneous	High	Psychiatrist	Yes	12 wk	HAMD 50%H
Malt et al17‡	High	Heterogeneous	High	GP	Yes	24 wk	MADRS 50%M
Mynors-Wallis et al21	High	Heterogeneous	High	GP	No	12 wk	MADRS
Philipp et al20	Low	ModDD	Low	GP	Yes	8 wk	HAMD
Thompson & Thompson28	Low	Heterogeneous	Low	GP	No	4 wk	HAMD
Thomson et al22	Low	Heterogeneous	High	GP	Yes	12 wk	HAMD
Barge-Schaapveld & Nicholson29	Low	MDD	High	Unclear	Yes	6 wk	HAMD
SSRI vs placebo
Doogan & Langdon19*	High	MDD	100 mg sertraline	GP	Yes	6 wk	MADRS 50%M
Lepola et al18	Low	MDD	10 mg escitalopram	Unclear	Yes	8 wk	MADRS 50%M
Malt et al17†	High	Heterogeneous	100 mg sertraline	GP	Yes	24 wk	MADRS
Montgomery et al30	High	MDD	10 mg escitalopram or 20 mg citalopram	Unclear	Yes	4 wk	MADRS
Wade et al16	High	MDD	10 mg escitalopram	Unclear	Yes	8 wk	MADRS

HAMD = Hamilton depression scale; 50%H = discrete outcomes where improvement is a greater than 50% reduction in HAMD; MADRS= Montgomery-Asberg Depression Rating Scale; 50%M = discrete outcomes where improvement is a greater than 50% reduction in the MADRS; heterogeneous = patients thought by their general practitioner to be depressed, which may or may not include patients with major depression as opposed to the studies with only patients with major depression; MDD = major depressive disorder; ModDD = moderate depressive disorder.

* Quality high if adequate sample size, concealment, description of treatment, representative sample, specified inclusion, details of withdrawals, valid outcomes.

† High dose defined as majority of TCA treated patients receiving at least equivalent of 100 mg/d amitriptyline (60 mg mianserin).

‡ Study has 3 arms (SSRI vs TCA vs placebo).