Shinkai 2004.

Methods	4 week randomised double blind study
Participants	Diagnosis: Inpatients with DSM‐IV major depressive disorder without psychotic features Male and Female. Threshold of baseline severity: HDRS‐17>=15 Total number of all allocated participants: N=41 Age: mean 53 (SD 17)y; range 20‐78y
Interventions	Milnacipran mean 80.25mg: N=20 Paroxetine mean 34.28mg: N=21 Flexible dosing schedule.
Outcomes	Hamilton Depression Rating Scale‐17 item
Notes	Funding: independent from industry
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "randomly"
Allocation concealment (selection bias)	Low risk	Quote: "randomly divided into either milnacipran or the paroxetine group using StatView, a computerized statistical package"
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing primary outcome.
Selective reporting (reporting bias)	High risk	Adverse events were not reported so that could not be entered in to the meta‐analysis.
Other bias	Unclear risk	Insufficient information to assess whether an important risk of bias exists.