Perez 1990.

Methods	Six‐week double blind, multicentre, randomised study.
Participants	Psychiatric outpatients meeting DSM‐III for major depressive episode, with a minimum baseline score of 30 on the MADRS. Age range: 18 years old or more; mean 41.6 years old. Exclusion criteria: pregnant or at risk of becoming pregnant, breast feeding; strong suicide potential; major physical disorders such as epilepsy, hepatic or renal disease.
Interventions	Fluvoxamine: 30 participants. Mianserin: 33 participants. Fluvoxamine dose range: 100‐300 mg/day Mianserin dose range: 60‐180 mg/day. No other form of antidepressant medication was allowed during the trial period.
Outcomes	MADRS, CGI‐I, Leeds Sleep Evaluation Questionnaire. Total dropout, dropout due to inefficiency, dropout due to side effects, side effect profile.
Funded by pharmaceutical companies	Funded by pharmaceutical company markets fluvoxamine.
Fluvoxamine as an investigational or comparator drug	Unclear.
Notes	Patients with major depressive episode (DSM‐III) were included, so there might be some bipolar depression, but correct number was not reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "randomized", no further details.
Allocation concealment (selection bias)	Unclear risk	No details.
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Quote: "double blind", no further details.
Incomplete outcome data (attrition bias) All outcomes	High risk	Study endpoint: 9/30 missing from fluvoxamine group (1 due to lack of efficacy, 6 due to adverse effects); 9/33 missing from control group (2 due to lack of efficacy, 5 due to adverse effects).
Selective reporting (reporting bias)	High risk	SDs of endpoint/change score for depression were not reported.