Lewis 2011.
Methods | Twelve‐week, randomised controlled trial. | |
Participants | Patients with depression, recruited in primary care, aged 18‐74 years who had already agreed with their general practitioner that antidepressant should be prescribed. Patients who had taken antidepressant medication within the 2‐weeks prior to the baseline assessment and those who could not complete self‐administered scales were excluded. General practitioner also excluded those with medical contraindications, psychosis, bipolar affective disorder, major substance or alcohol misuse and others whose participation was deemed inappropriate. |
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Interventions | Citalopram: 298 participants. Reboxetine: 303 participants. Citalopram dose: 20 mg/day. Reboxetine dose: 8 mg/day. |
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Outcomes | Primary outcome: total Beck depression Inventory Score (BDI) at 6‐weeks. Secondary outcomes: remission rates (defined as BDI score < 10) at 6‐weeks, Short Form Health Survey mental and physical sub‐scale scores and Hospital Anxiety and Depression Scale total scores. |
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "Randomization was conducted using a computer‐generated code, administered centrally and communicated by telephone and thereby concealed in advance from the researcher. Allocation was stratified by severity of symptoms and by centre, using variable block sized to maximise concealment". |
Allocation concealment (selection bias) | Low risk | Quote: "(Randomization was) concealed in advance from the researcher. Allocation was stratified by severity of symptoms and by centre, using variable block sized to maximise concealment". |
Blinding (performance bias and detection bias) All outcomes | Unclear risk | No data reported |
Incomplete outcome data (attrition bias) All outcomes | High risk | High attrition rate and unbalance between treatment groups (about 20% of lost to follow up in the citalopram group and about 30% in the reboxetine group) |
Selective reporting (reporting bias) | Low risk | Primary outcome data were reported. |
Other bias | Low risk | Sponsorship bias can be ruled out. |