Summary of findings 2. Selective serotonin reuptake inhibitor antidepressant compared to placebo for cannabis dependence.
| SSRI antidepressant compared to placebo for cannabis dependence | |||||
| Patient or population: cannabis dependence Setting: outpatient Intervention: SSRI antidepressant Comparison: placebo | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with placebo | Risk with SSRI antidepressant | ||||
| Participants abstinent at end of treatment | Study population |
RR 1.73 (0.61 to 4.89) |
128 (2 RCTs) | ⊕⊕⊝⊝ Lowa,b | |
| 82 per 1000 | 142 per 1000 (50 to 401) | ||||
| Participants experiencing adverse effects | Study population |
RR 0.76 (0.57 to 1.02) |
76 (1 RCT) | ⊕⊝⊝⊝ Very lowa,c | |
| 800 per 1000 | 608 per 1000 (456 to 816) | ||||
| Participants withdrawn due to adverse effects | Study population |
RR 1.71 (0.16 to 18.04) |
76 (1 RCT) | ⊕⊝⊝⊝ Very lowa,c | |
| 29 per 1000 | 49 per 1000 (5 to 515) | ||||
| Completion of scheduled treatment | Study population |
RR 0.79 (0.49 to 1.27) |
198 (3 RCTs) | ⊕⊝⊝⊝ Very lowa,b,d | |
| 680 per 1000 | 538 per 1000 (333 to 864) | ||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; SSRI: selective serotonin reuptake inhibitor. | |||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | |||||
aDowngraded one level for risk of bias: one study at high risk of bias due to differences in appointment attendance, one study at high risk of attrition bias.
bDowngraded one level for imprecision: very few events and small group sizes.
cDowngraded two levels for imprecision: very few events and small group sizes.
dDowngraded one level for inconsistency: significant heterogeneity between studies.