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. 2016 Sep 12;2016(9):CD011567. doi: 10.1002/14651858.CD011567.pub2

Summary of findings 6. SSRIs compared to MAOIs for adults with panic disorder.

SSRIs compared to MAOIs for adults with panic disorder
Patient or population: adults with panic disorder
 Settings: outpatient
 Intervention: SSRI
 Comparison: MAOI
Outcomes Illustrative comparative risks* (95% CI) Relative effect
 (95% CI) No of Participants
 (studies) Quality of the evidence
 (GRADE) Comments
Assumed risk Corresponding risk
MAOI SSRI
failure to respond 
 Follow‐up: 8‐12 weeks 264 per 1000 296 per 1000 
 (219 to 401) RR 1.12 
 (0.83 to 1.52) 396
 (2 studies) ⊕⊕⊕⊝
 moderate1  
total number of dropouts 
 Follow‐up: 12 weeks 67 per 1000 67 per 1000 
 (5 to 970) RR 1.00 
 (0.07 to 14.55) 30
 (1 study) ⊕⊕⊝⊝
 low2  
failure to remit 
 Follow‐up: 8 weeks 467 per 1000 434 per 1000 
 (346 to 546) RR 0.93 
 (0.74 to 1.17) 366
 (1 study) ⊕⊕⊕⊝
 moderate3  
panic symptoms See comment See comment Not estimable 0
 (0) See comment No studies provided data for this outcome
number of dropouts due to adverse events 
 Follow‐up: 8 weeks 60 per 1000 76 per 1000 
 (36 to 163) RR 1.26 
 (0.59 to 2.70) 366
 (1 study) ⊕⊕⊝⊝
 low4  
*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (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; RR: Risk ratio;
GRADE Working Group grades of evidence
 High quality: Further research is very unlikely to change our confidence in the estimate of effect.
 Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
 Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
 Very low quality: We are very uncertain about the estimate.

1 Downgraded one point due to imprecision: 95% CI ranges from no difference to appreciable benefit with MAOIs
 2 Downgraded two points due to imprecision: number of individuals included in the trial is very low (= 30) and 95% CI is very wide, ranging from appreciable benefit with SSRIs to appreciable benefit with MAOIs; only one study provides data
 3 Downgraded one point due to imprecision: even though the number of individuals included in the analysis is not low, only one study provides data
 4 Downgrded two points due to imprecision: 95% CI ranges from appreciable benefit with SSRIs to appreciable benefit with MAOIs; only one study provides data.