Lôo 1988.

Methods	Randomized, double‐blind, comparative trial
Participants	129 people with alcohol dependence with depression or dysthymic disorder (111 men and 18 women; mean age: approximately 38 years) Inclusion criteria: DSM‐III diagnoses of alcohol dependence or alcohol abuse and depression or dysthymia MADRS score ≥ 20 Exclusion criteria: persistent alcohol intoxication at time of trial presence of psychotic traits recent antidepressant or neuroleptic treatment serious somatic illness pregnancy or absence of contraception in a woman of childbearing potential Participants with bipolar disorder: information not available
Interventions	Drugs: tianeptine (37.5 mg/day; 64 participants; 57 men and 7 women; age (mean ± SD): 37.9 ± 1.0 years) amitriptyline (75.0 mg/day; 65 participants; 54 men and 11 women) Psychotherapy: information not available Scheduled duration of treatment: 4‐8 weeks (depending on the centre concerned) Sites: 7 centres, in France Setting: unclear Route of administration: orally Starting dose: tianeptine = 37.5 mg/day; amitriptyline = 75.0 mg/day Pattern of dose reduction: information not available
Outcomes	Depression: final MADRS score (obtained from a figure) final SCL‐90 (obtained from a figure) response Alcohol dependence: data not available Anxiety: final HRSA score (obtained from a figure) Dropouts Adverse effects
Notes	Baseline characteristics of participants Depression: primary depression (rate of participants): 100% duration: information not available MADRS score (mean ± SD): tianeptine = 30.0 ± 0.8; amitriptyline = 29.3 ± 0.8 Alcohol dependence: duration: information not available severity: information not available being actively drinking: participants were withdrawn from alcohol 2‐5 weeks before inclusion Other psychiatric comorbidity: information not available Other substance use disorders: information not available Other characteristics of study Other pharmacological treatment offered: other pharmacological treatments were allowed. Funding source: information not available Declarations of interest: information not available Other information In the original study, the duration of the trial was 4‐8 weeks depending on the centre concerned. In the present meta‐analysis, only data of 4 weeks were analyzed. Before the onset of the trial, participants received a pretreatment with a placebo for 3‐10 days to screen out placebo‐responder participants. After this period, participants received tianeptine or amitriptyline.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient information to permit judgement.
Allocation concealment (selection bias)	Unclear risk	Method of concealment not described.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Double‐blind stated. Medication and placebo prepared to appear identical. No specific reference made to blinding of participants and personnel.
Blinding of outcome assessment (detection bias) objective	Low risk	No information on the blinding of outcome assessors.
Blinding of outcome assessment (detection bias) subjective	Unclear risk	No information on the blinding of outcome assessors.
Incomplete outcome data (attrition bias) All outcomes	High risk	Intention‐to‐treat analysis not used. However, the numbers of dropouts were low (10/64, 12/65) and were not unbalanced between groups.
Selective reporting (reporting bias)	High risk	Several data were missing (final MADRS score for amitriptyline, adverse effects, and alcohol consumption).