Specchio 2004

Methods	A multi‐centre, non‐randomised, uncontrolled, prospective before and after study (Italy) Baseline period: Not reported Treatment period: 4 months
Participants	45 people with focal epilepsy and exceeding or equal to 20 on the MADRS 31 females and 14 males Mean age of 42.7 years
Interventions	Citalopram 20 mg per day
Outcomes	1) Seizure frequency 2) Improvement in depression measured by MADRS and Zung‐SDS 3) Adverse effects
Notes	39 people received intended treatment and analysed
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	No randomisation methods used
Allocation concealment (selection bias)	High risk	No methods for concealing allocation used
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	No details given regarding methods of blinding. Rated 3 on scale for risk of bias
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No details given regarding methods of blinding. Rated 3 on scale for risk of bias
Incomplete outcome data (attrition bias) All outcomes	Low risk	Small amount of missing data reported. Intention‐to treat‐analysis not employed. Rated 2 on scale for risk of bias
Selective reporting (reporting bias)	Low risk	Outcomes stated in methods section of report are present in the results. No protocol available. Rated 2 on scale for risk of bias
Other bias	Low risk	No other risk of bias detected. Rated 1 on scale for risk of bias
Confounding variables	High risk	No confounding variables considered or adjusted for. Rated 5 on scale for risk of bias