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. 2012 Jul 11;2012(7):CD007139. doi: 10.1002/14651858.CD007139.pub2

Rush 1985.

Methods Randomised controlled trial, 6 weeks
Participants 52 out‐ and inpatients suffering from major depression, non‐psychotic type. At least 18 on HDRS and at least a mean REM latency less or equal to 65.
Aged 18 to 65 years
Interventions Alprazolam versus amitriptyline (26/26 patients)
Placebo washout 10 to 14 days
Maximum dose: alprazolam 6 mg, amitriptyline 300 mg
Mean final dose: alprazolam 4.4 mg, amitriptyline 190 mg
Outcomes Primary outcome:
Mean HDRS after 6 weeks: alprazolam 12.7 (initial score of 24.1, SD 8.5), amitriptyline 6.9 (initial score of 26.1, SD 6.0)
50% decrease of total HDRS after 6 weeks: alprazolam 11 (44%), amitriptyline 21 (87.5%)
Secondary outcome:
All‐cause withdrawals: alprazolam 12 (48%), amitriptyline 8 (33%)
Notes Endpoint and raw score data analyses were employed
HDRS‐17
(After 3 weeks, 32 outpatients and 17 inpatients had assessments)
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk "Treatments were assigned on a randomized, double‐blind basis and were independent of all pretreatment clinical and laboratory evaluations." No information is provided
Allocation concealment (selection bias) Unclear risk No information is provided
Blinding (performance bias and detection bias) 
 Patients Unclear risk Unclear if they used identical tablets
Blinding (performance bias and detection bias) 
 Physicians Unclear risk No information is provided
Blinding (performance bias and detection bias) 
 Investigators Unclear risk No information is provided
Incomplete outcome data (attrition bias) 
 HDRS Unclear risk Only endpoint analysis is given while dropout rate is not equally distributed between the treatment groups
Incomplete outcome data (attrition bias) 
 Withdrawals/side effects Unclear risk The reasons for dropping out are not listed
Selective reporting (reporting bias) Unclear risk No information is provided
Other bias High risk A selective group of patients, due to the requirement of a shortened REM latency
Support from alprazolam manufacturer
Placebo washout High risk 10 to 14 days