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. 2020 May 11;2020(5):CD003689. doi: 10.1002/14651858.CD003689.pub4

Comparison 1. Pharmacological interventions (antidepressants) versus placebo.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Depression: meeting study criteria for depression at end treatment 9 734 Risk Ratio (M‐H, Random, 95% CI) 0.50 [0.37, 0.68]
1.1.1 CGI (high score = more severe) 1 137 Risk Ratio (M‐H, Random, 95% CI) 0.62 [0.34, 1.15]
1.1.2 Clinician interview/impression (no improvement) 1 65 Risk Ratio (M‐H, Random, 95% CI) 0.45 [0.26, 0.79]
1.1.3 Meets DSM‐III‐R criteria 3 148 Risk Ratio (M‐H, Random, 95% CI) 0.62 [0.27, 1.42]
1.1.4 Meets DSM‐IV criteria 2 181 Risk Ratio (M‐H, Random, 95% CI) 0.33 [0.15, 0.69]
1.1.5 HADS (high score = more severe) 1 111 Risk Ratio (M‐H, Random, 95% CI) 0.74 [0.32, 1.70]
1.1.6 HDRS (high score = more depressed) 1 92 Risk Ratio (M‐H, Random, 95% CI) 0.14 [0.02, 1.12]
1.2 Scoring above cut‐off points for a depressive disorder at end of treatment 0   Risk Ratio (M‐H, Random, 95% CI) Totals not selected
1.3 Depression: average change in scores between baseline and end of treatment 5 211 Std. Mean Difference (IV, Random, 95% CI) ‐0.05 [‐0.33, 0.23]
1.3.1 HDRS (high score = more depressed) 4 100 Std. Mean Difference (IV, Random, 95% CI) ‐0.16 [‐0.58, 0.26]
1.3.2 HADS (high score = more depressed) 1 111 Std. Mean Difference (IV, Random, 95% CI) 0.04 [‐0.34, 0.41]
1.4 Depression: mean scores at end of treatment 4 100 Mean Difference (IV, Random, 95% CI) 0.59 [‐1.46, 2.63]
1.4.1 HDRS (high score = more depressed) 4 100 Mean Difference (IV, Random, 95% CI) 0.59 [‐1.46, 2.63]
1.5 Cognition: average change in scores between baseline and end of treatment 3 159 Mean Difference (IV, Random, 95% CI) 0.11 [‐1.02, 1.24]
1.5.1 MMSE (low score = cognitive impairment) 3 159 Mean Difference (IV, Random, 95% CI) 0.11 [‐1.02, 1.24]
1.6 Cognition: Mean scores at end of treatment 2 48 Mean Difference (IV, Random, 95% CI) ‐0.42 [‐2.60, 1.76]
1.6.1 MMSE (low score = cognitive impairment) 2 48 Mean Difference (IV, Random, 95% CI) ‐0.42 [‐2.60, 1.76]
1.7 Activities of daily living: average change in scores between baseline and end of treatment 3 57 Mean Difference (IV, Random, 95% CI) 1.18 [‐7.77, 10.14]
1.7.1 Barthel Index (high score = more dependent) 3 57 Mean Difference (IV, Random, 95% CI) 1.18 [‐7.77, 10.14]
1.8 Activities of daily living: mean scores at end of treatment 3 116 Mean Difference (IV, Random, 95% CI) ‐3.86 [‐9.48, 1.77]
1.8.1 Barthel Index (high score = more dependent) 2 52 Mean Difference (IV, Random, 95% CI) 0.75 [‐12.97, 14.47]
1.8.2 Activities of daily living Index (high score = more dependent) 1 64 Mean Difference (IV, Random, 95% CI) ‐5.18 [‐7.38, ‐2.98]
1.9 Disability: average change in scores between baseline and end of treatment 4   Mean Difference (IV, Random, 95% CI) Totals not selected
1.9.1 Hemispheric Stroke Scale Total Score (high score = more neurological deficit) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.9.2 Hemispheric Stroke Scale Motor Subscale (high score = more deficit) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.9.3 Hemispheric Stroke Scale Gait Subscale (high score = more deficit) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.9.4 Johns Hopkins Functioning Inventory (high score = less function) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.10 Disability: mean scores at end of treatment 4   Mean Difference (IV, Random, 95% CI) Totals not selected
1.10.1 Hemispheric Stroke Scale total score (high score = more neurological deficit) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.10.2 Hemispheric Stroke Scale motor subscale (high score = more deficit) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.10.3 Hemispheric Stroke Scale gait subscale (high score = more deficit) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.10.4 Johns Hopkins Functioning Inventory (high score = less function) 2   Mean Difference (IV, Random, 95% CI) Totals not selected
1.11 Disability: moderate to severe disability at end of treatment 1 111 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
1.11.1 Modified Rankin Scale 1 111 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
1.12 Adverse events: death 9 496 Risk Ratio (M‐H, Random, 95% CI) 1.25 [0.32, 4.91]
1.12.1 At end of treatment 9 496 Risk Ratio (M‐H, Random, 95% CI) 1.25 [0.32, 4.91]
1.13 Adverse events: all 9   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
1.13.1 Central nervous system events (e.g. confusion, sedation, tremor) 4 214 Risk Ratio (M‐H, Random, 95% CI) 1.26 [0.51, 3.15]
1.13.2 Gastrointestinal effects (e.g. constipation, diarrhoea) 6 383 Risk Ratio (M‐H, Random, 95% CI) 1.21 [0.67, 2.19]
1.13.3 Recurrent stroke 2 114 Risk Ratio (M‐H, Random, 95% CI) 1.49 [0.25, 8.80]
1.13.4 Vascular events ‐ not stroke (e.g. dizziness, palpitation) 3 282 Risk Ratio (M‐H, Random, 95% CI) 1.13 [0.84, 1.50]
1.13.5 Psychiatric events (e.g. anxiety, increased depression) 1 100 Risk Ratio (M‐H, Random, 95% CI) 4.81 [0.24, 97.68]
1.13.6 Other events ‐ not listed above (e.g. dysuria, eye discomfort) 3 190 Risk Ratio (M‐H, Random, 95% CI) 1.12 [0.44, 2.85]
1.13.7 Protocol violation (e.g. refused treatment, withdrew consent) 5 309 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.62, 1.27]
1.14 Adverse events: leaving the study early (including death) 12 836 Risk Ratio (M‐H, Random, 95% CI) 1.03 [0.84, 1.26]
1.14.1 All dropouts and withdrawals 12 836 Risk Ratio (M‐H, Random, 95% CI) 1.03 [0.84, 1.26]