Summary of findings 6. Antidepressants versus any complementary medicine.

Antidepressants compared with any other intervention for postnatal depression
Patient or population: women of any age, with PND up to 12 months Settings: any Intervention: antidepressant (fluoxetine) Comparison: any complementary medicine (saffron)
Outcomes	Absolute assumed effects* (95% CI)		Relative effect (95% CI)	No of women (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with any other intervention	Risk with antidepressant
Depression response (acute phase, 5 ≤ 12 weeks)	406 per 1000	500 per 1000 (288 to 861)	RR 1.23 (0.71 to 2.12)	64 (1 RCT)	⊕⊝⊝⊝a,b,c Very low	Depression response defined as ≥ 50% decrease in HAM‐D
Depression remission (acute phase, 5 ≤ 12 weeks)	188 per 1000	219 per 1000 (83 to 579)	RR 1.17 (0.44 to 3.09)	64 (1 RCT)	⊕⊝⊝⊝a,b,c Very low	Depression remission defined as score ≤ 7 HAM‐D
Adverse events	Frequencies of adverse events were not significantly different between the 2 groups. No major adverse event and no death occurred		‐	‐	‐	‐
Depression severity	See comment		‐	‐	‐	No study reported this outcome
Treatment acceptability	See comment		‐	‐	‐	No study reported this outcome
Child‐related outcomes	See comment		‐	‐	‐	No study reported this outcome
*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; HAM‐D: Hamilton Rating Scale for Depression; PND: postnatal depression; RR: risk ratio
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

^aDowngraded one level for high risk of attrition and reporting bias.
^bDowngraded one level for imprecision as the number of participants is less than 400.
^cDowngraded one level for imprecision as the confidence interval includes no effect and appreciable harm.