Summary of findings 4. Antidepressant compared to antipsychotic for psychotic depression.
| Antidepressant compared to antipsychotic for psychotic depression | ||||||
| Patient or population: adults with psychotic depression Setting: hospital Intervention: antidepressant Comparison: antipsychotic | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | №. of participants (studies) | Certainty of evidence (GRADE) | Comments | |
| Risk with antipsychotic | Risk with antidepressant | |||||
| Clinical response of depression | Study population | RR 2.09 (0.64 to 6.82) | 36 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b,c | Study defined depression response as HRSD‐17 < 7 | |
| 176 per 1000 | 369 per 1000 (113 to 1000) | |||||
| Overall dropouts | Study population | RR 1.79 (0.18 to 18.02) | 36 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b,c | ||
| 59 per 1000 | 105 per 1000 (11 to 1000) | |||||
| Depression remission | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| Change in depression severity from baseline | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| Quality of life | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| Dropouts due to adverse effects | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| *The risk in the intervention group (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; RCT: randomised controlled trial; 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 imprecision due to small sample size.
bDowngraded one level for imprecision as CIs are consistent with appreciable benefit and appreciable harm.
cDowngraded one level for risk of publication bias.