Table 1.

Features of 15 Randomized Trials Comparing Either a Selective Serotonin Reuptake Inhibitor (SSRI) or Tricyclic Antidepressant (TCA) With Placebo

StudyQuality*DiagnosisTCA DoseResponsible for TreatmentCompeting InterestStudy PeriodOutcome
HAMD = Hamilton depression scale; 50%H = discrete outcomes where improvement is a greater than 50% reduction in HAMD; MADRS= Montgomery-Asberg Depression Rating Scale; 50%M = discrete outcomes where improvement is a greater than 50% reduction in the MADRS; heterogeneous = patients thought by their general practitioner to be depressed, which may or may not include patients with major depression as opposed to the studies with only patients with major depression; MDD = major depressive disorder; ModDD = moderate depressive disorder.
* Quality high if adequate sample size, concealment, description of treatment, representative sample, specified inclusion, details of withdrawals, valid outcomes.
† High dose defined as majority of TCA treated patients receiving at least equivalent of 100 mg/d amitriptyline (60 mg mianserin).
‡ Study has 3 arms (SSRI vs TCA vs placebo).
TCA vs placebo
Blashki et al26HighHeterogeneousHigh and lowGP and psychiatristNo4 wkHAMD
Brink et al27LowHeterogeneousHighGPYes6 wkHAMD
Doogan & Langdon19HighMDDHighGPYes6 wkMADRS 50%M
Feighner et al24HighHeterogeneousHighPsychiatristNo4 wkHAMD 50%H
Hollyman et al23HighHeterogeneousHighPsychiatristNo6 wkHAMD 50%H
Lecrubier et al25LowHeterogeneousHighPsychiatristYes12 wkHAMD 50%H
Malt et al17HighHeterogeneousHighGPYes24 wkMADRS 50%M
Mynors-Wallis et al21HighHeterogeneousHighGPNo12 wkMADRS
Philipp et al20LowModDDLowGPYes8 wkHAMD
Thompson & Thompson28LowHeterogeneousLowGPNo4 wkHAMD
Thomson et al22LowHeterogeneousHighGPYes12 wkHAMD
Barge-Schaapveld & Nicholson29LowMDDHighUnclearYes6 wkHAMD
SSRI vs placebo
Doogan & Langdon19*HighMDD100 mg sertralineGPYes6 wkMADRS 50%M
Lepola et al18LowMDD10 mg escitalopramUnclearYes8 wkMADRS 50%M
Malt et al17HighHeterogeneous100 mg sertralineGPYes24 wkMADRS
Montgomery et al30HighMDD10 mg escitalopram or 20 mg citalopramUnclearYes4 wkMADRS
Wade et al16HighMDD10 mg escitalopramUnclearYes8 wkMADRS