Results of Conventional and Network Meta-Analyses for the Main Acceptability Outcome Study Discontinuation Because of Adverse Effects
| Medication | TCA | SSRI | SNRI | NRI | Low-Dose SARI | NaSSA | rMAO-A | Hypericum | Placebo |
|---|---|---|---|---|---|---|---|---|---|
| TCA | |||||||||
| OR (95% CI)a | 1.15 (0.85–1.55) | 0.86 (0.46–1.62) | na | 1.18 (0.46–3.01) | 0.51 (0.18–1.42) | 2.57 (1.18–5.60) | 2.33 (.92–5.93) | 2.30(1.10–4.81) | |
| No. of studies; I2, %; P value1 | 14; 43; .05 | 2; 0; .80 | na | 2; 54; .14 | 1 | 5; 47; .11 | 2; 0; .89 | 7; 24; .25 | |
| OR (95% CI)c | 1.12 (0.84–1.47) | 0.89 (0.55–1.37) | 0.44 (0.18–1.06) | 1.86 (0.92–3.75) | 0.64 (0.36–1.14) | 2.63 (1.49–5.09) | 2.37 (1.28–4.49) | 2.47 (1.59–3.84) | |
| SSRI | |||||||||
| OR (95% CI)a | 0.87 (0.64–1.17) | 0.81 (0.58–1.13) | 0.39 (0.28–0.55) | na | 0.78 (0.42–1.44) | na | 1.48 (0.77–2.85) | 1.86 (1.16–2.98) | |
| No. of studies; I2, %; P value1 | 14; 43; .05 | 4; 38; .18 | 1 | na | 3; 31; .23 | na | 6; 0; .92 | 8; 0; .64 | |
| OR (95% CI)c | 0.89 (0.68–1.19) | 0.79 (0.55–1.19) | 0.39 (0.16–0.90) | 1.65 (0.85–3.45) | 0.57 (0.33–0.96) | 2.34 (1.24–4.84) | 2.11 (1.18–4.14) | 2.20(1.44–3.36) | |
| SNRI | |||||||||
| OR (95% CI)a | 1.16 (0.62–2.20) | 1.24 (0.89–1.74) | na | na | na | na | na | 2.96 (0.90–9.73) | |
| No. of studies; I2, %; P value1 | 2; 0; .80 | 4; 38; .18 | na | na | na | na | na | 1 | |
| OR (95% CI)c | 1.12 (0.73–1.81) | 1.26 (0.84–1.83) | 0.50 (0.19–1.23) | 2.08 (0.95–4.85) | 0.72 (0.36–1.37) | 2.95 (1.41–6.69) | 2.66 (1.33–5.57) | 2.77 (1.58–4.87) | |
| NRI | |||||||||
| OR (95% CI)a | 2.53 (1.81–3.53) | na | na | na | na | na | na | ||
| No. of studies; I2, %; P value1 | 1 | na | na | na | na | na | na | ||
| OR (95% CI)c | 2.25 (0.95–5.48) | 2.54 (1.11–6.37) | 2.01 (0.82–5.20) | 4.19 (1.59–12.48) | 1.45 (0.58–3.74) | 5.94 (2.09–17.13) | 5.35 (1.99–14.94) | 5.58 (2.28–13.66) | |
| SARI | |||||||||
| OR (95% CI)a | 0.84 (0.33–2.15) | na | na | na | 0.28 (0.10–0.79) | na | na | na | |
| No. of studies; I2, %; P value1 | 2; 54; .14 | na | na | na | 3; 58; 0.09 | na | na | na | |
| OR (95% CI)c | 0.54 (0.26–1.08) | 0.61 (0.29–1.17) | 0.48 (0.21–1.05) | 0.24 (0.08–0.63) | 0.35 (0.16–0.64) | 1.42 (0.58–3.55) | 0.78 (0.31–1.83) | 1.33 (0.61–2.89) | |
| NaSSA | |||||||||
| OR (95% CI)a | 1.97 (0.71–5.51) | 1.28 (0.69–2.36) | na | na | 3.55 (1.27–9.90) | na | na | 3.52 (1.40–8.84) | |
| No. of studies; I2, %; P value1 | 1 | 3; 31; .23 | na | na | 3; 58; .09 | na | na | 2; 0; .90 | |
| OR (95% CI)c | 1.56 (0.88–2.76) | 1.75 (1.04–3.02) | 1.39(0.73, 2.76) | 0.69 (0.27–1.71) | 2.89 (1.56–6.18) | 4.10(1.81–10.38) | 3.69 (1.71–8.56) | 3.85 (2.05–7.25) | |
| rMAO-A | |||||||||
| OR (95% CI)a | 0.39 (0.18–0.85) | na | na | na | na | na | na | na | |
| No. of studies; I2, %; P value1 | 5; 47; .11 | na | na | na | na | na | na | na | |
| OR (95% CI)c | 0.38 (0.20–0.67) | 0.43 (0.21–0.81) | 0.34 (0.15–0.71) | 0.17 (0.06–0.48) | 0.71 (0.28–1.73) | 0.24 (0.10–0.55) | 0.90 (0.35–2.04) | 0.94 (0.43–2.05) | |
| Hypericum | |||||||||
| OR (95% CI)a | 0.43 (0.17–1.09) | 0.68 (0.35–1.30) | na | na | na | na | na | 0.79 (0.31–1.97) | |
| No. of studies; I2, %; P value1 | 2; 0; 0.89 | 6; 0; .92 | na | na | na | na | na | 5; 0; .48 | |
| OR (95% CI)c | 0.42 (0.22–0.78) | 0.47 (0.24–0.85) | 0.38 (0.18–0.75) | 0.19 (0.07–0.50) | 0.78 (0.31–1.83) | 0.27 (0.11–0.58) | 1.11 (0.49–2.83) | 1.04 (0.53–2.06) |
CI = confidence interval; CI = credible interval; hypericum = extract from Hypericum perforatum L.; rMAO-A = reversible inhibitor of monoaminoxidase A (moclobemide, minaprine); na = not available; NaSSA = noradrenergic and specific serotonergic antidepressive agent (mianserin, mirtazapine); NRI = noradrenaline reuptake inhibitor (reboxetine); OR = odds ratio; SARI = serotonin (5-HT2) antagonist and reuptake inhibitor (trazodone); SNRI = serotonin-noradrenaline reuptake inhibitor (venlafaxine); SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic and tetracyclic antidepressant.
Note: Odds ratios >1 indicate more study discontinuation in patients receiving the treatment given in the row heading.
↵a Conventional meta-analysis of within-study comparisons with pooled odds ratios.
b Studies with direct comparisons available, with I2 value and P value from the χ2 test for heterogeneity.
↵c From network meta-analysis.