Study designs of evaluations included in the review
Randomised, double-blind, placebo-controlled trials with parallel treatment cells and a follow-up of at least 4 weeks.
Specific interventions included in the review
The drugs used in 3 or more studies were: imipramine (32 trials), amitriptylinr (12 trials), fluvoxamine (7 trials), trazodone (6 trials), moclobemide (6 trials), alprazolam (4 trials), fluoxetine (3 trials), nefazadone (3 trials), paroxetine (3 trials), zimelidine 3 trials).
Participants included in the review
Patients had to be in the age range 18 to 70 years with unipolar depression. Over two-thirds of the patients were out-patients. The most frequently used criteria for establishing depression were American Psychiatric Association DSM-III, followed by DSM-III-R and Research Diagnostic Criteria, Feighner, and ICD-9. No criteria were specified in 10 of the 49 studies.
Outcomes assessed in the review
Improvement in assessment score: including the Hamilton Rating Scale for Depression (HAMD), both 17- and 21-item forms, the Montgomery-Asberg Depression Rating Scale (MADRS), and the Clinical Global Impression Scale (CGI).
How were decisions on the relevance of primary studies made?
Three independent investigators reviewed the retrieved studies using 8 inclusion criteria: human patients, unipolar depression, patients aged from 18 to 70 years, patients 'medically well', double-blind randomised controlled trials (RCTs), acute treatment, 3 parallel treatment cells (investigational drug, reference drug and placebo), and a follow-up of at least 4 weeks.