Seven RCTs were included (n=322). The authors stated that the overall study quality was good. Six studies were considered to have unclear or doubtful allocation concealment (B) and one study showed adequate concealment (A).
Antidepressants were associated with a statistically significant increase in remission rates compared to placebo: 40.50% versus 22.22% (relative risk 0.77; 95% CI: 0.65 to 0.92). No significant heterogeneity was found (Χ2 p=0.29, I2 18%). The study with the longest duration (16 weeks) reported a nonsignificant increase in remission rates in the placebo group compared to the antidepressant group (relative risk 1.05, 95% CI: 0.78 to 1.42).
There were no statistically significant differences between antidepressants and placebo for the frequency of binge-eating episodes, discontinuation for any reason or weight change.
Antidepressants were associated with a statistically significant reduction in HAM-D depression scores compared to placebo (standardised mean difference -0.38, 95% CI: -0.74 to -0.03; five studies). No significant heterogeneity was found (Χ2 p=0.29, I2 18%).