Review author and year | No of primary studies | Review design | Efficacy and dose* | Dropouts and adverse drug effects* | Dose standardisation | Study duration (range) | Risk of bias in review |
Braun 202060 | 33 | SR MA, network MA | ↔︎ SSRI grouped ↔︎ citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline | ↑ SSRI grouped | Low, medium, high | 6 (2-12) weeks | Low |
Cheng 202061 | 115 | Model based MA | ↔ citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline | NA | Fluoxetine dose equivalents | 4-12 weeks | Low |
Dold 201762 | 5 | SR MA, MR | ↔ fluoxetine, paroxetine, sertraline | ↑ fluoxetine | Fluoxetine 20 mg/day, paroxetine 20 mg/day, and sertraline 50 mg/day v higher doses | 5 (3-8) weeks | Low |
Furukawa 201923 | 66 | SR MA | ↑ SSRI grouped (to 40 mg/day) ↑ citalopram (to 30 mg/day); ↔ escitalopram, fluoxetine, paroxetine; ∩ sertraline | ↑ | Fluoxetine dose equivalents | 8 (4-12) weeks | Low |
Furukawa 202063 | 108 | SR MA | ↔ SSRI grouped ↔ citalopram, escitalopram, fluoxetine, paroxetine, sertraline | ↑ flexible dose | Fluoxetine dose equivalents | 7 (4-12) weeks | Low |
Benkert 199664 | 7 (+7 reviews) | Narrative review | ↔ citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline | NA | Actual doses from other reviews | Not defined | Unclear |
Dunner 199256 | Pooled (n=460) | Pooled SKB data | ↔ paroxetine | NA | Paroxetine dose | Acute phase ≤6 weeks; long term phase 52 weeks | Unclear |
Gutsmiedl 202065 | 44 | SR MA, MR | ↔ SSRIs and non-SSRIs grouped | NA | Fluoxetine dose equivalents | 9 (4-26) weeks | Unclear |
Hamza 202181 | 60 | MA | SSRI grouped (↑ to 40 mg/day), ↑ citalopram (to 30 mg/day), paroxetine (to 40mg/day), sertraline (to 75 mg/day), ↔ escitalopram, fluoxetine | NA | Fluoxetine dose equivalents: individual drug effects reported as fluoxetine dose equivalents and not actual drug doses | 8 (4-12) weeks | Unclear |
Khan 200366 | 36 | FDA submissions, MA | ↔ SSRIs and non-SSRIs grouped | ↑ | SSRI study doses used | 6-8 weeks | Unclear |
Klemp 201167 | 26 | SR, MR | ↔ paroxetine | NA | Paroxetine dose | 8 (6-56) weeks | Unclear |
Montgomery 199557 | 1 | Narrative review | ↔ sertraline | ↑ | Sertraline dose | Acute phase 6-8 weeks; long term phase 44 weeks | Unclear |
Murdoch 200588 | Pooled (n=1307) | Pooled Lundbeck Forrest data | NA | ↑ escitalopram | Escitalopram dose | Not defined | Unclear |
Preskorn 199568 | 3 | Narrative review | ↔ sertraline | ↑ | Sertraline dose | ≤8 weeks | Unclear |
Purgato 201569 | 173 | SR, MR | ↔ fluoxetine | NA | Mean doses poorly reported. Minimum and maximum doses (mg), expressed as multiples of defined daily doses. Prescribed study doses were then divided by define daily doses and grouped as ≤20 or 20-80 mg/day | Majority ≤6 weeks | Unclear |
Safer 201620 | 33 | Narrative review | ↔ SSRIs and non-SSRIs grouped ↔ citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline | ↑ | SSRI dose | 8-28 weeks | Unclear |
Tan 199958 | 2 (+1 reviews) | Narrative review | ? citalopram | ↑ | Citalopram dose | 6 (3-24) weeks | Unclear |
Vaswani 200370 | 3 (+5 reviews) | Narrative review | ↑ citalopram (to 40 mg/day) ↔ fluoxetine, fluvoxamine, paroxetine, sertraline | ↑ | Not defined | Not defined | Unclear |
Adli 200513 | 12 | SR, narrative review | ↑ fluvoxamine ↔ citalopram, fluoxetine, paroxetine, sertraline | ↑ | SSRI dose | 4-8 weeks | High |
Altamura 198871 | 2 | Narrative review | ↔ fluoxetine | ↑ | Fluoxetine dose | 6 weeks | High |
Baker 200322 | 4 | SR MA | ? fluoxetine, paroxetine, sertraline | ↑ | Low, medium, high. No clear definition | ≤8 weeks | High |
Barbui 200282 | 103 | SR MA | ↑ fluoxetine | ↑ | 20-30, >30 mg/day; dose range 20-40 and >40 mg/day | ≤9 weeks | High |
Beasley 199072 | Pooled (n=669) | Pooled | ↔ fluoxetine | ↑ | Fluoxetine dose | ≤8 weeks | High |
Beasley 199389 | 3 | Narrative review | NA | Fluoxetine: ↑ anxiety, agitation, insomnia, drowsiness, asthenia | Not defined | 6 weeks | High |
Berney 200573 | 14 (+4 reviews) | Narrative review | ↔ citalopram, escitalopram, fluoxetine, paroxetine, sertraline ? fluvoxamine | ↑ fluoxetine, sertraline | SSRI dose | 6-8 weeks | High |
Bollini 199921 | 33 | SR MA | ∩ SSRIs and non-SSRIs grouped | ↑ | Imipramine dose equivalents | 6 (4-24) weeks | High |
Caley 200286 | 5 (+7 reviews) | Narrative review | ↑ citalopram; ∩ fluvoxamine; ↔ fluoxetine, sertraline; ? paroxetine | ↑ | SSRI dose | 4-6 weeks | High |
Corruble 200074 | 10 (+6 reviews) | SR, narrative review | ↔ SSRI grouped | NA | SSRI dose | 4-8 weeks | High |
Hansen 200983 | 74 | SR MA, MR | ↑ SSRIs and non-SSRIs grouped | NA | Licensed dose range (eg, fluoxetine: low <45 mg/day, high >45 mg/day) | 7 (6-24) weeks | High |
Hieronymus 201618 | 11 | MA, industry data | ↑ citalopram, paroxetine, sertraline | NA | Patient level doses | ≤6 weeks | High |
Holper 202087 | 153 | Network MA | ↑ escitalopram, fluoxetine ↔ citalopram, paroxetine | ↑ (age ≤70 years); ↑↑ (age >70 years) | Fluoxetine dose equivalents | 4-12 weeks | High |
Jakubovski 201619 | 40 | SR MA | ↑ SSRIs grouped | ↑ | Imipramine dose equivalents | 6 (4-24) weeks | High |
Jenner 199275 | Pooled (n=4668) | Pooled SKB data | ↔ paroxetine | ↑ | Paroxetine dose | 6 weeks (≤2 year) | High |
Lam 200676 | 3 | MA of Lundbeck data | ↔ escitalopram | NA | Escitalopram dose | 8 weeks | High |
Lane 199577 | 4 (+2 reviews) | Narrative review | ↔ citalopram, fluoxetine, paroxetine, sertraline | ↑ | Not defined | Not defined | High |
Montgomery 199478 | 9 | MA | ↔ citalopram | NA | Citalopram dose | 4-6 weeks | High |
Montgomery 199559 | 2 (+2 reviews) | Narrative review | ↔ citalopram | NA | Citalopram dose | ≤24 weeks | High |
Oliva90 | Not defined | SR MA | NA | ↑ nausea and vomiting, citalopram, escitalopram | Low v high dose | 6-12 weeks | High |
Papakostas 201084 | 9 | SR MA | ↑ SSRIs grouped | ↑ | Usual (10 mg/day: escitalopram, citalopram; 20 mg/day: fluoxetine, paroxetine, sertraline; 50 mg/day: fluvoxamine), intermediate, double usual dose, and higher | 6 weeks | High |
Parker 200085 | 1 (+1 review) | Narrative review | ↑ citalopram | ↑ | Citalopram dose | 4-6 weeks | High |
Rifkin 199779 | 4 | Narrative review | ↔︎ fluoxetine, paroxetine, sertraline | NA | SSRI dose | Not defined | High |
Ruhe 200680 | 8 | SR, narrative review | ↔︎ fluoxetine, paroxetine, sertraline | ↑ | SSRI dose | 8 (3-12) weeks | High |
Reviews in this table are ranked by assessed risk of bias (last column), and then alphabetically by author (first column). SSRI=selective serotonin reuptake inhibitor; SR=systematic review; MA=meta-analysis; MR=meta-regression; SKB=SmithKline Beecham; FDA=federal drug agency; NA=not assessed; acute=acute phase of depression treatment; long term=long term phase of depression treatment.
*Drug response effects are indicated as ↑ (increased), ↑↑ (marked increase), ↔ (flat), ∩ (curvy linear), or ? (unclear).