To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
It has been suggested that the efficacy of antidepressants has been
overestimated in clinical trials owing to unblinding of drug treatments
by adverse events.
To investigate the association between adverse events and the efficacy of
selective serotonin reuptake inhibitors (SSRIs).
The literature was searched to identify randomised, double-blind,
placebo-controlled trials of SSRIs in the treatment of major depression.
Efficacy outcomes were response to treatment and change in depressive
symptoms. Reporting of adverse events was used as an indicator of
tolerability. Random effects meta-analyses were used to calculate pooled
estimates. Meta-regression analyses were performed to investigate the
association between adverse events and efficacy. Potential mediation was
investigated with the Baron & Kenny approach.
A total of 68 trials (n = 17 646) were included in the
analyses. In meta-analysis SSRIs were superior to placebo in terms of
efficacy (odds ratio, OR = 1.62, 95% CI 1.51–1.72). More patients
allocated to SSRIs reported adverse events than did patients receiving
placebo (OR = 1.73, 95% CI 1.58–1.89). Meta-regression analyses did not
find an association between adverse events and efficacy
(P = 0.439). There was no indication of adverse
events mediating the effect of SSRI treatment.
Our results do not support, but also do not unequivocally disprove, the
hypothesis that adverse events lead to an overestimation of the effect of
SSRIs over placebo.
Email your librarian or administrator to recommend adding this to your organisation's collection.