Table 66Summary evidence profile for TCAs versus placebo (efficacy data)

Overall (all studies)AmitriptylineClomipramineDosulepinImipramineNortriptyline
Mean depression scores at endpointSMD −0.48 (−0.59 to −0.37)SMD −0.61 (−0.83 to −0.4)Not reportedSMD −0.49 (−0.7 to −0.29)SMD −0.41 (−0.54 to −0.27)SMD −0.8 (−1.37 to −0.24)
QualityModerateHighModerateModerateModerate
Number of studies; participantsK = 22;
n = 2445
K = 6;
n = 348
K = 1;
n = 386
K = 13;
n = 1603
K = 2;
n = 108
Forest plot numberPharm
TCAs 01.01
Pharm
TCAs 01.01
Pharm
TCAs 01.01
Pharm
TCAs 01.01
Pharm
TCAs 01.01
Mean depression change scores at endpointSMD −0.35 (−0.53 to −0.18)SMD −0.5 (−0.67 to −0.34)Not reportedNot reportedSMD −0.21 (−0.41 to −0.01)Not reported
QualityModerateHighHigh
Number of studies; participantsK = 7;
n = 1173
K = 3;
n = 645
K = 4;
n = 528
Forest plot numberPharm
TCAs 01.03
Pharm
TCAs 01.03
Pharm
TCAs 01.03
Non-responseRR 0.70
(0.66 to 0.75)
(43 versus 62.7%)
RR 0.71
(0.65 to 0.78)
(43.5 versus 67.3%)
Not reportedRR 0.74
(0.62 to 0.88)
(48.5 versus 65.6%)
RR 0.68
(0.62 to 0.76)
(41.8 versus 63.4%)
Not reported
QualityHighHighHighModerate
Number of studies; participantsK = 34;
n = 4717
K = 13;
n = 2145
K = 1;
n = 386
K = 20;
n = 2186
Forest plot numberPharm
TCAs 01.06
Pharm
TCAs 01.06
Pharm
TCAs 01.06
Pharm
TCAs 01.06
Non-remissionRR 0.74
(0.65 to 0.84)
(63 versus 82.6%)
RR 0.66
(0.44 to 1)
(51.9 versus 83.1%)
RR 0.58
(0.34 to 1)
(45 versus 77.8%)
RR 1.18
(0.18 to 7.48)
(11.8 versus 10%)
RR 0.83
(0.75 to 0.91)
(70.4 versus 85.4%)
RR 0.68
(0.52 to 0.88)
(62.1 versus 92.3%)
QualityModerateModerateModerateModerateModerateModerate
Number of studies; participantsK = 09;
n = 954
K = 3;
n = 152
K = 1;
n = 38
K = 1;
n = 37
K = 2;
n = 596
K = 2;
n = 131
Forest plot numberPharm
TCAs 01.04
Pharm
TCAs 01.04
Pharm
TCAs 01.04
Pharm
TCAs 01.04
Pharm
TCAs 01.04
Pharm
TCAs 01.04

From: 9, INTRODUCTION TO PHARMACOLOGICAL AND PHYSICAL INTERVENTIONS

Cover of Depression
Depression: The Treatment and Management of Depression in Adults (Updated Edition).
NICE Clinical Guidelines, No. 90.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2010.
Copyright © The British Psychological Society & The Royal College of Psychiatrists, 2010.

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