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Review: antidepressants do not reduce symptoms or failure to respond compared with placebo in minor depression

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Question: Are antidepressants and benzodiazepines effective and acceptable treatments for minor depression?

Outcomes: Depression symptoms (group mean scores or group mean change from baseline to end point on the Hamilton Rating Scale for Depression (HRSD), Montgomery-Åsberg Depression Scale (MADRS) and Clinical Global Impression (CGI) Rating Scale); failure to respond (using prespecified cut-offs on the given scales, eg, reduction <50% in HRSD or MADRS scores, not improved on the CGI); proportion of participants with major depressive disorder at the study end point (using a standardised diagnostic interview); drop-out rate.


Design: Systematic review and meta-analysis.

Data sources: MEDLINE, CINAHL, EMBASE, PsycInfo and Cochrane Controlled Trials Register. Websites of pharmaceutical companies, clinical trial registries and medical regulation agencies (eg, the US Food and Drug Administration) were used to locate additional clinical trials.

Study selection and analysis: Double-blind randomised controlled trials (RCTs) (phase III) comparing antidepressants or benzodiazepines versus placebo in adults with minor/subthreshold depression (DSM, ICD, Research Diagnostic Criteria or other standardised criteria). Studies had to exclude the …

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  • Sources of funding: Department of Mental Health and Substance Abuse – WHO.


  • Competing interests None.