SSRIs significantly increase the risk of both serious and non-serious adverse events .
The potential small beneficial effects seem to be outweighed by harmful effects .
Background The evidence on selective serotonin reuptake inhibitors ( SSRIs ) for major depressive disorder is unclear .
Methods Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo , ‘ active ’ placebo , or no intervention in adult participants with major depressive disorder .
Pretreatment neurophysiological and clinical characteristics of placebo responders in treatment trials for major depression
Rationale High placebo response rates are a confound in treatment trials for major depressive disorder ( MDD ) . A method for prospect i ve identification of placebo responders could enhance the efficiency of clinical trials . Objective The objective was to identify the neurophysiological , symptomatic , and cognitive characteristics of subjects who were likely to respond to placebo in clinical trials for MDD . Methods Fifty-one subjects with MDD were treated in clinical trials with either fluoxetine ( n=24 ) or venlafaxine ( n=27 ) versus placebo . All subjects underwent pretreatment assessment with  quantitative electroencephalographic  ( QEEG ) power and cordance , as well as symptom ratings and  neuropsychological testing . After a 1-week single-blind placebo lead-in , subjects were r and omized to double-blind placebo controlled treatment with a medication or placebo . At the end of 8 weeks , the blind was broken and treatment response assessed . Response was defined by a final Hamilton Depression Rating Scale score of ≤10 . Results Of the medication-treated and placebo-treated subjects , 52 % ( 13/25 ) and 38 % ( 10/26 ) responded . Placebo responders had lower pretreatment fronto central cordance in the theta frequency b and than all other subjects ( P<0.006 ) and medication responders in particular ( P<0.004 ) . Placebo responders also had faster cognitive processing time , as assessed by neuropsychological testing , and lower reporting of late insomnia ( P<0.03 ) . Exploratory examination of a multiple variable model for predicting placebo response was conducted using logistic regression , in which these three pretreatment measures accurately identified 97.6 % of eventual placebo responders . Conclusions These findings suggest that combined clinical , neurophysiological , and cognitive assessment s of prospect i ve subjects for clinical trials may be useful for identifying MDD subjects who are likely to show robust response  to  placebo . Prospect i ve validation of these results in a larger , independent sample of subjects is necessary to establish the reliability and usefulness of this method for prospect i ve identification of placebo responders
SSRIs significantly increase the risk of both serious and non-serious adverse events .
The potential small beneficial effects seem to be outweighed by harmful effects .
Background The evidence on selective serotonin reuptake inhibitors ( SSRIs ) for major depressive disorder is unclear .
Methods Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo , ‘ active ’ placebo , or no intervention in adult participants with major depressive disorder .