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 .
What does the HAMD mean?
Little is known about the clinical relevance of the Hamilton Rating Scale for Depression ( HAMD-17 ) total scores . It is unclear how total scores translate into clinical severity , or what commonly used measures for response ( reduction from baseline of ≥ 50 % in the total score ) and remission ( total HAMD-17 score ≤ 7 ) mean from a clinical perspective . We therefore compared : ( a ) the percentage and absolute change in the HAMD-17 total scores with Clinical Global Impression-Improvement ( CGI-I ) ; ( b ) the absolute and percentage change in the HAMD-17 total scores with Clinical Global Impression-Severity ( CGI-S ) absolute change ; and ( c ) the percentage and absolute change in the HAMD-17 total scores with CGI-I in the subgroups of patients with ≤ median and > median HAMD-17 total scores at baseline . The method used was equipercentile linking of HAMD-17 and CGI ratings from 43 drug trials in patients with Major Depressive Disorder ( MDD ) ( n = 7131 ) . Our results confirm the validity of the commonly used measures for remission and response in MDD trials : a CGI-I score of 2 ( ' much improved ' ) corresponded to a reduction from baseline of > 50 % and < 60 % , and a CGI-I score of 1 ( ' very much improved ' ) to a reduction of > 75 % and < 85 % . The CGI-S score of 1 ( ' normal . , not at all ill ' ) corresponded to the HAMD-17 total score of < 5 and the CGI-S score of 2 ( ' borderline mentally ill ' ) to the score between 6 and 8 . An effect of baseline illness severity was observed
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 .