A metaregression analysis indicated that , after adjusting for possible confounders , studies where fluoxetine was the experimental agent were positively associated with treatment effect , indicating a significant advantage for fluoxetine .
The evidence that the outcome of fluoxetine trials varied according to whether this drug was used as a new compound or a reference one suggests the presence of bias
The present study investigated whether the outcome of r and omized clinical trials study ing fluoxetine favored fluoxetine , where this was the experimental agent , and favored comparator antidepressants in trials where fluoxetine was the reference agent .
Hypericum perforatum versus fluoxetine in the treatment of mild to moderate depression
In a r and omized , controlled , double-blind trial , 70 patients ( mean age , 49.7 years ) suffering from mild to moderate depression received one tablet of either  St. John ’s Wort ( Hypericum perforatum ) extract ( Calmigen ® ) or fluoxetine hydrochloride ( Prozac ® ) twice a day for 6 weeks . Efficacy was determined according to the 17-item Hamilton Rating Scale for Depression ( HAMD ) , the von Zerssen depression scale ( DS ) , Clinical Global Impression ( CGI ) , and patients ’ overall evaluation . Significant decreases ( P<.001 ) of 50 % in theHypericum group and 58 % in the fluoxetine group in the HAMD score and of 42 % and 52 % on the DS spoke to the efficacy of both medications . TheHypericum extract achieved 83 % of the efficacy of fluoxetine on the HAMD and 78 % on the DS . Assessment s by physicians ( CGI ) and patients indicated considerable improvement with no between-treatment differences . Of the 9 dropouts ( 13 % ) , 2 in theHypericum group and 2 in the fluoxetine group were due to adverse reactions . Safety evaluations demonstrated only minor changes . TheHypericum preparation tested in this study is therapeutically equivalent to fluoxetine and is therefore a rational alternative to synthetic antidepressants
A metaregression analysis indicated that , after adjusting for possible confounders , studies where fluoxetine was the experimental agent were positively associated with treatment effect , indicating a significant advantage for fluoxetine .
The evidence that the outcome of fluoxetine trials varied according to whether this drug was used as a new compound or a reference one suggests the presence of bias
The present study investigated whether the outcome of r and omized clinical trials study ing fluoxetine favored fluoxetine , where this was the experimental agent , and favored comparator antidepressants in trials where fluoxetine was the reference agent .