Fig 1.
Study flow chart.
Fig 2.
Network of eligible comparisons on discontinuations due to adverse events.
The line width is proportional to the number of studies that compare each pair of treatments, and the size of each node is proportional to the number of comparisons the treatment is included in. Plac = placebo; oAD = other antidepressant; MAOI = monoamine oxidase inhibitor; Cmpl = complementary treatment; aPS = antipsychotic; TCA = tricyclic antidepressant; SSRI = selective serotonin reuptake inhibitor; SARI = serotonin antagonist reuptake inhibitor.
Fig 3.
Network of eligible comparisons on experiencing any adverse event.
The line width is proportional to the number of studies that compare each pair of treatments, and the size of each node is proportional to the number of comparisons the treatment is included in. Plac = placebo; oAD = other antidepressant; MAOI = monoamine oxidase inhibitor; Cmpl = complementary treatment; aPS = antipsychotic; TCA = tricyclic antidepressant; SSRI = selective serotonin reuptake inhibitor; SNRI = serotonin noradrenalin reuptake inhibitor; Benz = benzodiazepine.
Fig 4.
Network meta-analysis estimates of discontinuation rates due to adverse events for substance classes compared with placebo.
Odds ratios higher than 1 reflect a higher discontinuation rate due to adverse events in the substance class arms, whereas odds ratios lower than 1 reflect a higher discontinuation rate due to adverse events in the placebo arms; OR = odds ratio; CI = confidence interval; aPS = antipsychotics (containing amisulpride and flupenthixol); Cmpl = complementary treatments (containing acetyl-l-carnitine); MAOI = monoamine oxidase inhibitors (containing moclobemide and phenelzine); oAD = other antidepressants (containing ritanserin and minaprine); Plac = placebo, sari = serotonin antagonist and reuptake inhibitor (containing trazodone); SSRI = selective serotonin reuptake inhibitors (containing sertraline, fluoxetine, escitalopram, and paroxetine); TCA = tricyclic antidepressants (containing imipramine, amineptine, and amitriptyline); ‘contrasts that are informed by at least one direct comparison to placebo.
Table 1.
Pairwise comparison between substance classes regarding discontinuation rates due to adverse events (below the diagonal) and rates of patients experiencing at least one adverse event (above the diagonal).
Fig 5.
Network meta-analysis estimates of experiencing any adverse event for substance classes compared with placebo.
Odds ratios higher than 1 reflect a higher rate of patients experiencing at least one adverse event in the substance class arms, and odds ratios lower than 1 reflect a higher rate of patients experiencing at least one adverse event in the placebo arms; OR = odds ratio; CI = confidence interval; aPS = antipsychotics (containing amisulpride and flupenthixol); Benz = benzodiazepine (containing lorazepam); Cmpl = complementary treatments (containing acetyl-l-carnitine); MAOI = monoamine oxidase inhibitors (containing moclobemide); oAD = other antidepressants (containing ritanserin and minaprine); Plac = placebo; SNRI = serotonin noradrenalin reuptake inhibitor (containing duloxetine and reboxetine); SSRI = selective serotonin reuptake inhibitors (containing sertraline, fluoxetine, escitalopram, and paroxetine); TCA = tricyclic antidepressants (containing imipramine, amineptine, and amitriptyline); ‘contrasts that are informed by at least one direct comparison to placebo.
Fig 6.
Adverse event profiles for all investigated agents.