SynthesisNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2020
Item-based analysis of the effects of duloxetine in depression: a patient-level post hoc study.
Synthesis in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Efficacy of Pharmacological Interventions in Milder Depression: A Systematic Review and Meta-Analysis.Neuropsychopharmacology reports · 2025Pooled it
- Pooled it
- A Systematic Review of Efficacy, Safety, and Tolerability of Duloxetine.Frontiers in psychiatry · 2020Pooled it
- Effects of lavender oil preparation silexan on different symptoms of major depression - results from a randomized, controlled trial.The international journal of neuropsychopharmacology · 2026Trial
- Initial severity of the Positive and Negative Syndrome Scale (PANSS)-30, its main subscales plus the PANSS-6, and the relationship to subsequent improvement and trial dropout: a pooled participant-level analysis of 18 placebo-controlled risperidone and paliperidone trials.Translational psychiatry · 2023Trial
- The effect of sertraline on networks of mood and anxiety symptoms: secondary analysis of the PANDA randomized controlled trial.Nature. Mental health · 2025Article
- Impact of sedative and appetite-increasing properties on the apparent antidepressant efficacy of mirtazapine, selective serotonin reuptake inhibitors and amitriptyline: an item-based, patient-level meta-analysis.EClinicalMedicine · 2024Article
- Automated mood disorder symptoms monitoring from multivariate time-series sensory data: getting the full picture beyond a single number.Translational psychiatry · 2024Article
- The response pattern to SSRIs as assessed by the Montgomery-Åsberg Depression Rating Scale: a patient-level meta-analysis.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2022Article
- High-content imaging of human hepatic spheroids for researching the mechanism of duloxetine-induced hepatotoxicity.Cell death & disease · 2022Article
- Article
- Impact of chosen cutoff on response rate differences between selective serotonin reuptake inhibitors and placebo.Translational psychiatry · 2022Article
- Different depression: motivational anhedonia governs antidepressant efficacy in Huntington's disease.Brain communications · 2022Article
- Lamotrigine for acute bipolar depression: An exploratory item-level analysis.Brain and behavior · 2021Article
- Do side effects of antidepressants impact efficacy estimates based on the Hamilton Depression Rating Scale? A pooled patient-level analysis.Translational psychiatry · 2021Article
- One (effect) size does not fit at all: Interpreting clinical significance and effect sizes in depression treatment trials.Journal of psychopharmacology (Oxford, England) · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Oft-cited trial-level meta-analyses casting doubt on the usefulness of antidepressants have been based on re-analyses of to what extent the active drug has outperformed placebo in reducing the sum score of the Hamilton Depression Rating Scale (HDRS-17-sum) in clinical trials. Recent studies, however, suggest patient-level analyses of individual HDRS items to be more informative when assessing the efficacy of an antidepressant. To shed further light on both symptom-reducing and symptom-aggravating effects of a serotonin and noradrenaline reuptake inhibitor, duloxetine, when used for major depression in adults, we hence applied this approach to re-analyse data from 13 placebo-controlled trials. In addition, using patient-level data from 28 placebo-controlled trials of selective serotonin reuptake inhibitors (SSRIs), the response profile of duloxetine was compared to that of these drugs. Duloxetine induced a robust reduction in depressed mood that was not dependent on baseline severity and not caused by side-effects breaking the blind. A beneficial effect on depressed mood was at hand already after one week; when outcome was assessed using HDRS-17-sum as effect parameter, this early response was however masked by a concomitant deterioration with respect to adverse event-related items. No support for a suicide-provoking effect of duloxetine was obtained. The response profile of duloxetine was strikingly similar to that of the SSRIs. We conclude that the use of HDRS-17-sum as effect parameter underestimates the true efficacy and masks an early effect of duloxetine on core symptoms of depression. No support for major differences between duloxetine and SSRIs in clinical profile were obtained.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.