Initial depression severity and response to antidepressants v. placebo: patient-level data analysis from 34 randomised controlled trials

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Several often-cited meta-analysis have reported that the efficacy of antidepressant medications depends on the severity of depression. They found that drug–placebo differences increased as a function of initial severity, which was attributed to decreased responsiveness to placebo among patients with severe depression rather than to increased responsiveness to medication. We retested this using patient-level data and also undertaking a meta-analysis of trial-level data from 34 randomised placebo controlled trials (n = 10 737) from the NEWMEDS registry. Although our trial-level data support prevous findings, patient-level data do not; initial severity and outcomes were similarly related in treatment and placebo groups.

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