Cipriani A, et al. Comparative efficacy and acceptability of 21 antidepressants¶

One-paragraph summary¶

This network meta-analysis synthesized 522 double-blind randomized trials and 116,477 adults with acute MDD. All 21 antidepressants were more efficacious than placebo for response; ORs ranged from 2.13 for amitriptyline to 1.37 for reboxetine, with differences in acceptability and head-to-head performance.

Key findings¶

Every included antidepressant separated statistically from placebo.
Efficacy and acceptability rankings were not identical.
Scale allowed direct and indirect comparison.

Limitations¶

Short acute trials and trial-population selection.
Rankings do not predict individual response; sponsorship and reporting remain concerns.

Why it matters¶

It is the largest modern synthesis underlying the claim that antidepressants work on average while leaving clinical magnitude open to debate.

Cited by wiki pages¶

Overview
Antidepressant pharmacology
The efficacy debate