This study aims to summarise the evidence on more than 140 pharmacological and non-pharmacological treatment options for major depressive disorder (MDD) and to evaluate the confidence that patients and clinicians can have in the underlying science about their effects.This is a review of systematic reviews.This study used MEDLINE, Embase, Cochrane Library, PsycINFO and Epistemonikos from 2011 up to February 2017 for systematic reviews of randomised controlled trials in adult patients with acute-phase MDD.We dually reviewed abstracts and full-text articles, rated the risk of bias of eligible systematic reviews and graded the strength of evidence.Nineteen systematic reviews provided data on 28 comparisons of interest. For general efficacy, only second-generation antidepressants were supported with high strength evidence, presenting small beneficial treatment effects (standardised mean difference: -0.35; 95

作者：Gerald, Gartlehner；Gernot, Wagner；Nina, Matyas；Viktoria, Titscher；Judith, Greimel；Linda, Lux；Bradley N, Gaynes；Meera, Viswanathan；Sheila, Patel；Kathleen N, Lohr

来源：BMJ open 2017 年 7卷 6期