OBJECTIVE Model-based meta-analysis was used to describe the time-course and dose-effect relationships of antidepressants and also simultaneously investigate the impact of various factors on drug efficacy. METHODS This study is a reanalysis of a published network meta-analysis. Only placebo-controlled trials were included in this study. The change rate in depression rating scale scores from baseline was used as an efficacy indicator because a continuous variable is more likely to reflect subtle differences in efficacy between drugs. RESULTS A total 230 studies containing 64 346 patients were included in the analysis. The results showed that the number of study sites (single or multi-center) and the type of setting (inpatient or noninpatient) are important factors affecting the efficacy of antidepressants. After deducting the placebo effect, the maximum pure drug efficacy value of inpatients was 18.4% higher than that of noninpatients, and maximum pure drug efficacy value of single-center trials was 10.2% higher than that of multi-central trials. Amitriptyline showed the highest drug efficacy. The remaining 18 antidepressants were comparable or had little difference. Within the approved dose range, no significant dose-response relationship was observed. However, the time-course relationship is obvious for all antidepressants. In terms of safety, with the exception of amitriptyline, the dropout rate due to adverse events of other drugs was not more than 10% higher than that of the placebo group. CONCLUSION The number of study sites and the type of setting are significant impact factors for the efficacy of antidepressants. Except for amitriptyline, the other 18 antidepressants have little difference in efficacy and safety.

中文翻译：

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抗抑郁药在成人急性重症抑郁症患者中的治疗时间，剂量作用及其影响因素分析。

基于模型的荟萃分析用于描述抗抑郁药的时程和剂量效应关系，同时还研究了各种因素对药物疗效的影响。方法本研究是对已发表的网络荟萃分析的重新分析。本研究仅包括安慰剂对照试验。与基线相比，抑郁评分量表分数的变化率被用作功效指标，因为连续变量更可能反映出药物之间功效的细微差别。结果分析共纳入230项研究，包括64 346例患者。结果表明，研究地点的数量（单中心或多中心）和环境类型（住院或非住院）是影响抗抑郁药疗效的重要因素。扣除安慰剂作用后，住院患者的最大纯药物疗效值比非住院患者高18.4％，单中心试验的最大纯药物功效值比多中心试验的最高10.2％。阿米替林显示出最高的药物疗效。其余18种抗抑郁药具有可比性或相差无几。在批准的剂量范围内，未观察到明显的剂量反应关系。但是，时程关系对于所有抗抑郁药都是显而易见的。在安全性方面，除阿米替林外，其他药物不良事件引起的辍学率比安慰剂组高不超过10％。结论研究地点的数量和类型是影响抗抑郁药疗效的重要因素。除了阿米替林之外，