Table 16, Summary of included studies for primary care versus secondary care subgroup analysis for comparison 1e Serotonin–norepinephrine reuptake inhibitors (SNRIs) versus SSRIs - Service delivery Models and settings for delivery of services

Table 16Summary of included studies for primary care versus secondary care subgroup analysis for comparison 1e Serotonin–norepinephrine reuptake inhibitors (SNRIs) versus SSRIs

Study	Population	Intervention	Comparison	Comments
Primary care (K=2, N=634)
Montgomery 2004 RCT Denmark, Finland, France, Germany, Ireland, Spain, & Switzerland	Primary care N=293 Baseline severity: More severe Mean age (years): 48 Sex (% female): 71 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Escitalopram 10-20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Tylee 1997 RCT UK	Primary care N=341 Baseline severity: More severe Mean age (years): 44.5 Sex (% female): 71 Ethnicity (% BME): NR	Venlafaxine 75mg/day	Fluoxetine 20mg/day	Treatment duration (weeks): 12 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Secondary care (K=29, N=5,484)
Allard 2004 RCT Sweden & Denmark	Secondary care N=151 Baseline severity: More severe Mean age (years): 73 Sex (% female): 80 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Citalopram 10-20mg/day	Treatment duration (weeks): 22 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Alves 1999 RCT Portugal	Secondary care N=87 Baseline severity: More severe Mean age (years): 43.7 Sex (% female): 92 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Fluoxetine 20-40mg/day	Treatment duration (weeks): 12 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Bielski 2004 RCT US	Secondary care N=202 Baseline severity: More severe Mean age (years): 37.4 Sex (% female): 58 Ethnicity (% BME): 25	Venlafaxine 225mg/day	Escitalopram 20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Clerc 1994 RCT France & Belgium	Secondary care N=68 Baseline severity: More severe Mean age (years): 51.3 Sex (% female): 68 Ethnicity (% BME): NR	Venlafaxine 200mg/day	Fluoxetine 40mg/day	Treatment duration (weeks): 6 Outcomes (for primary versus secondary care subgroup analysis): Response
Costa 1998 RCT Argentina, Brazil, Chile, Colombia, Uruguay, & Venezuela	Secondary care N=382 Baseline severity: More severe Mean age (years): 40.2 Sex (% female): 79 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Fluoxetine 20-40mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
DeNayer 2002 RCT Belgium	Secondary care N=146 Baseline severity: More severe Mean age (years): 42.8 Sex (% female): 68 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Fluoxetine 20-40mg/day	Treatment duration (weeks): 12 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Detke 2004^a RCT US	Secondary care N=274 Baseline severity: More severe Mean age (years): 43.3 Sex (% female): 72 Ethnicity (% BME): 0	Duloxetine 80mg/day or 120mg/day	Paroxetine 20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Diaz-Martinez 1998 RCT Mexico	Secondary care N=145 Baseline severity: More severe Mean age (years): NR Sex (% female): 72 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Fluoxetine 20-40mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Response
Dierick 1996 RCT Belgium, Italy, Switzerland & France	Secondary care N=314 Baseline severity: More severe Mean age (years): 43.4 Sex (% female): 65 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Fluoxetine 20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Response
Eli Lilly HMAT-Aa RCT US	Secondary care N=173 Baseline severity: More severe Mean age (years): NR Sex (% female): NR Ethnicity (% BME): NR	Duloxetine 80mg/day	Paroxetine 20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Goldstein 2002^a RCT US	Secondary care N=103 Baseline severity: More severe Mean age (years): 41.5 Sex (% female): 61 Ethnicity (% BME): 17	Duloxetine 40-120mg/day	Fluoxetine 20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Goldstein 2004^a RCT US	Secondary care N=178 Baseline severity: More severe Mean age (years): 40.5 Sex (% female): 63 Ethnicity (% BME): 21	Duloxetine 80mg/day	Paroxetine 20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Hao 2014 RCT China	Secondary care N=281 Baseline severity: More severe Mean age (years): 38.5 Sex (% female): 59 Ethnicity (% BME): NR	Duloxetine 60mg/day	Paroxetine 20mg/day	Treatment duration (weeks): 6 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Higuchi 2009^a RCT Japan	Secondary care N=223 Baseline severity: More severe Mean age (years): 38.3 Sex (% female): NR Ethnicity (% BME): NR	Duloxetine 60mg/day	Paroxetine 20-40mg/day	Treatment duration (weeks): 6 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Hwang 2004 RCT Taiwan	Secondary care N=105 Baseline severity: More severe Mean age (years): 65.1 Sex (% female): 58 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Paroxetine 20-40mg/day	Treatment duration (weeks): 4 Outcomes (for primary versus secondary care subgroup analysis): Response
Jiang 2017 RCT China	Secondary care N=26 Baseline severity: More severe Mean age (years): 45.5 Sex (% female): 73 Ethnicity (% BME): NR	Duloxetine (mean final dose 60mg/day)	Escitalopram (mean final dose 13.13mg/day)	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Response
Khan 2007 RCT US	Secondary care N=278 Baseline severity: More severe Mean age (years): 42.4 Sex (% female): 61 Ethnicity (% BME): 20	Duloxetine 60mg/day	Escitalopram 10-20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Kornaat 2000 RCT Country NR	Secondary care N=156 Baseline severity: More severe Mean age (years): NR Sex (% female): 64 Ethnicity (% BME): NR	Venlafaxine 75-225mg/day	Fluoxetine 20-40mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Mehtonen 2000 RCT Finland	Secondary care N=147 Baseline severity: More severe Mean age (years): 42.6 Sex (% female): 66 Ethnicity (% BME): NR	Venlafaxine 75-150mg/day	Sertraline 50-100mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Nemeroff 2007^a RCT US	Secondary care N=206 Baseline severity: More severe Mean age (years): 39 Sex (% female): 65 Ethnicity (% BME): 11	Venlafaxine 75-225mg/day	Fluoxetine 20-60mg/day	Treatment duration (weeks): 6 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Nierenberg 2007^a RCT US	Secondary care N=547 Baseline severity: More severe Mean age (years): 42.2 Sex (% female): 66 Ethnicity (% BME): 24	Duloxetine 60mg/day	Escitalopram 10mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Perahia 2006^a RCT Bulgaria, Croatia, Hungary, Poland, Romania, Russia, & Slovakia	Secondary care N=293 Baseline severity: More severe Mean age (years): 45.4 Sex (% female): 71 Ethnicity (% BME): 0	Duloxetine 80mg/day or 120mg/day	Paroxetine 20mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Rickels 2000 RCT Country NR	Secondary care N=51 Baseline severity: More severe Mean age (years): 37.4 Sex (% female): 75 Ethnicity (% BME): NR	Venlafaxine 150-225mg/day	Fluoxetine 20-40mg/day	Treatment duration (weeks): 6 Outcomes (for primary versus secondary care subgroup analysis): Remission
Rudolph 1999^a RCT US	Secondary care N=203 Baseline severity: More severe Mean age (years): 40 Sex (% female): 72 Ethnicity (% BME): NR	Venlafaxine 75-225mg/day	Fluoxetine 20-60mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Sheehan 2009b^a RCT US	Secondary care N=194 Baseline severity: More severe Mean age (years): 39.7 Sex (% female): 59 Ethnicity (% BME): NR	Venlafaxine 225-375mg/day	Fluoxetine 60-80mg/day	Treatment duration (weeks): 6 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Shelton 2006 RCT US	Secondary care N=160 Baseline severity: More severe Mean age (years): 39.3 Sex (% female): 53 Ethnicity (% BME): 17	Venlafaxine 75-225mg/day	Sertraline 50-150mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Sir 2005 RCT Australia & Turkey	Secondary care N=163 Baseline severity: More severe Mean age (years): 37 Sex (% female): 69 Ethnicity (% BME): 2	Venlafaxine 75-225mg/day	Sertraline 50-150mg/day	Treatment duration (weeks): 8 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Study F1J-MCHMAQ- Study Group Ba RCT US	Secondary care N=119 Baseline severity: More severe Mean age (years): 39.8 Sex (% female): NR Ethnicity (% BME): NR	Duloxetine 40-120mg/day	Fluoxetine 20mg/day	Treatment duration (weeks): 10 Outcomes (for primary versus secondary care subgroup analysis): Remission Response
Tzanakaki 2000 RCT Greece & Italy	Secondary care N=109 Baseline severity: More severe Mean age (years): 48 Sex (% female): 79 Ethnicity (% BME): NR	Venlafaxine 225mg/day	Fluoxetine 60mg/day	Treatment duration (weeks): 6 Outcomes (for primary versus secondary care subgroup analysis): Remission Response

Study

Population

Intervention

Comparison

Comments

Primary care (K=2, N=634)

Montgomery 2004

RCT

Denmark, Finland, France, Germany, Ireland, Spain, & Switzerland

Primary care

N=293

Baseline severity: More severe

Mean age (years): 48

Sex (% female): 71

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Escitalopram 10-20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Tylee 1997

RCT

Primary care

N=341

Baseline severity: More severe

Mean age (years): 44.5

Sex (% female): 71

Ethnicity (% BME): NR

Venlafaxine 75mg/day

Fluoxetine 20mg/day

Treatment duration (weeks): 12

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Secondary care (K=29, N=5,484)

Allard 2004

RCT

Sweden & Denmark

Secondary care

N=151

Baseline severity: More severe

Mean age (years): 73

Sex (% female): 80

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Citalopram 10-20mg/day

Treatment duration (weeks): 22

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Alves 1999

RCT

Portugal

Secondary care

N=87

Baseline severity: More severe

Mean age (years): 43.7

Sex (% female): 92

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Fluoxetine 20-40mg/day

Treatment duration (weeks): 12

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Bielski 2004

RCT

Secondary care

N=202

Baseline severity: More severe

Mean age (years): 37.4

Sex (% female): 58

Ethnicity (% BME): 25

Venlafaxine 225mg/day

Escitalopram 20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Clerc 1994

RCT

France & Belgium

Secondary care

N=68

Baseline severity: More severe

Mean age (years): 51.3

Sex (% female): 68

Ethnicity (% BME): NR

Venlafaxine 200mg/day

Fluoxetine 40mg/day

Treatment duration (weeks): 6

Outcomes (for primary versus secondary care subgroup analysis):

Response

Costa 1998

RCT

Argentina, Brazil, Chile, Colombia, Uruguay, & Venezuela

Secondary care

N=382

Baseline severity: More severe

Mean age (years): 40.2

Sex (% female): 79

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Fluoxetine 20-40mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

DeNayer 2002

RCT

Belgium

Secondary care

N=146

Baseline severity: More severe

Mean age (years): 42.8

Sex (% female): 68

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Fluoxetine 20-40mg/day

Treatment duration (weeks): 12

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Detke 2004^a

RCT

Secondary care

N=274

Baseline severity: More severe

Mean age (years): 43.3

Sex (% female): 72

Ethnicity (% BME): 0

Duloxetine 80mg/day or 120mg/day

Paroxetine 20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Diaz-Martinez 1998

RCT

Mexico

Secondary care

N=145

Baseline severity: More severe

Mean age (years): NR

Sex (% female): 72

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Fluoxetine 20-40mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Response

Dierick 1996

RCT

Belgium, Italy, Switzerland & France

Secondary care

N=314

Baseline severity: More severe

Mean age (years): 43.4

Sex (% female): 65

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Fluoxetine 20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Response

Eli Lilly HMAT-Aa

RCT

Secondary care

N=173

Baseline severity: More severe

Mean age (years): NR

Sex (% female): NR

Ethnicity (% BME): NR

Duloxetine 80mg/day

Paroxetine 20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Goldstein 2002^a

RCT

Secondary care

N=103

Baseline severity: More severe

Mean age (years): 41.5

Sex (% female): 61

Ethnicity (% BME): 17

Duloxetine 40-120mg/day

Fluoxetine 20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Goldstein 2004^a

RCT

Secondary care

N=178

Baseline severity: More severe

Mean age (years): 40.5

Sex (% female): 63

Ethnicity (% BME): 21

Duloxetine 80mg/day

Paroxetine 20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Hao 2014

RCT

China

Secondary care

N=281

Baseline severity: More severe

Mean age (years): 38.5

Sex (% female): 59

Ethnicity (% BME): NR

Duloxetine 60mg/day

Paroxetine 20mg/day

Treatment duration (weeks): 6

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Higuchi 2009^a

RCT

Japan

Secondary care

N=223

Baseline severity: More severe

Mean age (years): 38.3

Sex (% female): NR

Ethnicity (% BME): NR

Duloxetine 60mg/day

Paroxetine 20-40mg/day

Treatment duration (weeks): 6

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Hwang 2004

RCT

Taiwan

Secondary care

N=105

Baseline severity: More severe

Mean age (years): 65.1

Sex (% female): 58

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Paroxetine 20-40mg/day

Treatment duration (weeks): 4

Outcomes (for primary versus secondary care subgroup analysis):

Response

Jiang 2017

RCT

China

Secondary care

N=26

Baseline severity: More severe

Mean age (years): 45.5

Sex (% female): 73

Ethnicity (% BME): NR

Duloxetine (mean final dose 60mg/day)

Escitalopram (mean final dose 13.13mg/day)

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Response

Khan 2007

RCT

Secondary care

N=278

Baseline severity: More severe

Mean age (years): 42.4

Sex (% female): 61

Ethnicity (% BME): 20

Duloxetine 60mg/day

Escitalopram 10-20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Kornaat 2000

RCT

Country NR

Secondary care

N=156

Baseline severity: More severe

Mean age (years): NR

Sex (% female): 64

Ethnicity (% BME): NR

Venlafaxine 75-225mg/day

Fluoxetine 20-40mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Mehtonen 2000

RCT

Finland

Secondary care

N=147

Baseline severity: More severe

Mean age (years): 42.6

Sex (% female): 66

Ethnicity (% BME): NR

Venlafaxine 75-150mg/day

Sertraline 50-100mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Nemeroff 2007^a

RCT

Secondary care

N=206

Baseline severity: More severe

Mean age (years): 39

Sex (% female): 65

Ethnicity (% BME): 11

Venlafaxine 75-225mg/day

Fluoxetine 20-60mg/day

Treatment duration (weeks): 6

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Nierenberg 2007^a

RCT

Secondary care

N=547

Baseline severity: More severe

Mean age (years): 42.2

Sex (% female): 66

Ethnicity (% BME): 24

Duloxetine 60mg/day

Escitalopram 10mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Perahia 2006^a

RCT

Bulgaria, Croatia, Hungary, Poland, Romania, Russia, & Slovakia

Secondary care

N=293

Baseline severity: More severe

Mean age (years): 45.4

Sex (% female): 71

Ethnicity (% BME): 0

Duloxetine 80mg/day or 120mg/day

Paroxetine 20mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Rickels 2000

RCT

Country NR

Secondary care

N=51

Baseline severity: More severe

Mean age (years): 37.4

Sex (% female): 75

Ethnicity (% BME): NR

Venlafaxine 150-225mg/day

Fluoxetine 20-40mg/day

Treatment duration (weeks): 6

Outcomes (for primary versus secondary care subgroup analysis):

Remission

Rudolph 1999^a

RCT

Secondary care

N=203

Baseline severity: More severe

Mean age (years): 40

Sex (% female): 72

Ethnicity (% BME): NR

Venlafaxine 75-225mg/day

Fluoxetine 20-60mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Sheehan 2009b^a

RCT

Secondary care

N=194

Baseline severity: More severe

Mean age (years): 39.7

Sex (% female): 59

Ethnicity (% BME): NR

Venlafaxine 225-375mg/day

Fluoxetine 60-80mg/day

Treatment duration (weeks): 6

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Shelton 2006

RCT

Secondary care

N=160

Baseline severity: More severe

Mean age (years): 39.3

Sex (% female): 53

Ethnicity (% BME): 17

Venlafaxine 75-225mg/day

Sertraline 50-150mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Sir 2005

RCT

Australia & Turkey

Secondary care

N=163

Baseline severity: More severe

Mean age (years): 37

Sex (% female): 69

Ethnicity (% BME): 2

Venlafaxine 75-225mg/day

Sertraline 50-150mg/day

Treatment duration (weeks): 8

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Study F1J-MCHMAQ- Study Group Ba

RCT

Secondary care

N=119

Baseline severity: More severe

Mean age (years): 39.8

Sex (% female): NR

Ethnicity (% BME): NR

Duloxetine 40-120mg/day

Fluoxetine 20mg/day

Treatment duration (weeks): 10

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

Tzanakaki 2000

RCT

Greece & Italy

Secondary care

N=109

Baseline severity: More severe

Mean age (years): 48

Sex (% female): 79

Ethnicity (% BME): NR

Venlafaxine 225mg/day

Fluoxetine 60mg/day

Treatment duration (weeks): 6

Outcomes (for primary versus secondary care subgroup analysis):

Remission
Response

a: Three-armed trial but where possible the demographics reported here are for only the two relevant arms.
: BME: black, minority, ethnic; K: number of studies; mg: milligrams; N: number of participants; NR: not reported; RCT: randomised controlled trial.

From: Service delivery Models and settings for delivery of services

Cover of Service delivery Models and settings for delivery of services

Service delivery Models and settings for delivery of services: Depression in adults: Evidence review A.

NICE Guideline, No. 222.

London: National Institute for Health and Care Excellence (NICE); 2022 Jun.

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