Major depressive disorder<unk>  is used for the treatment of major depressive episodes in adults in Europe. Ten placebo controlled trials have been performed to investigate the short term efficacy of<unk>  in major depressive disorder. At the end of treatment, significant efficacy was demonstrated in six of the ten short-term double-blind placebo-controlled studies. Two were considered "failed" trials, as comparators of established efficacy failed to differentiate from placebo. Efficacy was also observed in more severely depressed patients in all positive placebo-controlled studies. The maintenance of antidepressant efficacy was demonstrated in a relapse prevention study. One meta-analysis found<unk>  to be as effective as standard antidepressants, with an effect size () of 0.24. A meta-analysis found that<unk>  is effective in treating severe depression. Its antidepressant effect is greater for more severe depression. In people with a greater baseline score (>30 on HAMD17 scale), the<unk> -placebo difference was of 4.53 points. Controlled studies in humans have shown that<unk>  is at least as effective as the SSRI antidepressants paroxetine, sertraline, escitalopram, and fluoxetine in the treatment of major depression. A 2018 meta-study comparing 21 antidepressants found<unk>  was one of the more tolerable, yet effective antidepressants. However, the body of research on<unk>  has been substantially affected by publication bias, prompting analyses which take into account both published and unpublished studies. These have confirmed that<unk>  is approximately as effective as more commonly used antidepressants (e.g. SSRIs), but some qualified this as "marginally clinically relevant", being only slightly above placebo. According to a 2013 review,<unk>  did not seem to provide an advantage in efficacy over other antidepressants for the acute-phase treatment of major depression. Use in special populations It is not recommended in Europe for use in children and adolescents below 18 years of age due to a lack of data on safety and efficacy. However, a study reported in September, 2020, showed greater efficacy vs. placebo for<unk>  25mg per day in youth age 7-18 years. Only limited data is available on use in elderly people ≥ 75 years old with major depressive episodes. It is not recommended during pregnancy or breastfeeding.
Agomelatine
Tropisetron
Granisetron
Alosetron
Avacopan
Cabergoline
Loteprednol
Cilansetron