[
 {
  "local_id": "C1",
  "type": "empirical",
  "core": true,
  "statement": "Of the 932 interventional studies naming an antidepressant with results posted on ClinicalTrials.gov on 2026-10-13, 393 randomized trials compare an antidepressant with placebo in 413 comparisons with 99,730 participants, and in the 306 adult trials that randomized participants from the start (71,643 participants) non-serious nausea is more frequent on antidepressants (Mantel-Haenszel risk ratio 2.08, 95% CI 1.98 to 2.18), as these drugs' known side effects predict.",
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    "result": "S.trials.found",
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    "result": "S.trials.adult_trials",
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    "result": "S.trials.adult_participants",
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  "falsified_if": "A rerun finds different numbers of trials, comparisons or participants, or a nausea risk ratio whose interval includes 1.",
  "confidence": 0.95
 },
 {
  "local_id": "C2",
  "type": "empirical",
  "core": true,
  "statement": "In those 306 adult trials, serious suicidal behaviour (completed suicide, suicide attempt, intentional self-harm or intentional overdose) affected 46 of 40,564 participants on antidepressants and 19 of 31,079 on placebo (Mantel-Haenszel risk ratio 1.86, 95% CI 1.06 to 3.27; p = 0.030), and any serious suicidality 82 against 43 (1.48, 1.01 to 2.18; p = 0.045), but neither difference is significant after the registered Holm correction across these two co-primary endpoints (adjusted p = 0.060 for both), and under random effects both shrink toward 1 (1.22, 0.78 to 1.90; 1.10, 0.78 to 1.55).",
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   {
    "result": "S.primary.P1.all.placebo_affected",
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    "result": "S.primary.P1.all.placebo_at_risk",
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   {
    "result": "S.primary.P1.p_holm",
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   {
    "result": "S.primary.P2.all.drug_affected",
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   {
    "result": "S.primary.P2.all.placebo_affected",
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   {
    "result": "S.primary.P2.p",
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   {
    "result": "S.primary.P2.p_holm",
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   {
    "result": "S.primary.P1.all.rr",
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   {
    "result": "S.primary.P1.all.lo",
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   {
    "result": "S.primary.P1.all.hi",
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   {
    "result": "S.primary.P2.all.rr",
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   {
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   {
    "result": "S.primary.P2.all.hi",
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   {
    "result": "S.primary.P1.random_effects.rr",
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   {
    "result": "S.primary.P1.random_effects.hi",
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   {
    "result": "S.primary.P2.random_effects.rr",
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   {
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   {
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  "depends_on": [
   "C1"
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  "falsified_if": "A rerun gives different counts, a Holm-adjusted p below 0.05 for either endpoint, or a Mantel-Haenszel interval for suicidal behaviour that includes 1.",
  "confidence": 0.9
 },
 {
  "local_id": "C3",
  "type": "empirical",
  "core": true,
  "statement": "The 95% interval for serious suicidal behaviour in these adult trials (1.06 to 3.27) lies above the FDA's 2009 estimate for adults aged 25 to 64 (odds ratio 0.87) and contains both later re-analyses' estimates for suicide attempts (2.38 and 1.63), and the interval for any serious suicidality (1.01 to 2.18) lies above the FDA's estimate for suicidality at 25 to 64 (0.79).",
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   {
    "result": "S.primary.P1.all.lo",
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   {
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   {
    "result": "S.primary.P2.all.lo",
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    "tolerance": 0.01
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   {
    "result": "S.primary.P2.all.hi",
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   {
    "result": "S.primary.P1.against.excludes_stone_2009_behaviour_25_64",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.primary.P1.against.excludes_hengartner_2019_attempts",
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   {
    "result": "S.primary.P1.against.excludes_kaminski_2020_attempts",
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   {
    "result": "S.primary.P2.against.excludes_stone_2009_suicidality_25_64",
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  ],
  "depends_on": [
   "C2"
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  "falsified_if": "A rerun gives intervals that contain 0.87 (behaviour) or 0.79 (suicidality), or that exclude 1.63 or 2.38.",
  "confidence": 0.85
 },
 {
  "local_id": "C4",
  "type": "empirical",
  "core": false,
  "statement": "In 30 pediatric trials randomized from the start (7,094 participants), any serious suicidality affected 38 of 4,547 participants on antidepressants and 8 of 2,547 on placebo (risk ratio 2.41, 95% CI 1.13 to 5.16; p = 0.023; Benjamini-Hochberg q = 0.076 across the secondary analyses), an interval containing the FDA's 2006 pediatric estimate of 1.95, while serious suicidal behaviour alone was 14 against 5 (1.17, 0.43 to 3.22).",
  "evidence": [
   {
    "result": "S.trials.pediatric_trials",
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   {
    "result": "S.trials.pediatric_participants",
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   {
    "result": "S.secondary.A19.all.drug_affected",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.secondary.A19.all.drug_at_risk",
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   {
    "result": "S.secondary.A19.all.placebo_affected",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.secondary.A19.all.placebo_at_risk",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.secondary.A19.p",
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   {
    "result": "S.secondary.A19.q",
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   {
    "result": "S.secondary.A19.against.excludes_hammad_2006_pediatric_suicidality",
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   {
    "result": "S.secondary.A18.all.drug_affected",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.secondary.A18.all.placebo_affected",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.secondary.A19.all.rr",
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    "tolerance": 0.01
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   {
    "result": "S.secondary.A19.all.lo",
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   {
    "result": "S.secondary.A19.all.hi",
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    "tolerance": 0.01
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   {
    "result": "S.secondary.A18.all.rr",
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   {
    "result": "S.secondary.A18.all.lo",
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    "tolerance": 0.01
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   {
    "result": "S.secondary.A18.all.hi",
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  ],
  "depends_on": [
   "C1"
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  "falsified_if": "A rerun gives different counts, or a pediatric suicidality interval that includes 1 or excludes 1.95.",
  "confidence": 0.8
 },
 {
  "local_id": "C5",
  "type": "empirical",
  "core": false,
  "statement": "In 131 adult trials of depressive disorders randomized from the start, serious suicidal behaviour affected 37 of 21,105 participants on antidepressants and 12 of 13,240 on placebo (risk ratio 2.19, 95% CI 1.10 to 4.36; p = 0.026; q = 0.076), while across all adult trials serious suicidal ideation alone was 36 against 24 (1.18, 0.69 to 2.01) and completed suicide 5 against 2, too few to test.",
  "evidence": [
   {
    "result": "S.trials.adult_depressive_trials",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.secondary.A6.all.drug_affected",
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   {
    "result": "S.secondary.A6.all.drug_at_risk",
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   {
    "result": "S.secondary.A6.all.placebo_affected",
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   {
    "result": "S.secondary.A6.all.placebo_at_risk",
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   {
    "result": "S.secondary.A2.all.drug_affected",
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   {
    "result": "S.secondary.A2.all.placebo_affected",
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   {
    "result": "S.secondary.A4.all.drug_affected",
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   {
    "result": "S.secondary.A4.all.placebo_affected",
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   {
    "result": "S.secondary.A4.testable",
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   {
    "result": "S.secondary.A6.all.rr",
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   {
    "result": "S.secondary.A6.all.lo",
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   {
    "result": "S.secondary.A6.all.hi",
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   {
    "result": "S.secondary.A2.all.rr",
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   {
    "result": "S.secondary.A2.all.lo",
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   {
    "result": "S.secondary.A2.all.hi",
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  "depends_on": [
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  "falsified_if": "A rerun gives different counts, or a depressive-disorder interval that includes 1.",
  "confidence": 0.8
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 {
  "local_id": "C6",
  "type": "empirical",
  "core": false,
  "statement": "Across the trials randomized from the start, the trial-level odds ratio shows no significant trend with the trials' mean age (9 to 61 years): 1.5% per year for serious suicidal behaviour (95% CI -1.9% to 5.1%; 51 comparisons with events) and -1.3% per year for any serious suicidality (-3.5% to 1.1%; 73 comparisons).",
  "evidence": [
   {
    "result": "S.age.G1.comparisons",
    "produced_by": "code/summarize.py"
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   {
    "result": "S.age.G2.comparisons",
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   {
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   {
    "result": "S.age.G2.p",
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   {
    "result": "S.age.G1.pct_per_year",
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    "tolerance": 0.1
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   {
    "result": "S.age.G1.pct_lo",
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   {
    "result": "S.age.G1.pct_hi",
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   {
    "result": "S.age.G2.pct_per_year",
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   {
    "result": "S.age.G2.pct_lo",
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   {
    "result": "S.age.G2.pct_hi",
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   {
    "result": "S.age.G1.age_min",
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   {
    "result": "S.age.G1.age_max",
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  "falsified_if": "A rerun gives a significant trend in either regression, or different slopes.",
  "confidence": 0.7
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 {
  "local_id": "C7",
  "type": "empirical",
  "core": false,
  "statement": "In the same adult trials, any serious adverse event affected 913 of 40,564 participants on antidepressants and 743 of 31,079 on placebo (risk ratio 1.09, 95% CI 1.00 to 1.19), and death from any cause, where every group reported it, 159 against 136 (1.17, 0.98 to 1.39).",
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   {
    "result": "S.checks.K2.all.drug_affected",
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    "result": "S.checks.K2.all.placebo_affected",
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    "result": "S.checks.K3.all.rr",
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   {
    "result": "S.checks.K3.all.hi",
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   {
    "result": "S.checks.K2.all.rr",
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   {
    "result": "S.checks.K2.all.lo",
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  "depends_on": [
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  "falsified_if": "A rerun gives different counts or estimates.",
  "confidence": 0.9
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]