Upping the anti (depressant)

A paper on antidepressants by Kirsch and co-authors published last month in PLoS Medicine has received a lot of attention. The antidepressants studied are the six most widely prescribed approved between 1987 and 1999: Prozac, Paxil, Effexor, Serzone, Zoloft, and Celexa. The Editors' Summary explains: The researchers obtained data on all the clinical trials submitted to the FDA ... They then used meta-analytic techniques to investigate whether the initial severity of depression affected the HRSD [Hamilton Rating Scale for Depression] improvement scores for the drug and placebo groups in these trials. They confirmed first that the overall effect of these new generation of antidepressants was below the recommended criteria for clinical significance. Then they showed that there was virtually no difference in the improvement scores for drug and placebo in patients with moderate depression and only a small and clinically insignificant difference among patients with very severe depressio...