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An unrealistic view

Posted by plosmedicine on 31 Mar 2009 at 00:20 GMT

Author: Ellen Goudsmit
Position: Chartered Health Psychologist
E-mail: ellengoudsmit@hotmail.com
Submitted Date: February 26, 2008
Published Date: February 26, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

I don't understand why this paper was published. One can not determine treatment effect based on one outcome measure after six weeks of treatment. Any practitioner would have known that the effects of SSRIs don't really begin to be noticeable until about four weeks. What we have here is the physician's impression of effectiveness after two weeks. The placebo effect hasn't worn off yet.

The information might have been submitted to the FDA but practitioners really require data covering at least three months, ideally with a follow-up.

Finally, different types of depression require a different anti-depressant. It's like HRT. What suits one may not suit another. It's much better, therefore, to compare two different drugs for the treatment of a fairly homogeneous group. If your patient requires a sedating SSRI, and you test an activating one, you can't conclude that all SSRIs don't work. Ideally, patients with moderate/severe depression should be offered drugs AND psychotherapy/support.

No competing interests declared.