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Response to Richard Hockey

Posted by plosmedicine on 30 Mar 2009 at 23:56 GMT

Author: Julio Licinio
Position: Professor & Chairman of Psychiatry
Institution: University of Miami
Submitted Date: June 20, 2006
Published Date: June 21, 2006
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Because the increased prescriptions of antidepressants are correlated to increased medical visits it is tempting to conclude that decreased suicides are a function of greater recognition of depression. It should be noted that the biggest cause of suicide is clinical major depression and increased visits do not treat that, antidepressants do. In a comprehensive review of the literature on the role of long-term antidepressant use to prevent relapse of major depression, GeddesJR et al. reported that "data were pooled from 31 randomised trials (4410 participants). Continuing treatment with antidepressants reduced the odds of relapse by 70% (95% CI 62-78; 2p<0.00001) compared with treatment discontinuation. The average rate of relapse on placebo was 41% compared with 18% on active treatment." [Lancet. 2003 Feb 22;361(9358):653-61]. We therefore conclude that just seeing a doctor is on the long-term not protective against major depression and it s consequences, such as suicide. The weight of existing data supports a positive effect of antidepressants. It is plausible that effective long-term treatment of depression by other methods might also be beneftial.

No competing interests declared.