If I may say so, I think something is missing in this discussion of the efficacy of SSRIs. It is well expressed at the end of an article on the efficacy or otherwise of Cognitive Behavior Therapy in the American Journal of Psychiatry in May 2005, in which Parker et al. write in relation to *all* treatments:
"The current treatment model for depression lacks 'horses sense' in encouraging the view that any therapeutic modality should be universal rather than targeted." So the question should be more discriminating: in what circumstances, and to what degree (if at all) are SSRIs an appropriate treatment for moderate to acute depression and anxiety? The trials [sic] and tribulations in assessing the validity of clinical trials of antidepressants are well explored in Quitkin et al. (2000). A balanced examination of the literature, including close critical analyses of the reports of clinical trials, suggests that simplistic *generalised* conclusions about antidepressants as "efficacious" or "not at all or barely efficacious" are inappropriate. The article argues for a more nuanced approach, which would include the point made in the above quote from Parker et al. References: G. Parker et al. "Cognitive Behavior Therapy for Depression? Choose Horses for Courses." Am. J. Psychiatry, 160: 5, May 2003. F. M. Qutikin et al. "Validity of Clinical Trials of Antidepressants." Am. J. Psychiatry 157: 3, March 2000. Allen Esterson Former lecturer, Science Department Southwark College, London http://www.esterson.org/ --- To make changes to your subscription go to: http://acsun.frostburg.edu/cgi-bin/lyris.pl?enter=tips&text_mode=0&lang=english
