Antidepressant drugs have previously been shown to be ineffective in mild depression

doi:10.1136/bmj.320.7230.311/a

BMJ 2000;320:311 ( 29 January )

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Antidepressant drugs have previously been shown to be ineffective in mild depression

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EDITOR $---$ Peveler et al confirm the inefficacy of antidepressant drugs in the treatment of mild depression.¹ I reviewed thissubject when working as a medical assessor with responsibilityfor new product licences for the Committee on Safety of Medicinesduring 1979-81. The standard antidepressants imipramine and amitriptylinehad been studied in randomised controlled trials in differenttypes of depression. Both drugs had been tested against placeboin patients with mild depression, and both were found to be nobetter than placebo; in contrast, in studies with mixed categoriesof patients with depression and in hospital studies efficacy wasclearlyshown.

Despite this background, new antidepressants were granted licences without restrictions on the basis of studies with no specificevidence of efficacy in mild depression. Placebo studies withthe newer antidepressants to determine valid criteria for treatmentof depression in general practice are long overdue. As far ascounselling against non-compliance . . . [Full text of this article]

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