Selective serotonin reuptake inhibitors: THREAD trial may show way forward

doi:10.1136/bmj.330.7488.420-b

BMJ 2005;330:420-421 (19 February), doi:10.1136/bmj.330.7488.420-b

Letter

Selective serotonin reuptake inhibitors

THREAD trial may show way forward

The first 150 words of the full text of this article appear below.

EDITOR—Geddes and Cipriani comment that available randomisedevidence does not provide reliable estimates of the costs andbenefits of treatment with selective serotonin reuptake inhibitors(SSRIs) in patients with varying degrees of severity and lamentsthe decline in non-commercial funding.¹ Recent guidelines fromthe National Institute for National Excellence (NICE) also lackevidence.² The NHS health technology assessment programme isfunding a trial to tackle this very question. Led by the Universityof Southampton, in partnership with the University of Liverpooland Institute of Psychiatry, the THREAD (threshold for antidepressants)trial is comparing the effectiveness of SSRIs combined withsupportive care with supportive care alone in primary care.

Since Paykel said that severity of depression around the thresholdof DSM major depressive episode was the level at which antidepressantdrugs were more effective than placebo,³ two recent studieshave shown that SSRI antidepressants may be effective in patients. . . [Full text of this article]

Robert Peveler, professor of liaison psychiatry

University of Southampton, Royal South Hants Hospital, Southampton SO14 0YG rcp@soton.ac.uk

Tony Kendrick, professor of primary medical care

University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST

THREAD Study Group

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