BMJ  2004;329:E322 (11 September), doi:10.1136/bmj.329.7466.E322

BMJ USA: Letter

Letter

RAPID RESPONSES FROM BMJ.COM

Following is an edited excerpt from one of the Rapid Responses generated by this review, all of which can be read in their entirety at http://bmj.bmjjournals.com/cgi/content/full/329/7456/34.—Editor

I hope I am not the only person who is a little uncomfortable with the balance in Gunnell and Ashby's clinical review of the risks versus benefits of SSRIs. I am sure that this is an excellent area for review, as there is much misinformation on this topic. However, I am not sure how much this article clears the air....We are in danger of throwing the baby out with the bath-water if we stop using drugs with rare serious adverse effects and do not use anything in their place, leaving the patient essentially untreated. Clearly more research evidence is needed about the benefits and risks of SSRIs but it may be sobering to remember that less than one in 10 patients who are depressed in the community receive adequate doses of antidepressants, regardless of their suicide risk.1 It is important therefore to present a balanced view.

Alex J Mitchell, consultant in liaison psychiatry

Leicester General Hospital Leicester, UK

References

  1. Suominen KH, Isometsa ET, Henriksson MM, Ostamo AI, et al. Inadequate treatment for major depression both before and after attempted suicide. Am J Psychiatry 1998;155: 1778-1780.[Abstract/Free Full Text]

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