Place of tricyclics in depression of young people is not proved

doi:10.1136/bmj.311.7001.390

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Ian Anderson

Senior lecturer in psychiatry School of Psychiatry and Behavioural Sciences, Manchester Royal Infirmary, Manchester M13 9WL

EDITOR,--P Hazell and colleagues address an important issue in their meta-analysis of the efficacy of tricyclic antidepressants in child and adolescent depression.1 Owing to deficiencies in both the material and analysis, however, it is vital that their results are taken to mean that the efficacy of such depressants is “not proved” rather than that they are ineffective in this situation.

Firstly, the authors do not discuss the diagnosis and severity of depression in the patients. In adult psychiatry “minor” and mild depression show less specific response to antidepressive drugs than …