The notion that antidepressants are overprescribed is certainly popular and hardly new. There is profound suspicion of them: antidepressants are regularly caricatured in the media as an addictive emotional anaesthetic, peddled by thoughtless general practitioners as a matter of convenience, and taken by credulous dupes who seek “a pill for every ill.” Little wonder that decrying antidepressant prescription is such a sure-fire crowd pleaser for the press (for example, “Ministers act to wean Scotland off £55m-a-year antidepressant habit,” Scotsman, 6 December, 2006).

The reality is very different. Depressive disorder is a common, recurrent, debilitating, and potentially lethal illness. Psychiatric drugs, including antidepressants, have equivalent effectiveness to drugs in other branches of medicine (as detailed in a review of 94 meta-analyses comparing drug effect sizes in medical disease with drugs in psychiatric disorder1). Given recent demonstrations that depression is still under-recognised and undertreated,2 3 the claim that antidepressants are …