Letters Antidepressants v cognitive behavioural therapies

Authors’ reply to Gøtzsche and Hamilton

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i617 (Published 10 February 2016) Cite this as: BMJ 2016;352:i617
  1. Halle R Amick, research associate1,
  2. Gerald Gartlehner, associate director2,
  3. Bradley N Gaynes, professor, associate chair of research training3,
  4. Kathleen N Lohr, distinguished fellow2
  1. 1Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
  2. 2RTI International, Research Triangle Park, NC 27709, USA
  3. 3Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
  1. amick{at}med.unc.edu

We thank Gøtzsche and Hamilton for their thoughtful responses.1 2 3

Gøtzsche raises an important problem: the risk of dependence in people taking second generation antidepressants. The evidence for this is mixed, and the discussion of the balance between harm and benefit remains an active one.4 Careful consideration of what dependence is and how it overlaps with symptoms of drug discontinuation is key. Withdrawal symptoms are associated with discontinuation of many second generation antidepressants, but they are …

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