Intended for healthcare professionals

Rapid response to:


Effectiveness of antidepressants

BMJ 2018; 360 doi: (Published 09 March 2018) Cite this as: BMJ 2018;360:k1073

Rapid Response:

Why risk with antidepressant pills when comparative studies show CBT is equally effective?

Dear Editors,
Recent evidence reveals that administered antidepressants increase suicide risks by 2-5 times. [2][3][4][5][6][9]
Cognitive behavioural therapy halves the risk of repeated suicide attempts. [12]
A recent meta-analysis, level I evidence, clearly demonstrated that SSRIs double the risk of suicide and violence in adults. [4]
Furthermore, antidepressants increase all cause mortality by 33%! [10][11]
Another meta-analysis published in the British Journal of Psychiatry has found that even patients with the most severe depression can expect to get as much benefit from cognitive behavioural therapy (CBT) as those with less severe symptoms. [7]
Even Behavioural Activation effectively decreases depressive symptoms. [8]

Competing interests: No competing interests

10 March 2018
Stavros Saripanidis
Consultant in Obstetrics and Gynaecology
Thessaloniki, Hellas