In the April issue of Nature Reviews Neuroscience, Claudia Wiedemann reviews reactions to a meta analysis by Kirsch et al. of data on antidepressant drugs submitted to the Food and Drug Administration that resulted in the licensing of four of the most commonly prescribed antidepressants: the selective serotonin reuptake inhibitors (SSRIs) Prozac, Seroxat, Effexor and Serzone. For anything but the most severe depression, there was no difference between the drugs and placebos. Kirsch suggests that there is little reason to prescribe anti-depressant medication to any but the most severely depressed patients. The conclusion of the study:
Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.