Antidepressants in the treatment of depression: the clinician and the controversy.

This article considers the controversy over the effectiveness of treatment with antidepressant medication versus placebo. In this journal issue, Kirsch and Low find that antidepressants were not clinically significantly more effective than placebo except possibly for persons with severe depression, as measured by score changes on the Hamilton Rating Scale for Depression (HAM-D). The present article summarizes some selected research studies that reach different conclusions, finding effective treatment outcomes with use of antidepressants, including a different meta-analysis of antidepressant drug trials that showed medication has a small, but nevertheless clinically significant effect over placebo use. Also briefly reviewed are selected studies that compare the effects of combined treatment using anti-depressants and psychotherapy, vs. placebo, compared to the use of medication alone.