G. Venning, Antidepressant drugs have previously been shown to be ineffective in mild depression, Brit. Med. J., 29 January 2000, 320, 311

This is an interesting letter from a former Medical Assessor for the CSM (1979-1981). Having reviewed the evidence for the standard/reference antidepressant drugs, amitryptaline and imipramine, he concluded and advised the CSM that, in mild depression, neither drug was found better than placebo. He argues here that "placebo studies with the newer antidepressants to determine valid criteria for treatment of depression in general practice are long overdue."

His advice appears to have been consistently ignored. The 1999/2000 edition of the Data Sheet Compendium/Summary of Product Characteristics shows that all SSRIs are indicated for all depressive illness - with no reference to avoiding their use in mild depression:

"Prozac [fluoxetine], Lustral [sertraline], Faverin [fluvoxamine] and Efexor [venlafaxine] are indicated for "the treatment of the symptoms of depressive illness ..."

Dutonin [nefazodone] "is indicated for the symptomatic treatment of all types of depressive illness ...

Cipramil [citalopram] "treatment of depressive illness"

Seroxat [paroxetine] "treatment of symptoms of depressive illness of all types ..."

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