Efficacy of antidepressants in adults

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Abstract
Introduction The National Institute for Health and Clinical Excellence (NICE) recently recommended that antidepressants, in particular selective serotonin reuptake inhibitors, should be first line treatment for moderate or severe depression.1 This conclusion has broadly been accepted as valid.2 The message is essentially the same as that of the Defeat Depression Campaign in the early 1990s, which probably contributed to the 253% rise in antidepressant prescribing in 10 years.1 From our involvement in commenting on the evidence base for the guideline we believe these recommendations ignore NICE data. The continuing concern that selective serotonin reuptake inhibitors may increase the risk of suicidal behaviourw1 w2 means there needs to be further consideration of evidence for the efficacy of antidepressants in adults as there has been in children.