hey docjohn, thanks for your thoughts. i'm actually not quite sure on how we are disagreeing, however.

> the research is quite clear in the overall efficacy of SSRIs to treat depression. While some specific SSRIs are weaker than others in terms of their efficacy, the overall positive therapeutic effects of SSRIs on depression are undisputed.

i guess here it depends what you mean by 'efficacy'. do you mean:

- measured effects of SSRI's vs no treatment
- measured effects of SSRI's vs inert placebo
- measured effects of SSRI's vs active placebo

i don't deny that SSRI's are very effective on the first measure of efficacy. on the second measure of efficacy efficacy is down on the last measure but still better than no treatment to be sure. on the third measure of efficacy (which is more true to the spirit of ensuring the double blind isn't broken by side-effects and / or taste of the medication) efficacy simply isn't looking so good...

it is this last measure of efficacy that i'm interested in.

> no researcher seriously believes SSRIs, as a class of drugs, have no or just minimal positive effects on depression.

that is correct. i'm interested in a particular kind of efficacy, however: namedly, how much more effective SSRI's are for depression compared with benzo's and anti-psychotics and other psychoactive medications.

> So out of 75,000 research subjects, 21 people had committed suicide. On placebo, only 10 or 11 people did.

and these are the supposedly favourable studies that are disclosed by the drug companies. the studies which they were unable to interpret as favourable aren't disclosed to us. we simply have no idea whether they have similarly misinterpreted 'not beneficial' results from studies that are better interpreted as 'positively harmful' results.

> To put it into perspective, a person suffering from depression is far more likely to be involved in a serious car accident that will result in their death than to commit suicide while on an SSRI.

based on the supposedly favourable studies, yeah. the difference, however, is that it is not claimed that SSRI's will help prevent death by car accident whereas it is claimed that SSRI's will help prevent depressive symptoms (where suicide is surely one of those).