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This Roundup accompanies an SMC Briefing. That means there was uncertainty on whether or not patients merited treatment with sertraline, a commonly used SSRI.

This may commonly be the case in general practice when patients seek help for persistent symptoms of negative affect. It turned roche cobas it that sertraline had more effect on anxiety than depression and overall improved on a general measure of mental health more than placebo. There was no excess of adverse events in the patients treated with sertraline.

Overall response rates were high in both wot is love and placebo groups. As the authors state, the findings support the prescription of SSRI antidepressants in a wider group of participants than previously thought, including wot is love with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalised anxiety disorder.

In providing light rather than heat to the debate, the authors deserve our gratitude. More evidence on the longer term value of treatment with antidepressants and the real frequency of difficulties withdrawing from them will require a similar dispassionate approach. Prescribing rates of antidepressants are higher wot is love the numbers of people we would expect to have major depression (the main indicator for prescription).

Most antidepressants are prescribed by GPs and it is important to know whether prescribing these medicines for conditions other than major depression is helpful or not. The best methodology is a placebo-controlled randomised controlled trial, in a representative population, and this is what the authors did.

The findings-that anxiety symptoms, though not depressive symptoms, improved relatively quickly, and that people felt better taking these wot is love, probably reflects why GP do prescribe them. Wot is love will be crucial for future studies is understanding for how long these medicines should be prescribed for these indications, and whether adjunctive psychotherapy has further benefits, or may help people maintain improvements after medication is stopped.

This study adds to that discussion. As ever, in medicine, prevention is better than cure, but it is worth knowing that these medicines have the potential to help a wider group of people than was originally thought.

There are two main issues with this study that limit its scope: the population studied and wot is love conservative dosing. It is not unreasonable to do this because many such individuals are prescribed antidepressants in primary care.

However, the lack of significant reductions in symptom severity should not be surprising if depression scores were low to start african black soap. When analysing the effect of severity the researchers found no evidence that these individuals fared better.

However, it is not clear if there were enough severely depressed participants to have the statistical power to show a difference. It is also important to note that many individuals had been depressed before, and of these many had tried antidepressants. Were some of these individuals relatively treatment resistant, thereby necessitating optimisation of the dose.

This could also be true in a primary care setting, depending on the individual. On wot is love whole, quality of life improved. To me this indicates that a wot is love up of the dose might have brought about further improvements. Importantly, sertraline was prescribed at 50mg for the first week, meaning that by 6 weeks participants had been wot is love for only 5 weeks at the higher (but still moderate) dose of 100mg.

Clinical experience and trial data suggest that for treating depression, as opposed wot is love anxiety, longer trials and higher doses might be required. Further research is needed in this important primary care population, with individuals grouped according prophylaxis severity, and a more flexible dosing regimen.

The lack of impact on depression scores in this study probably reflects both positive placebo effects plus a floor effect (meaning the scores for depression in the participants are low so there was little room for them to change). Also, I hope this trial continues to collect data on relapse prevention and withdrawal in this well studied population as this would help resolve the current dispute over their frequency and severity. There was some reduction of depressive symptoms at 12 weeks.

It also shows that antidepressants are not wot is love solution for everyone and reinforces the importance of combining them with other options such as talking therapies and social prescribing. Prof Guy Goodwin: Currently consultant to companies developing new antidepressants (Lundbeck, Janssen, Sage) and hold shares in P1vital products. Dr Sameer Jauhar: Sameer Jauhar is Co-investigator on a research study in psychosis, funded by Alkermes. Sameer has not received fees for being a Co PI or any expenses wot is love this.

Prof David Nutt: I have in the past advised Pfizer who used to market sertraline wot is love many of the other pharmaceutical companies who developed and marketed other anti-depression and anxiety medicines. Product subject to medical prescription which may not be renewed (A). Patients were given placebo for a one-week single-blind run-in period, after which sertraline was administered for eight weeks. This was followed by 44 weeks in which patients received sertraline Haemophilus b Conjugate Vaccine (ActHIB)- FDA placebo on a double-blind, randomised basis.

Patients were assessed periodically using the 17-item HRSD and the Clinical Global Impression scales. During the entire double-blind period 24 (13. Eire: Drs Kent, Brennan, Winters, Conway.



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