Klaus Ebmeier (University of Edinburgh, UK) and colleagues reviewed recent developments and current controversies in depression. They state that while psychotherapies are now generally recommended for the treatment of milder depression or as an adjunct to antidepressant drugs in more severe illness, drug treatments remain the mainstay of antidepressant therapy. ECT, they add, remains the most effective treatment for depression, especially if patients present with psychotic symptoms, such as delusions and hallucinations.
Professor Ebmeier states: "Recent moral panics about suicidal effects and dependenceinducing potential of antidepressants have tilted the balance of publicly perceived risk against them, but both their effectiveness and their ready availability make them the likely choice for most patients."
In an accompanying editorial The Lancet comments: "Depression affects around one in six people in the USA at some time in their lives, and may double their chance of death. These figures are similar for other developed countries and are compounded by the fact that over 50% of people with depression will become functionally impaired because of their illness. Sadly, for many people a diagnosis of depression is made worse by the social stigma that still clings to all mental-health diagnoses, by difficulties in accessing treatment options, and by confusion about which treatments work and which may make their problems worse."