Evidence-Based Somatic Treatment of Depression in Adults

This article reviews recent studies and controversies about the effectiveness of antidepressant medications for depression. It is divided into three broad topics: (1) the heated controversy regarding how one should interpret "efficacy studies" of antidepressants, that is, the standard placebo-controlled double-blind studies used by drug companies to gain Food and Drug Administration approval; (2) "effectiveness studies," open-label studies enrolling types of patients who are excluded from efficacy studies, focusing on one enormous study in particular-the STAR-D trial; and (3) the evidence base that can guide clinicians in the choice of antidepressants for particular patients.