Six months ago, I asked What's The Best Antidepressant?, and I discussed a paper by Andrea Cipriani et al. The paper claimed that of the modern antidepressants, escitalopram (Lexapro) and sertraline (Zoloft) offer the best combination of effectiveness and mild side effects, and that sertraline has the advantage of being much cheaper.
The Cipriani paper was a meta-analysis of trials comparing one drug against another. With a total of over 25,000 patients, it boasted an impressively large dataset, but I advised caution. Their method of crunching the numbers (indirect comparisons) was complex, and rested on a lot of assumptions.
I wasn't the only skeptic. Cipriani et al has attracted plenty of comments in the medical literature, and they make for some fascinating reading. Indeed, they amount to crash-course in the controversies surrounding antidepressants today - a whole debate in microcosm. So here's the microcosm, in a nutshell:
