Dr. Michelson Replies

To the Editor: We appreciate and note Dr. Terao’s comments. With respect to the discrepancy between our results and those of Landén et al. (1999), we note that in addition to differences in length of treatment, their findings derive from a study primarily designed to assess antidepressant efficacy rather than sexual function. The interpretation of their report is, consequently, limited by a number of methodological issues. Conversely, our study was not designed to assess the efficacy of buspirone augmentation of fluoxetine for residual depressive symptoms, and indeed, we selected patients without such symptoms to avoid confounding the analysis of sexual function. In that context, our findings with amantadine were suggestive and consistent with those of several previous reports and merit further investigation. Nonetheless, our study is not a fair assessment of augmentation therapies among patients who have an incomplete response to fluoxetine therapy, nor was it intended to be.