Head-to-Head Trials Needed Too

The article “Does Placebo Effect Mask True Efficacy of Antidepressants?” in the July 2 issue is pro-industry enough that a disclosure statement about any financial relationship with commercial interests on the part of Michael Thase, M.D., would be appropriate. A more neutral and comprehensive article would discuss the fact that new antidepressants are compared only with placebo in trials for FDA approval. Why aren't older antidepressants, available as inexpensive generics, included in these trials along with placebos? Such inclusion is needed to resolve questions about whether an antidepressant is effective and whether drugs under patent are better than old standbys.