title: Evaluating treatments for the mood disorders: time for the evidence to get real.
abstract: OBJECTIVE
  To detail limitations to level I evidence derived from randomised controlled trials of antidepressant treatments and which is held to be fundamental to the development and validity of treatment guidelines.
  
  
  METHODS
  Recent efficacy studies and meta-analyses of treatments of major depression are considered.
  
  
  RESULTS
  The largest database in psychiatry--demonstrating that all principal treatments are of similar efficacy, and that antidepressant drugs are not distinctly superior to placebo treatment--is unlikely to be valid.
  
  
  CONCLUSIONS
  Excessive belief in and weighting of the evidence emerging from randomised controlled trials deserves to be criticized. An argument is put for adopting alternative approaches to evaluating the likely effectiveness of any antidepressant treatment.
authors.affiliation: School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Randwick, Australia. g.parker@unsw.edu.au
authors.forename: Gordon
authors.initials: G
authors.lastname: Parker
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D019317:Evidence-Based Medicine / Q000592:standards*; D006801:Humans; D019964:Mood Disorders / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic / Q000592:standards
chemical_list: D000928:Antidepressive Agents