Sir

Your Editorial 'No more scavenger hunts' (Nature 452, 1; doi:10.1038/452001a 2008) indicates that the press reaction to a recent meta-analysis of antidepressant efficacy was exaggerated — and that it was “not the media's finest hour”. But I do not find their reaction surprising.

To one who has followed the scientific literature over the years, the fact that antidepressants' superiority over placebo is at best modest may come as no surprise: in fact, this is apparent in most published clinical trials. But the portrayal of antidepressants as advertised by pharmaceutical companies, ratified by medical professionals, propagated by mass media and absorbed by the general public during the past two decades has been very different. They are promoted as highly efficacious drugs (not true, when considering effect magnitude) that correct the 'chemical imbalances' underlying depression (not true, when considering how little we know about its pathophysiology) and improve depressive symptoms better and faster than psychotherapy (not true, when considering most clinical trials that compare the two). This publicity prompted an even more misguided rejection of antidepressant therapy by some of its opponents, with claims that the drugs would 'dope' people into happiness and prevent them from working out their problems.

Publicizing the modest effects of antidepressants goes some way towards countering the much more exaggerated positive hype that preceded it. Although it might not have been the media's finest hour, on this subject it was still finer than most.