Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: In interpreting the TADS results,1 the central issue is the benefit-to-risk ratio, which
can be determined by considering the number needed to treat (NNT), the number
needed to harm (NNH), and the number needed to prevent.2 In
this study, a categorical positive response was achieved in 71.0% of participants
treated with fluoxetine in combination with CBT; in 60.6% with fluoxetine
alone; in 43.2% with CBT alone; and in 34.8% with placebo. Based on these
outcomes, the NNT is 3.9 for fluoxetine alone compared with placebo and 3.7
for drug vs no drug. I believe that these represent low NNTs (high benefit)
that are clinically meaningful.
Carroll BJ. Adolescents With Depression. JAMA. 2004;292(21):2577-2579. doi:10.1001/jama.292.21.2578-a