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April 8, 1983

Treatment of Depression

Author Affiliations

The Mount Sinai Medical Center New York

JAMA. 1983;249(14):1824-1825. doi:10.1001/jama.1983.03330380022006

To the Editor.—  Two editorials by Drs Lundberg (also on p 1879) and Uhlenhuth commenting on an article by Keller et al in that same issue suggest that the finding that many physicians treat major depression with benzodiazepines rather than antidepressants is not such a bad thing, because antidepressants are more dangerous than antianxiety agents. Dr Lundberg finds the use of antidepressants in that situation comparable with giving a loaded revolver or a dagger to a person threatening to attempt suicide.I find this attitude puzzling. Inadequate treatment is not the answer to the problem of adequate treatment that may be dangerous. The answer is the physician taking the time and effort to assess the risk of suicide as carefully as possible and to seek consultation in instances of doubt. This is hardly a foolproof method, but neither is inadequate treatment.It would be interesting to know what the reasons