Recent developments and controversies in depression

Ebmeier and colleagues' assertion that "their effectiveness...make[s] them the likely choice for most patients" goes well beyond the evidence base, which is distinctly thin-particularly in a primary-care setting where most prescribing takes place.4 This is to offer false confidence to family doctors who tell the mixed bag of patients gathered under the rubric of "depression" that they need antidepressants to correct a "chemical imbalance". The move away from early typologies such as endogenous-non-endogenous depression, imperfect though they were, was a major error by the field.2 Clinical depression is a strikingly heterogeneous syndrome, yet this variability is seldom controlled for in current research, although we know studies on mixed pathologies are of little scientific value.3 As a result, many research areas in depression are marked by a plethora of studies that fail to agree on a conclusive result. Reliance on positive findings with animal models of depressive behaviour to support the hypothesis confirms this poverty: the model is not the disease, and today's models are at best incomplete.